Ingrown Toenail

Ingrown toenail is a condition in which a spike, a serrated edge of the nail has pierced down the side of the nail fold. When this happens, it can lead to inflammation, swelling or accumulation of pus at the side/s of the nail.  Hypergranulation (excessive tissues growth) tissues can also be seen on the nail folds in severe cases. Most common factors that lead to ingrown toenail are faulty nail cutting, wearing poor fitting footwear, tearing of the toenails and excessive curvature of the toenails.

If the ingrown toenail is not infected, the splinter can be removed by your Podiatrists. Narrow pointed footwear should be avoided to prevent direct excessive pressure. A suitable antiseptic solution such as Betadine can be used to treat and prevent any infection. If this is a recurrent problem, a nail surgery will be necessary to permanently remove a small part of the nail.  Occasionally we may recommend removing the entire toenail to achieve the best result.

 What is ingrown toenail surgery?

Ingrown toenail surgery is a partial nail excision and chemical sterilisation of the nail matrix performed under local anaesthetic. It involves the removal of the ingrown portion of the toenail, together with the corresponding portion of the nail root, and the application of phenol to prevent that portion of the toenail from regrowing. This procedure is performed under local anaesthetic and the prognosis is generally very good. The procedure takes approximately one hour.

If you are taking Aspirin or Warfarin, please check with your doctor or pharmacist on whether it’s safe for you to go off them for 1 week before your surgery. This help to minimise bleeding afterwards.

Do you remove the entire toenail?

In most cases, we only need to remove one edge of the nail. Once the toe is healed the toenail simply looks slightly narrower but straighter.

In more severe cases, where the nail is severely deformed and causing pain on both edges of the toe, we may recommend removing the entire toenail to achieve the best result.

 Can an ingrown toenail grow back after surgery?

There is a small chance an ingrown toenail can grow back after surgical treatment, but this only happens to about 5% of the cases. In other word, you have 95% success rate.

Will I need time off work or school?

Immediately after the procedure you should rest and keep your foot elevated for the rest of the day. You will also need to wear an open-toe shoe for 1-2 weeks, and avoid high heels and tight-fitting footwear.

Most people recover very quickly from ingrown toenail surgery and can return to work (for light duties) or school within a day or two. You should not participate in physical education, sports or swimming for two weeks after the procedure. 

If you have a physically demanding occupations, we suggest you take 3-7 days off.

Will I need to take antibiotics?

With any surgical procedure there is a risk of developing an infection as the wound heals. It is important that you follow our instructions for cleaning and dressing your toe, and that you keep your toe clean and dry.

We will review your foot regularly after surgery to ensure your toe is healing well. If there are no signs of infection (increasing pain, pus, heat, redness or swelling), it is unlikely you will need to take antibiotics.

What do I need to do on the day of my surgery?

• Bring a slipper or sandal to wear for the return journey home. This will allow room for the toe dressing which may be bulky.
• Make transport arrangements for your journey home. You will be able to walk after the operation, but you should rest the foot as much as possible. You are strongly advised not to drive until the effects of the local anaesthetics have worn off.
• If you are under 18 years of age you must be accompanied by a responsible adult.

What can I expect after my surgery?

• Usually there is some postoperative bleeding. This can be minimised by resting your foot and keep it elevated in the first 24 hours after the surgery.
• Minor pain and discomfort to the operated site/s. This can be controlled by Panadol, or your preferred choice of analgesics obtained over the counter in any pharmacy.

How do I look after my wound after the surgery?

• It is important that you keep the operated toe clean and dry for the first week. To maintain foot hygiene, use baby wipes to clean the rest of the foot and toes while avoiding the operated toe. Your podiatrist will do your first dressing change after this period.
• We advise you wear socks to bed to avoid the dressing got accidentally kicked off in your sleep.
• If your dressing gets wet, you must take it off, apply a new dressing and contact us ASAP
• Your podiatrist will review the wound 2-3 days after the surgery. After this review you can look after the wound at home. We recommend Betadine or an antiseptic solution of your choice to the wound and dress it with a sterile dressing. Please change your dressing daily and remember to keep the toe dry for 1-2 weeks until the wound is no longer sore to touch.