Permanent Ingrown Toenail Removal: What to Expect and When It’s the Right Choice

Ingrown toenails are one of the most common and painful nail conditions we see in the clinic. They can start as a mild irritation but quickly escalate into a red, swollen, and often infected mess that makes every step uncomfortable. While some cases respond well to conservative care, others return again and again, interfering with daily life, school, sport, or work.

At My Family Podiatry, we offer permanent ingrown toenail removal for patients who are ready to stop the cycle. This simple in-clinic procedure, called a Partial Nail Avulsion (PNA) with phenolisation, is highly effective, safe, and designed to prevent that section of nail from growing back.

In this guide, we will walk you through what the procedure involves, who it’s suitable for, recovery expectations, and the difference between conservative and permanent options.

What Causes Ingrown Toenails?

Ingrown toenails occur when the edge of the nail grows into the surrounding skin, rather than over the top of it. This leads to pain, swelling, and often infection. Some of the most common reasons include:

• Poor nail cutting technique (e.g. cutting too far down the sides)

  
  

• Tight or narrow footwear

  
  

• Trauma to the nail

  
  

• Naturally curved or wide nail shapes

  
  

• Excessive sweating or soft skin around the nail

  
  

• Genetic predisposition

  
  

While anyone can develop an ingrown toenail, we 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 we believe 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:

1. 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.

   
   

2. Nail Section Removal: The ingrown section of nail is removed, including the root portion, to ensure the source of irritation is eliminated.

   
   

3. 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 ensures that the same problem doesn’t return again and again.

   
   

4. Dressing and Aftercare: The toe is cleaned and dressed with a sterile dressing. You will be given 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.

What Does Recovery Look Like?

Most people are pleasantly surprised at how straightforward recovery is. Because only a small section of the nail is removed, healing is generally quick and uneventful.

• Walking is possible immediately (although we recommend taking it easy for the first 24 hours)

  
  

• You may need to avoid enclosed shoes for a day or two

  
  

• We provide written aftercare instructions and the necessary dressings

  
  

• Most people are back to full activities within a few days

  
  

• The area will continue to heal over the following 2 to 4 weeks

  
  

You will return for 2 follow-up visits to ensure everything is healing well. In the rare event of any concerns, we are only a phone call away.

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 will always 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.

Final Thoughts

Permanent removal of an ingrown toenail may sound intimidating, but it is a quick, simple, and highly effective solution that provides long-term relief. If you are dealing with pain, swelling, or recurring infections, it may be time to consider a Partial Nail Avulsion with phenolisation.

At My Family Podiatry, we perform these procedures in-clinic, under local anaesthetic, with minimal downtime. Whether you need conservative care or are ready for a permanent fix, we are here to help.

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