Ingrown Toenail Removal – What is Nail Surgery?

Ingrown Toenail Removal

Ingrown toenail removal is a permanent solution to an ingrown toenail. We can also remove problematic nails or thickened and unsightly nails.

Ingrown Toenail Removal – What is Nail Surgery?

Ingrown toenail removal is a permanent solution to an ingrown toenail. We can also remove problematic nails or thickened and unsightly nails. Nail surgery will involve having a local anaesthetic to numb your toe. The offending piece of nail will then be removed (partial nail avulsion) and in some cases the complete nail (total nail avulsion). This will be discussed during your assessment appointment. A chemical called ‘Phenol’ is applied to the nail bed which will kill the nail cells stopping the nail from growing back. A bulky, supportive dressing will be applied to your toe, which you will need to keep on for 48 hours. The procedure takes up to 1 hour, depending on the severity and quantity of what is required.

An initial appointment is required to ensure suitability for nail surgery. Here at The Healthcare Hub, nail surgery is a package of 3 appointments. This will involve the procedure appointment and 2 follow-up appointments. We will see you 1-week post-operation to check your progress, re-dress your toe and provide new advice and guidance on continued care. We will then see you again in 4-5 weeks to check the progress of healing. You can contact us at any time if you have any concerns: we will be very happy to help and guide you here at The Healthcare Hub as your toe heals and recovers.

When is Nail Surgery Required?

Nail surgery can be both the first and last treatment option, depending on the patient’s suitability and need. Ingrown toenail removal for ingrowing toenails needs to happen sooner rather than later. If left untreated, ingrown nails can become infected and this will lead to more and more pain the longer the issue is neglected.

If nail surgery isn’t your first treatment option we advise that nail surgery is required if/when the problematic nail is persistent. This is when conservative treatment is no longer working and also if there are a reoccurring infection present. Antibiotics will only help to calm the nail down and eliminate the infection. However, the nail needs to be treated and removed to stop the infection from reoccurring and to stop the pain.

In some cases, nail surgery has to be the first treatment option because of the history, severity, and/or lifestyle. The questions you should ask yourself if you are contemplating having nail surgery or not are; how long has this been going on? Is this affecting my day-to-day life? Does this keep happening every few weeks or months? If the answer to those questions is; it has been going on for over a couple of months, yes it is affecting me every day, and yes it keeps reoccurring and gets infected regularly, then nail surgery is the best treatment option for you going forward.

What conditions are commonly treated with Nail Surgery?

Nail surgery can be carried out for both acute and chronic ingrowing toenails, fungal toenails, and also thick and unsightly toenails. Nail surgery is the treatment option to choose when other conservative treatments have not worked, or if you want a permanent solution initially.

It is important to remember, if you have an ingrown toenail, the whole toenail may not need to be removed. Some people are under the impression that the whole nail needs to be removed, whereas in actual fact, if only one side of the nail is ingrown, you can have a partial nail avulsion, meaning only the problematic part of the nail needs to be removed, so you will be left with a slightly narrower nail.

Signs and Symptoms:

  • Pain/discomfort in the sides/corner of your toe
  • Toe may become inflamed
  • Signs of infection – heat, swelling, redness around nail, puss or bleeding
  • Overgrowth of skin that is painful and may bleed
  • Hypergranulation tissue present

Causes can include:

  • Trauma/injury – stubbing a toe, dropping an object on the toe
  • Tight shoes, tight socks/hosiery
  • Poor nail cutting (picking toenails!)
  • The natural shape of nail – genetics
  • Fungal nail infection/thickening of the nail.

What’s involved in the aftercare of nail surgery?

After having nail surgery, the toe usually takes approximately 6-8 weeks to completely heal but every individual heals differently, and consequently, healing times may vary post-operatively.

We recommend having the rest of the day off after undergoing your nail surgery so that you can rest your foot. If your job is physical, you should arrange a few days off work.

In terms of looking after your toe, you will need to saltwater bathe your toe daily for 5 minutes only and dress it with a new sterile dressing every day. You will need to do this every day for the first 2-3 weeks. For the following weeks, you still need to saltwater bathe the toe.

You will also NOT be able to swim or get the toe wet until the area is healed and a reduction in your activity/sport will be required, failure to do this will increase the healing time and may cause infection.

What to expect immediately post-op?

The anaesthetic will last for roughly 2-3 hours post-operation. When the anaesthetic wears off, the operated area can be sore, it may throb, and it is common to have to take painkillers for the first 24 – 48 hours.

The initial dressing the Podiatrist will apply needs to stay on for 48 hours, after this, you will start saltwater bathing and dressing the toe with a smaller sterile dressing every day.

Are there any post-operation symptoms that I should report to my podiatrist?

Other than the pain that might come when the anaesthetic wears off, it is important to look for signs and symptoms of infection as the weeks go on. Your toe will become inflamed approximately 7-10 days post-surgery and there may be discharge. This is the normal reaction to the chemical applied to the nail to stop it from re-growing. The discharge may continue for 6-8 weeks, sometimes longer, and your toe will look worse before it looks better.

What signs of the infection do you need to monitor?

  • Redness that starts tracking up the toe and foot
  • Excess swelling
  • Excess pain
  • Strong/different odour

If you do have any signs of infection, you will require antibiotics from your GP straight away.

If you believe you might need nail surgery, we recommend getting in touch for a nail surgery consultation with one of our HCPC registered Podiatrists, all of whom have completed a 3-year BSc Podiatry degree to ensure personal and professional service from the Healthcare Hub.

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