Ingrown Toenail Removal Treatment

What is Ingrown Toenail Surgery?

Ingrown toenail surgery is a minor surgical procedure which generally does not involve any cutting of the skin.

The ingrown part of the nail at the base is loosened around the nail bed. The procedure is performed typically under a local anaesthetic around the base of the toe. The procedure is painless.

Nail wedge, which a small part of the nail is removed from the side, aesthetically we do not remove too much of the nail to ensure that most of the nail plate is maintained. This is usually a permanent procedure to resolve chronic ingrown toenails or infected ingrown toenails.

Symptoms of ingrown toenail

Ingrown toenail symptoms can include pinching at the skin in shoes as well as occasionally inflammation of the area due to the nail pushing into the skin.

We also see chronic infections where the body is reacting as if it’s got foreign material inside it and develops hypergranulation tissue, which is excess growth of tissue and infection which causes a lot of pain and discomfort.

Causes of ingrown toenails

Causes vary from genetics, where you have wide nail plates that you’re born with.

Sometimes the nail plates change shape over time and become involuted.

Some of the other reasons are cutting the toenails too short or trauma to the nail which cause them to ingrow.

Diagnosis for ingrown toenai

Diagnosis for ingrown toenail is a clinical diagnosis. Usually the specialist will check whether the nail is growing within the skin and advise.

It’s important to see your podiatrist for any management of this and especially if there’s infection, you may need antibiotics.

Surgical versus non-surgical treatments

Non-surgical treatments can include salt water bathing and using antibiotics. However, if the nail is grown within the skin, then this will need removing.

You can try removing it yourself if it’s superficial, but in most cases this could be quite deep and requires a surgical treatment with a local anaesthetic.

Recovery and aftercare for ingrown toenail surgery

Recovery is quite straightforward. You maintain a reasonable dressing that you need to use a large shoe and on for 4 hours. There’s minimal pain. You may have to take one to two doses of paracetamol for 24 hours. You will then bathe the toe in salt water every day for two to three weeks until the nail bed dries. There should be no further treatment required.

Conclusions

Ingrown toenail procedures are generally straightforward and minor procedures. They can be done in between at lunchtime or as an office procedure. It does not require long recovery. You will remain mobile throughout. You require a minor wound management for up to three to four weeks on average.

Frequently asked questions

Q. What’s the difference between surgical and non-surgical ingrown toenail removal treatment?

A. The main difference is that surgical procedure is more permanent, it involves a local anaesthetic and usually used for more chronic conditions that are recurrent. We use a chemical called phenol to destroy the nail root in the corner so it never grows back. The non-surgical treatment is where we just remove the ingrown toenail deep into the tissue carefully without local anaesthetic in most cases.

Q. Can I treat an ingrown toenail at home or should I see a professional for removal?

A. It’s advisable that we use sterile instruments to remove an ingrown toenail as it becomes infected. If it’s just causing pinching of skin without growing into the skin and there’s no open wound, this can be done at home. You have to be careful not to leave a spike, which can regrow and cause infection. If there is any broken skin or inflammation, then you should see a podiatrist or a podiatric surgeon.

Q. What is the difference between partial toenail removal and total toenail removal for ingrown toenails?

A. Most ingrown toenails require only partial nail avulsion, which means that only the side of the nails are removed. In some severe cases with chronic inflammation and where nails are deformed and thickened, you may remove the nail permanently and have no nail, this is known as a total toenail removal and it’s rarely done.

Q. Is it safe to remove an ingrown toenail at home or should I go to see a podiatrist?

A. It would be recommended that if you have an open wound, then you should always see a podiatrist.

Q. How should I manage pain after ingrown toenail removal?

A. The pain is usually minimal, you will need paracetamol in some cases and other cases it will require no pain relief afterwards. It is a minor procedure where there’s no cutting of skin.