Ingrown Toenail Treatments; Surgical versus Non-surgical

Introduction to Ingrown Toenails

Ingrown toenails occur, present with a nail that is penetrating the soft tissues around the nail bed, causing a local infection or inflammatory process, caused a foreign body reaction resulting in a condition called paronychia or granulation tissue formation. In most cases this starts off as a minor inflammation and can result in significant infection and more chronic problem in the long term.

The cause of ingrown toenails may well be poor nail cutting or hygiene, as well as predispositions with wider or misshapen toenails, which are difficult to cut properly.

Treatments and Surgical Treatment for Ingrown Toenails

The initial treatment may well be that you need to try to remove the spike carefully without traumatising the soft tissue. Bathing in salt water can sometimes harden the skin and remove any abscess.

Surgical Treatment of Ingrown Toenails

There are two types of surgery.

Partial nail avulsion

One is a procedure where a chemical is used to destroy the nail root in the corner for permanent treatment of ingrown toenails, known as a partial nail avulsion procedure. Typically this would involve a chemical such as phenol or sodium hydroxide.

The nail is carefully peeled back in the corner and there’s no cuts made to the skin. The nail root is exposed once the ingrown toenail has been removed. The nail root is then killed or destroyed with phenol chemical typically mostly in the United Kingdom.

This is a permanent treatment for ingrown toenails. It reduces the width of the nail and any recurrent problems. It is effective in at least 95% of cases.

Zadik’s procedure

The second operation is known as an excisional nail procedure, also known as a Winograd or a Zadik procedure.

The nail bed is cut out by exposing the nail bed and removing the ingrown toenail. It is then stitched back so that the skin is cut is covered again.

This also has a high success rate and very much depends on whether there is excess tissue to be removed or not.

Preparing for Ingrown Surgery

Preparation very much depends on the type of procedure, whether a phenolisation procedure or a partial nail avulsion procedure. There’s very little preparation.

I would keep a loose trainer or a sandal available for the first 24 hours, so where there’s a large dressing applied and then removed to a smaller dressing.

Typically post-operatively, you will start bathing in salt water on a daily basis and redressing the wound for a two to three week period whilst the wound area heals.

You’ll be able to resume most activity in terms of walking the same day or the next day, but may need to refrain for sports for seven to ten days.

However, if it will need to be an excisional procedure, you need to protect the wound and keep it dry for a week, and stitches are removed typically at 10 to 14 days, and you can then return to most activities.

Addressing Chronic or Recurring Ingrown Toenails

For people suffering from chronic or recurring toenails, a permanent nail excisional procedure such as partial nail avulsion or an excisional nail procedure is suitable. It very much depends on the degree of the ingrown toenail and type of toe and soft tissue surroundings.

Many people tend to live with ingrown toenails not knowing that there is a permanent treatment that is usually a minor surgical procedure performed in an outpatient setting under local anaesthetic.

Frequently Asked Questions

Q. How to get rid of an ingrown toenail overnight?

A. The mainstay of treatment is if there’s localised inflammation, then bathing salt water can help. Removing a small spike that might be accessible without causing any infection with clean nippers may work.

Q. How to remove an ingrown toenail?

A. Typically you would clean the area with either alcohol solution and bathe the salt water. If the nail is soft, then you can cut back the nail that is impinging. However, if there is an infection, then you need to see a podiatrist.

Q. What is the surgical procedure for the ingrown toenail?

A. The surgical procedure is known as a partial nail avulsion phenolisation procedure or excisional nail procedure.

Q. What are the cause of ingrown toenail?

A. Causes include wide nails, which are genetic, or poor cutting technique or just injury.

Q. How to prevent ingrown toenails?

A. Prevention is very much dependent on keeping the area clean and cutting appropriately.