Nail surgery.
Why Might You Need Nail Surgery?
Ingrown toenails most commonly affect the big toe, although any toenail can be affected. They may cause pain, redness, swelling, bleeding, discharge or infection.
Some cases can be managed conservatively through careful nail treatment, advice on cutting and changes to footwear. Nail surgery may be recommended if the problem keeps returning, remains painful despite treatment, or causes hypergranulation tissue, persistent inflammation or signs of infection.
Surgery may also be considered for nails that are severely curved, thickened, damaged by trauma or affected by a painful fungal infection.
The procedure is carried out under local anaesthetic. Part or all of the nail is removed, and a chemical may be applied to reduce the chance of the affected section growing back.
Common causes of problem toenails include:
Incorrect nail cutting
Tight or poorly fitting footwear
Injury or repeated pressure
Curved or involuted nails
Bunions or clawed toes
Fungal infection
Your podiatrist will assess the toe and advise whether nail surgery is the most suitable option.
The Procedure
Before nail surgery, we will complete a full assessment and review your medical history and medication to ensure the procedure is suitable for you.
The toe is numbed using a local anaesthetic. Wherever possible, we perform a partial nail avulsion, removing only the troublesome side—or sides—of the nail. In some cases, removing the whole nail may be the most appropriate option.
If the nail has been repeatedly painful or infected, phenol may be applied to the nail matrix to greatly reduce the chance of it growing back. Occasionally, the nail may instead be allowed to regrow, such as where the problem resulted from a one-off injury or incorrect cutting.
For some fungal nails, removing the nail can reduce the amount of infected material and allow an antifungal treatment to be applied directly to the exposed area.
After the Procedure
You must arrange for someone to drive you home or use a taxi, as you should not drive while your toe remains numb. A bulky dressing will be applied, so please bring an open-toed sandal or similarly roomy footwear.
We recommend resting with your foot elevated for the remainder of the day and limiting activity over the following day or two. Most patients experience little discomfort, but a suitable over-the-counter painkiller may be taken if needed. Avoid using aspirin for pain relief, although prescribed aspirin should not be stopped unless advised by a healthcare professional.
You will need to keep the toe dressed until it has healed. Following nail surgery with phenol, healing commonly takes between 4 and 12 weeks, depending on the procedure and the individual.