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Ingrown Toe Nail

What is it?

Ingrown toe nails occur when the edges of the nail grow into the skin next to the nail. Your big toe is the most likely toe where this happens. It can be extremely painful, especially when there is pressure on the area such as when you are wearing shoes.

Why does it happen?

Ingrown toenails have a genetic component. People who naturally have more curved nails are more likely to develop ingrown toenails than those with naturally straight nails. Previous injury, tight footwear and improper nail cutting technique can all predispose to ingrown toe nails.

How can I treat it?

The initial form of management is proper nail care and bringing the nail edge away from the skin and to cut the nail in a cleaner straighter fashion to stop it from growing into the skin. This can be done by a specialised podiatrist and if this is the most appropriate treatment, I will be able to organise this for you. This is usually effective but if the problems becomes repeated or becomes infected, surgery to remove part of the nail may be warranted.

What does surgery involve?

Surgery is done as a daycase under local anaesthesia. I usually do not have to cut the skin and a 1/3rd of the nail including the curved area can be removed down to the skinfold. Using gentle scraping and a solution of Phenol which is a strong alcohol, I remove the cells which make the nail regrow stopping the offending part of the nail coming back.  Using this technique, the Royal National Orthopaedic Hospital reported recurrence rates of less than 5%.

Aftercare

After surgery as a raw area is left there can be some bleeding from under the nail. This is only a very small amount but can be disconcerting if it drips through the dressings. To avoid this a large bulky toe dressing is applied and I recommend you relax and keep your foot elevated for 48 hours after surgery. I will see you one week after surgery at which time all dressings will come down and you can start wearing trainers. You can usually shower from this time and start driving at 2-3 weeks after surgery or earlier depending on pain. The area under the nail will take 3-4 weeks to fully heal up

Risks and complications

There are risks to all surgery and conservative measures should be tried when possible. If surgery is an option, we will discuss all of the pros and cons and the risks that are specific to you in detail. Specific risks of this procedure are-

  • There is a risk of some mild bleeding the day after surgery as there is a raw area where the nail has been removed.
  • There is a small risk of infection.
  • There is a risk that the nail can come back but this is unlikely

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