Ingrown Toenail Surgery: What to Expect, Recovery and When You Need It
- My Family Podiatry
- Aug 17, 2021
- 4 min read
Anyone who has dealt with a recurring ingrown toenail knows how disruptive it can be. Some cases respond well to conservative care, but for others the nail keeps becoming ingrown despite changes to nail trimming, footwear or general care. When this happens, a permanent procedure called a Partial Nail Avulsion (PNA) with phenolisation is often the most effective long-term solution.
This guide covers what the procedure involves, when it is the right choice, what to expect during recovery, and the conservative alternatives we consider first.
Why the Nail Keeps Becoming Ingrown
In our previous blog, we discussed some of the reasons nails can initially become ingrown. The reasons they continue to be ingrown include:
Improper removal of the original ingrown nail: If the original ingrown nail edge is not properly removed and the edge smoothed, it may keep a sharp edge which leads to another ingrown nail.
Ill-fitting footwear: Shoes that are too tight can place pressure on the toes, pushing the skin and nails close together and increasing the risk of nails becoming ingrown.
Toenails which are too wide for the nail bed: This occurs regularly and is more related to genetics than any issue that could have been prevented. The nail may sit too wide for the nail bed resulting in continuing pressure and recurrent ingrown nails.
Previous trauma leading to an altered nail shape: Trauma can result in nails thickening, lifting or even curling. This can cause the nail to become repeatedly ingrown even after an initial ingrown nail is removed.
While anyone can develop an ingrown toenail, we most commonly see them in teenagers, athletes, tradespeople and people with poor circulation or diabetes.
When Is Permanent Removal The Right Choice?
A one-off ingrown toenail may settle with conservative care such as proper nail cutting, footwear changes, or a short course of antibiotics. But if the problem is:
Recurrent (keeps returning)
Infected
Causing significant pain
Interfering with daily activities
Not resolving with conservative care
…then permanent nail removal may be the best option. At My Family Podiatry, we assess the severity of your symptoms, how many times it has recurred, and whether any underlying nail shape or biomechanical issues are contributing. If the issue is unlikely to resolve on its own, we may recommend a Partial Nail Avulsion.
What Is a Partial Nail Avulsion (PNA) with Phenolisation?
A PNA is a minor surgical procedure performed under local anaesthetic in the clinic. It involves removing only the problematic edge of the nail, not the entire nail. The procedure is quick, usually taking 30 to 45 minutes, and you walk out afterwards.
Here is what to expect:
Local Anaesthetic: We begin by injecting local anaesthetic around the base of the toe. This quickly numbs the area so the procedure is completely pain-free.
Nail Section Removal: The ingrown section of nail is removed, including the root portion, to ensure the source of irritation is eliminated.
Phenol Application: A chemical called phenol is applied to the base of the nail (the nail matrix) to prevent regrowth of that specific edge. This is what makes the result permanent.
Dressing and Aftercare: The toe is cleaned and dressed with a sterile dressing. You receive clear instructions for at-home care and a follow-up appointment to review healing.
This procedure preserves the majority of your nail and usually leaves the toe with a straight, healthy appearance. Most patients are back to work one to two days after the procedure depending on the nature of their work, and children can return to school the next day.
Postoperative Care And Considerations
Like all surgical procedures, ingrown toenail surgery carries some risks. Although generally safe, potential complications include infection, delayed healing, scarring, pain and regrowth of the removed nail edge. It is essential to follow all aftercare instructions and report any concerning symptoms to your podiatrist promptly. If an infection is already present in the toe before the procedure, a course of oral antibiotics may need to be prescribed by your GP first. Your podiatrist will advise you if this is required.
For a detailed walk-through of what to expect during the days and weeks after the procedure, see our Ingrown Toenail Surgery Recovery guide.
What If I Don't Want Permanent Removal?
Not everyone is ready for a surgical option, and that is completely fine. At My Family Podiatry, we also offer conservative management for ingrown nails when appropriate. This may include:
Gentle trimming and reshaping of the nail
Use of antiseptics to reduce inflammation
Education on correct nail cutting technique
Padding and footwear advice
Regular maintenance to prevent future issues
We discuss all available options during your appointment and help you choose the best course of action based on your age, activity level, medical history and preference.
FAQ
Is ingrown toenail surgery permanent?
A partial nail avulsion with phenolisation is designed to be a permanent solution for the edge of nail that keeps growing in. While no procedure is perfect, recurrence rates are generally low when it is performed properly.
Is ingrown toenail surgery painful?
The procedure itself is usually done under local anaesthetic, so the toe is numb during treatment. Some soreness afterwards is normal, but most people manage well with simple post-procedure care.
How long does it take to recover from ingrown toenail surgery?
Most people can return to normal daily activity fairly quickly, although the toe can remain tender and require dressings for a short period while it heals.
When do you need surgery for an ingrown toenail?
Surgery is usually considered when the nail keeps recurring, becomes infected repeatedly, or conservative treatment is no longer giving lasting relief.
Can you still treat an ingrown toenail without surgery?
Yes. Many ingrown toenails can be managed conservatively, especially if they are early, mild or related to nail trimming, pressure or temporary irritation.
Do I need to see a podiatrist or a GP for an ingrown toenail?
Both can help, but podiatrists commonly manage ingrown toenails from conservative care right through to partial nail avulsion procedures in clinic.
At My Family Podiatry, we treat ingrown toenails regularly, from conservative care through to permanent Partial Nail Avulsion procedures. If you have been dealing with recurrent ingrown nails and are ready to discuss your options, call 07 3088 6116 or use the button below to book an appointment.