Ingrown toenail surgery

What is an ingrown toenail?

Toenails, particularly the nail on the big toe, can grow into and pierce the skin at the sides of the nail. This causes the skin to swell and the area can become painful, unsightly and prone to infection.

During ingrown toenail surgery, all or part of the nail is carefully removed. In time, a new nail grows back. Sometimes the underlying nail bed is also removed. In this case the nail will never grow back.

It is usually performed as a day-case procedure using local anaesthesia. This means that the toe will be numb but you will still be awake. Very rarely, the operation is done under general anaesthesia, which means you will be asleep throughout the procedure and will feel no pain.

Your surgeon will discuss with you which type of anaesthesia is most appropriate for you. They will also explain the benefits and risks of having your ingrowing toenail treated, and any alternatives to the procedure.

About the operation

The technique used to remove the nail depends on how ingrown it is, whether one or both sides are affected and whether there’s an infection.

Sometimes your surgeon will remove the whole nail. In other cases only the small wedge of nail growing into the skin is removed. The folds of skin alongside the nail may also be cut away.

Once the nail has been removed, an antibiotic ointment is usually applied to the operated area and the toe is dressed with bandages. If you frequently get ingrowing toenails, a chemical called phenol may be applied to the nail bed after the operation. This helps stop the nail growing back.

Afterwards, your toe will be sore but this should ease after a few days.

Having a toenail removed is a common and generally safe procedure. However, all surgery carries risks as well as benefits.

It’s likely that your new nail will be an odd shape and colour, and won’t look the same as your other toenails. If your nail bed is treated with phenol, inflammation can develop inside your toe causing your foot to swell. This is painful but rare. You may require anti-inflammatory drugs for the swelling.

Although your surgeon will be experienced at performing this procedure, phenol treatment does not always work and your nail may grow again.

The chance of complications depends on the exact type of operation you are having and other factors such as your general health. Ask your surgeon to explain in more detail how any risks apply to you.

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