Ingrown toenails are the most common toenail problem. As the nail irritates the skin, it often creates pain, redness, swelling, and warmth in the toe. If the ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area.
Ingrown toenails may be caused by:
- Improperly trimmed nails.
- Very curved edges of the nails.
- Shoe pressure or repeated trauma to the feet from normal activities.
- They can be inherited.
- Previous or current nail problems, such as fungal infections or losing a toenail due to trauma.
Most cases will require conservative treatment, while others may need surgical correction which can be conducted by your podiatrist using local anaesthesia.
Nail surgery is a minor procedure which involves removing part or the entire toenail. This is done in such a way that the nail does not grow back.
When is Nail Surgery Required?
- When an ingrown toenail repeatedly gets infected.
- When the toe is continually painful.
- When you are unable to wear closed shoes
What does the Nail Surgery involve?
A pre-operative appointment is required at which a complete neurovascular examination is performed, history taken including a list of current medications and allergies to determine whether the patient is fit for surgery. Chronically infected toes may require an X-ray to rule out secondary bone infection and a visit to the GP for a course of antibiotics. All of the benefits and possible complications of nail surgery will be discussed by your podiatrist at this appointment.
- At the operation appointment a local anaesthetic is injected to either side of the toe to numb it.
- Once the toe is numb a tourniquet is applied to prevent blood loss.
- The complete toenail or a small section of the offending toenail is removed from the side or sides of the nail while the rest of the nail remains intact.
- A chemical called phenol is then applied to the ‘matrix’ or ‘root’ of the toenail area to prevent the nail re-growing.
- The area is flushed with an antiseptic.
- Sterile dressings are applied to the toe and no stitching is required.
- A sandal, thong or a deep wide shoe is to be worn home.
- The dressing will need to be kept dry and will be changed by the podiatrist after 3-5 days. The toe is then re-dressed and self-care instructions will be advised by your podiatrist.
- A second follow-up visit will be booked after 5-7 days.
- The toe generally becomes completely healed in approx. 4-6 weeks.
The diagram shows removal of one side of the nail only. A similar procedure is used to remove both sides of the nail, or the entire nail if necessary.