What is an ingrowing toenail?

An ingrowing toenail happens when the toenail grows into the skin around it. The skin can get damaged, causing infection and pain.

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

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

What are the benefits of surgery?

Your child should no longer have infection and pain.

Are there any alternatives to surgery?

Try to cut your child’s toenails straight across and do not leave sharp edges. Your child should wear shoes that comfortably fit the shape of their feet.

Keep your child’s feet clean.

Your GP or podiatrist 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. Antibiotics can be used to treat infection but this will not treat the ingrowing toenail.

What does the operation involve?

The operation usually takes about 20 minutes and may involve one or more of the following techniques.

• Nail avulsion — Removing the whole toenail. The toenail will regrow.
• Wedge excision — Removing part of the toenail where it is growing into the skin, along with the area of tissue in the corner that the toenail grows from. The toenail will regrow but will be narrower than before.

• Nail-bed ablation — Removing part of the toenail or the whole toenail and then applying a chemical to the area of tissue that the toenail grows from. Surgery or electrocautery can also be used. This will prevent the toenail from growing back in the area that was treated.
• Zadek’s procedure — Removing the whole toenail and then cutting away the area of tissue that the toenail grows from. This will prevent the toenail from growing back.

What complications can happen?

General complications of any operation

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

Specific complications of this operation

• infection in the underlying bone
• infection of the surgical site

Consequences of this procedure

• pain
• unsightly scarring of the skin

How soon will my child recover?

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

Your child should not play sports or do strenuous exercise for 2 weeks. Keep the dressing dry.

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

If the ingrowing toenail happens again, your child may need another operation.

Summary

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

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