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Ingrowing Toenails

An ingrowing toenail can be a cause of severe debilitating pain in the foot.  It may affect your choice of footwear or prevent you from partaking in your favourite pastime or activity or just prevent you from being pain free.

An ingrowing toenail occurs when a piece of the nail pushes into the skin and causes pain.  A true ingrowing toenail will pierce the skin and flesh of the toe, resulting in pain, redness, swelling and infection, possibly with bleeding and pus present too.

The nail does not have to pierce the skin in order to cause pain.  The nail can change shape and become more curved and push down on the skin without breaking it.  This is called an involuted nail.

Ingrowing toenails can be caused by:

  • Cutting your nails too short or digging down the side
  • Letting your nails grow too long
  • Trauma to the nail
  • Tight footwear
  • Genetic/hereditary element

They are most common in active teenagers but a patient of any age may develop an ingrowing toenail, whether they are active or not.

Treatment:

If you have only had it a few weeks, it may heal if the nail is cut properly and the wound is allowed to heal.  If it is infected, soaking your foot in warm, salt water for 5 minutes daily can help treat the infection.  In some cases antibiotics may be indicated but this is very rare.

Please note:  Antibiotics cannot cure an ingrowing toenail!  They can help reduce the infection, but the piece of nail causing the pain and infection in the first place will remain piercing through the skin and the ingrowing toenail will come back.

If the ingrowing toenail has been present for a while, it comes and goes or keeps getting infected, nail surgery is indicated.  This involves painlessly removing the infected portion of the nail under local anaesthetic.

Some patients suffer with the pain from ingrowing toenails for years, without realising there is a permanent and simple solution to eradicate the pain.

Call us or book online here now for your initial appointment so we can assess your toe, advise you of the best option for you and relieve your pain and get you back to what you enjoy best.

This can be done at our Essex Podiatry Lawford, Manningtree and Wickford practices.

Ingrowing toenail Surgery

Recurrent ingrowing toenails require permanently removal of the offending piece of nail or regular ongoing routine podiatry.  We would recommend surgical removal as the gold standard in the majority of cases.

We would require an Initial Appointment in order to assess the ingrowing toenail and your medical history.  We will  advise you of all the possible treatment options and recommend which is likely to give you the best possible outcome.

If we agree that surgery is the best option, we will then book you in at a convenient time for you to have the painful piece of nail removed.  Depending on your symptoms, the shape of your nail and your medical history and occupation we may recommend removing one side of the nail,  both sides of the nail or the whole toenail.  This will be fully discussed with you and the best procedure for you will be recommended.

On the day of surgery, we will complete the paperwork and consent form and then give you a small anaesthetic injection either side of the offending toe.  Once your toe is numb, we will clean the area and apply a tourniquet to the toe, to ensure there is no bleeding.  We will then remove either the side/s or the entirety of the problematic toenail as discussed.

Once this is removed we then apply a small amount of a chemical called phenol which burns the cells that grow the nail.  This stops the offending piece of nail growing back.

Next we dress the toe, run through the post-operative instructions and book your redressing appointment which is normally within 3-7 days.

For the rest of the day we expect you to sit with your foot up.  You will need to keep the dressing on and dry until we see you back for your redressing appointment.  Initially the first dressing can be quite bulky, which may mean you cannot get your work shoes on.  This may require you to have a few days off work.

At the redressing appointment, we will review the dressing, evaluate the toe and assess healing. We will then redress it again and you will be given further dressing advice to do this at home yourself.   You will need to keep it covered for approximately 6 weeks in total.

Possible but rare complications of nail surgery include:

  • Regrowth of the offending piece of nail, approximately 5-10% chance.  If this happens we offer to redo the surgery for you free of charge.
  • Infection 2.5%
  • Delayed healing-  Occasionally it may take longer than 6 weeks to heal.
  • Allergic reaction
  • Poor Cosmesis- You may not like how it looks
  • You may develop a new toe or nail problem.
  • Continued pain- It's possible you may still have some pain in your toe.
  • You may need further treatment.

Our clinical lead podiatrist, David Reid has performed over 500 successful nail surgeries!

We are registered with Bupa, WPA and Cigna to carry out the surgery for you.