Ingrowing Toenails (Ingrown Toenail)

An ingrown toenail is a common condition which can be very painful leading to infection and prolonged pain.   Various treatments can be given by a doctor or podiatrist (chiropodist).  Nail surgery is easily and effectively performed using local anaesthetic to treat and  prevent regrowth of the affected nail. The procedure takes up to an hour and the patient can return to work and their normal routine the following day.

Will it get worse?

The infection and swelling generally gets worse if untreated.

What are the common symptoms?

1. Pain
2. Swelling
3. Bleeding / weeping
4. Foul odour
5. Difficulty in shoes
6. Difficulty walking

How is it recognised?

This is easily diagnosed on clinical examination.

What can I do to reduce the pain?

There are several things that you can do to try and relieve your symptoms:

1. Wear good fitting shoes
2. Take care with nail cutting
3. Bathe the foot in warm, salt water daily
4. Keep the toe covered with a clean / sterile dressing
5. Have a course of antibiotics from your GP
6. See a podiatrist

What will happen if I leave this alone?

It is likely to get worse.

Will podiatry cure the problem?

Simple measures carried out by a podiatrist such as packing underneath the nail, to elvate the nail and alleviate pressure on the sulcus can be all that us required, you be advised about this

How can I cure the deformity?

For more severe or recurrent cases, surgery is required.

How does the operation correct the deformity?

There are two types of operation:

1. Partial nail removal (avulsion) with destruction of the nail bed / root
2. Total nail removal (avulsion) with destruction of the nail bed / root

The most common procedure is removal of the side of the nail. Whilst this alone will resolve the infection, the nail will regrow and possibly cause the same problem. Destruction of the nail bed and root (matrix) prevents re-growth. This is usually achieved by using a chemical (phenol) although this can be achieved via an electric current.

This is a highly successful operation.

Will I have to be put be asleep?

The procedure is performed perfectly safely under local anaesthetic (you are awake). Some patients worry that they may feel pain during the operation but it would not be possible to perform the operation if this were the case

I have heard it is very painful

The partial nail avulsion procedure using phenol rarely causes any significant discomfort. The anaesthetic can cause discomfort, but after it has taken affect the procedure is painless. Relief is often immediate with some patients merely requiring some pain killers that would normally be taken for a headache.

Are there a lot of complications?

There are risks and complicationswith all operations and these should be discussed in detail with your specialist. However, this operation has a very low complication rate. A thorough examination of your foot and general health is important so that these complications can be minimised.

Although every effort is made to reduce complications, these can occur. In addition to the general complications that can occur with foot surgery, there are some specific risks with ingrown toenail surgery:

1. Nail re-growth (low at 5-8%)
2. Inclusion cyst
3. Reaction to the chemical

When will I be able to walk again and wear shoes?

For the partial nail avulsion using chemical ablation, you can walk immediately after the operation, although it is generally best to rest that night. You will need to bathe the foot in warm salt water for 15 minutes, twice daily and redress the toe until it has healed. This is generally between 2-4 weeks due to the chemical burn but it is not usually painful during this period.

For the surgical excision procedure you will need to rest your foot for 2-3 days and sutures (stitches) are removed at two weeks.

When will I be able to drive again?

When you feel able to perform an emergency stop. This is usually the next day for the chemical procedure and up to two weeks post operatively for the surgical excision but you should always check with your insurance company first.

When will I be able to return to work?

The next day for the chemical procedure and dependent upon your comfort levels for the surgical procedure (1-2 weeks).

When will I be able to return to sport?

You should be able to return to full sport as soon as the toe has healed (2-4 weeks).

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