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  • Writer's pictureMy Family Podiatry

Ingrown Toenail Surgery: A Comprehensive Guide

Updated: Dec 27, 2023

Anyone who has ever suffered with an ingrown toenail can tell you how awful and painful they can be. Unfortunately for some people, their nails can become ingrown repeatedly leading to an ongoing cycle of pain and discomfort. If the nail is recurrently ingrown, ingrown toenail surgery, specifically a procedure called a partial nail avulsion (PNA) with phenolisation can offer a lasting solution. This surgical treatment involves the permanent removal of the problematic nail edge, effectively preventing the nail from becoming ingrown again.

A toenail highlighted red on the edges to indicate painful ingrown nails
Painful Ingrown Nail

Why Is The Nail 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.

Effective Ingrown Toenail Treatment: A PNA with Phenolisation

At My Family Podiatry, we will initially try conservative treatment methods to remove the ingrown nail and attempt to grow the nail out. If these are unsuccessful, ingrown toenail surgery is often indicated. This is most commonly a partial nail avulsion, thought depending on the extent of damage to the nail a full nail avulsion may be required. This is the most effective treatment for preventing ingrown nails returning. The procedure is straightforward and you will be back in enclosed shoes within 1-2 days.

The procedure starts by numbing the affected toe with a local anaesthetic. After the toe is numb, the ingrown nail edge is removed including the nail matrix (the area the nail grows from at the base). A chemical called phenol is applied to the area to prevent the nail edge from growing back. Finally, the toe is cleaned and bandaged, care instructions are provided and you can head home to put your foot up for the evening. Typically no more than a couple of paracetamol are required for pain relief following this procedure.

Typically 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. With a 94% success rate, a PNA with phenolisation offers an excellent solution for those who have been suffering with recurrent ingrown toenails.

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. Therefore, it's essential to follow all postoperative care instructions and promptly report any concerning symptoms to your healthcare provider​. Before the procedure it may be necessary to begin a course of oral antibiotics prescribed by your GP if an infection is present in the ingrown toenail and you will be advised of this by your podiatrist if required.

At My Family Podiatry, we specialise in feet and the lower limb. With the help of our experienced podiatrists, ingrown toenail surgery can provide a lasting solution to your pain and discomfort. Call 07 3088 6116 or use the button below to book an appointment to discuss if ingrown toenail surgery may be the right treatment for you.

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