Surgery for Ingrowing Toenail (adult)

What is an ingrowing toenail?

An ingrowing toenail happens when your toenail grows into the skin around it (see figure 1). 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. The problem often runs in families as a common cause is having toenails that do not grow straight. 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 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 nail avulsion (removing your whole toenail), wedge excision (removing part of your toenail), nail-bed ablation (removing part of or the whole toenail and then applying a chemical or an electric current to the area of tissue that your toenail grows from), and Zadek’s procedure (removing your whole toenail and then cutting away the area of tissue that your toenail grows from).

What complications can happen?

1. General complications

  • Pain
  • Bleeding
  • Unsightly scarring

2. Specific complications

  • Infection of the surgical site (wound)
  • Infection in the underlying bone

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 two weeks. Keep the dressing dry.Try to cut your toenails straight across and do not leave sharp edges. Wear shoes that fit the shape of your feet comfortably.
An ingrowing toenail can happen again.

Summary

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

Acknowledgements

Author: Prof Simon Parsons DM FRCS (Gen. Surg.) Illustrations: Medical Illustration Copyright © Medical-Artist.com

This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.