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Nail Surgery
1st October 2012

An ingrowing toenail is one that pierces the flesh of the toe and can be extremely painful. In more severe cases, it can become infected, producing pus and bleeding.

Ingrowing toenails most commonly affect the large toenail, but can affect the other toes too.

A nail that is curling (involuted or convoluted) into the flesh, but isn’t actually piercing the skin, isn’t a true ingrowing toenail, but can also be very painful and inflamed.

Who gets ingrowing toenails?

  • Ingrowing toenails affect both men and women
  • They tend to be more common among teenagers and older people
  • Active, sporty people are particularly prone as they usually get hot sweaty feet
  • Those wearing tight socks that squeeze the toes
  • People wearing shoes with tight toe boxes
  • People cutting their toenails too low

How to prevent getting ingrowing toenails

  • Cut your nails straight across
  • Do not cut you nails too low at the edge or down the side
  • Good hygiene
  • Avoid tight footwear

Treatment

The type of treatment that is recommended will depend on the severity of the ingrowing toenail.

Many ingrowing toenails can be treated effectively just by having the affected nail cut properly. The ingrowing portion of nail will carefully be cut back and removed. This in many cases will be enough to alleviate pain and prevent the nail from becoming infected.

However, if your toenail does not improve it may be recommended that part, or all, of the nail is surgically removed.

Partial nail avulsion

Partial nail avulsion is where part of the toenail is removed and is the most common surgical procedure for treating ingrown toenails.

Partial nail avulsion is carried out under local anaesthetic, which is injected into the base of your toe. The affected side of your toenail is cut away to make the nail narrower.

After the side of the nail has been removed, a chemical called Phenol is applied to the affected area to prevent any nail re-growth and causing an ingrown toenail to develop in the future.

Total nail avulsion

In more severe cases and to reduce the risk of an ingrown toenail developing in the future, the entire nail may be removed.

As with partial nail avulsion, this is also carried out using local anaesthetic.

During the procedure, the nail will be totally removed and you will be left with the indentation (the concave area of skin) where your toenail used to be. It is perfectly safe to not have a toenail and your toe will continue to function normally.

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