Ingrown Toe Nail Surgery and Treatment Options

An ingrown toenail occurs when the side of the nail digs or cuts into the side of the toe. This can be caused by having a curly shaped nail, a wide nail or as a result of picking or cutting the nail badly.

The symptoms of an ingrown toenail can vary from mild discomfort to having swelling, severe pain and bloody fresh tissue (hypergranulation) trying to heal the area.

Treatment of ingrown toenails can be a simple as trimming away the offending piece of jagged nail. This can be easily achieved with the small instruments we have to find the offending shard of nail! If this is too uncomfortable we are able to provide a local anaesthetic if needed.

In some cases patients have sought the advice of their doctor who has prescribed antibiotics, but if the nail is still ingrowing into the skin, the infection will return.

In certain circumstances and despite conservative treatment involving trimming or packing the nail, some toenails may require minor surgery. This is usually a procedure we call a partial nail avulsion and involves removing the side or sides of nail that penetrate the skin, removal of inflammed and swollen tissue and application of a chemical to the nail bed to prevent its recurrence. This procedure is proven to be about 98% effective and has been used for many years by podiatrists. A local anaesthetic is needed and it takes no more than an hour to complete. Surprisingly for many there is usually little pain after the treatment since having the ingrown nail removed is a welcome relief.

Michael Abrahams performs an operation to remove an ingrown toenail for Channel 4’s Embarrassing Bodies program and gives you an idea of what can be done to eradicate these problems permanently. Skip forward a minute if you want to get straight to the procedural information!

 

If the nails are excessively thickened and damaged the entire nail can be removed to relieve the pressure from shoes.

Our assurance

Our surgery is unrushed, thoughtful and caring. We will take the time to explain fully the treatment options and help you decide the most appropriate course of action.
We have experience with children and nervous patients and have worked with hypnotherapists in the past for needle phobia and anxiousness.
Our surgery fees are inclusive and cover the procedure and follow up appointments.

How will the ingrown toenail be removed?

You will be given an injection of local anaesthetic which will make your toe numb.
Once the toe is numb, the podiatrist will then remove part of the edge of nail – usually a millimetre or two. A chemical will be applied to destroy the exposed nail bed and normally ensures that the nail will not ingrow again.
A dressing will then be applied to the toe and you will be able to walk normally, although you are advised not to drive whilst the toe is numb.
It is advisable to bring loose fitting or open toed footwear with you on the day of the procedure.
Ideally avoid sport and strenuous use of the feet for the following week but time off work/school is seldom required.

Will it be painful afterwards?

Some patients may experience slight discomfort after the anaesthetic has worn off and we advise a painkiller such as paracetamol to be taken whilst the toe is still numb. Most are pleasantly surprised at how comfortable the toe is. This is understandable given a nasty ingrown nail has been removed and no longer digging in!

This may be continued for the following couple of days but usually only if required.

Dressings and follow-up

You will normally be adivided to attend the clinic for a short appointment a few days then a week after the operation being carried out.
The dressing will require being changed on a daily basis at home and your Podiatrist will discuss with you the most suitable arrangements to ensure that your wound receives appropriate care until it is healed. This usually involves soaking in warm salt water for 2-3 minutes and applying a dressing to avoid sock fluff and dirt getting in the toe!

It is normal to experience localised pinkness or redness around the side or base of the toe. A yellow discharge is also expected for 2-4 weeks after the treatment as the toe heals.

Availability

Prior to surgery you would have been seen for a consultation or received prior treatment. You may have a referral letter from your Doctor or Podiatrist.

We are happy to see you for consultation and surgery at the same appointment, but tend to have a telephone consultation first to check suitability.
We will ask you general questions about your health.
Specific interest is with patients taking warfarin, aspirin or other blood thinning medicines.
We rarely carry out the treatment during pregnancy except when the toe keeps becoming infected and the toe nasty and inflammed.
We may arrange antibiotics for patients who suffer with immunodeficiency conditions but are not required for those with heart murmurs or implants. In the majority of cases clearing the nail removes any infection and the phenol used to kill the nail bed of that area off is antiseptic.

Should you wish to discuss Nail Surgery further, or should you have any questions about the information provided here, please speak our practice manager or you can email a picture. In any event we usually suggest a consultation first to ensure its a suitable procedure. If its an emergency we will invariably be able to fit you in.

Friendly staff and good airy rooms. Very professional and sound advice.

Satish