What is an ingrowing toenail?

An ingrowing toenail happens when your toenail grows into the skin around it. The skin can get damaged, causing infection and pain. The problem usually happens to your big toe.

The most common cause of an ingrowing toenail is not cutting your toenails properly, by cutting them too short or down the sides of your toenail.

Wearing shoes that do not have enough width to fit your toes in their natural position can also cause an ingrowing toenail.

What are the benefits of surgery?

You should no longer have infection and pain.

Are there any alternatives to surgery?

Try to cut your toenails straight across and do not leave sharp edges. Wear shoes that comfortably fit the shape of your feet.

Your GP or podiatrist (a specialist in treating problems of the lower legs and feet) may be able to push the skin away from the ingrowing toenail or cut away the piece of toenail that has grown into the skin.

What does the operation involve?

The operation is usually performed under a local anaesthetic.

The operation usually takes about 10 minutes and may involve one or more of the following techniques.

• Nail avulsion — Removing your whole toenail.
• Wedge excision — Removing part of your toenail where it is growing into the skin, along with the area of tissue in the corner that your toenail grows from.
• Nail-bed ablation — Removing part of the toenail or the whole toenail and then applying a chemical (usually phenol) to the area of tissue that the toenail grows from. Surgery or electrocautery (using heat from an electric current to remove harmful tissue) can also be used.
• Zadek’s procedure — Removing your whole toenail and then cutting away the area of tissue that your toenail grows from.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

What complications can happen?

General complications of any operation

• bleeding
• allergic reaction to the equipment, materials or medication

Specific complications of this operation

• infection of the surgical site (wound)
• infection in the underlying bone
• recurrence of an ingrowing toenail

Consequences of this procedure

• pain
• unsightly scarring of your toe

How soon will I recover?

After a short while you will be able to go home.

Spend most of the time during the first few days with your leg raised so that the swelling settles. After that, you can usually start to be a little more active.

Do not play sports or do strenuous exercise for 2 weeks. Keep the dressing dry.

Your doctor will tell you when you can return to normal activities.

Try to cut your toenails straight across and do not leave sharp edges.

An ingrowing toenail can happen again. You may need another operation.

Summary

Surgery to remove an ingrowing toenail should take away infection and pain.

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