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Ingrown Toenail Surgery

An ingrown toenail occurs when the edge of the toenail grows into the surrounding skin, causing pain, redness, swelling, and sometimes infection. It most commonly affects the big toe and can be due to improper nail trimming, tight footwear, trauma, or genetic factors.

Surgery is recommended when the ingrown toenail is recurrent, severely painful, or infected, and non-surgical treatments have failed.

 

Indications for Surgery

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  • Chronic or recurrent ingrown toenails despite conservative treatment.

  • Infection with pus or overgrowth of skin (granulation tissue).

  • Severe pain that affects daily activities.

  • Failure of home remedies, nail trimming, or antibiotics.

Surgical treatment provides a long-term solution by removing the problematic nail edge and preventing regrowth.

What Does the Surgery Involve?

Ingrown toenail surgery is performed under local anesthesia.

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Surgical Techniques:

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  1. Partial Nail Avulsion (Most Common)

    • Only the ingrown portion of the nail is removed, leaving the rest of the nail intact.

    • A chemical (phenol or sodium hydroxide) may be applied to prevent regrowth.

  2. Total Nail Avulsion (Less Common)

    • The entire toenail is removed if it is thickened or severely damaged.

    • The nail may grow back over time, but sometimes a permanent removal is performed.

  3. Wedge Excision or Soft Tissue Removal

    • If there is excess skin growth (granulation tissue), it may be surgically removed.

    • This improves healing and reduces recurrence risk.

  4. Matrixectomy (Permanent Removal of Nail Root)

    • For severe, recurrent ingrown toenails, the nail matrix (growth area) is destroyed to prevent regrowth permanently.

 

The procedure is quick, minimally invasive, and allows for rapid recovery.

Alternative Treatments

Before surgery, non-surgical treatments may be attempted:

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  • Soaking the foot in warm saltwater – Helps reduce swelling and infection risk.

  • Proper nail trimming – Straight across, avoiding cutting too short.

  • Antibiotic Creams or Oral Antibiotics – Used if infection is present.

  • Cotton or Dental Floss Under the Nail – Lifts the edge of the nail to encourage proper growth.

 

If the ingrown toenail keeps returning or causes significant discomfort, surgery is the best option.

Risks and Complications

Ingrown toenail surgery is a low-risk procedure, but some complications may occur:

 

General Surgical Risks:

  • Infection – Uncommon but possible if post-op care is not followed.

  • Bleeding – Minimal, but some oozing may occur after surgery.

 

Procedure-Specific Risks:

  • Recurrence of Ingrown Toenail – If the nail regrows incorrectly, a second procedure may be needed.

  • Abnormal Nail Growth – The new nail may be thinner, thicker, or irregular.

  • Pain or Sensitivity – Some mild discomfort may persist for a few weeks.

  • Delayed Healing – More common in patients with diabetes or poor circulation.

 

Most patients heal without complications, and the procedure is highly effective in preventing recurrence.

Recovery and Rehabilitation

Time Off Work

  • Desk jobs: 1–3 days

  • Jobs requiring prolonged standing: 1–2 weeks

 

Return to Driving

  • 1–2 days if no discomfort.

 

Return to Activities & Sports

  • Walking: immediate, but with a bandage.

  • Running and sports: 2–4 weeks.

 

Rehabilitation Timeline

  • Days 1–7:

    • Keep the foot elevated to reduce swelling.

    • Daily dressing changes and antiseptic application.

  • Weeks 1–2:

    • Gradual return to normal shoes (wide and comfortable footwear).

    • Avoid tight or narrow shoes to prevent recurrence.

  • Weeks 3+:

    • Resume full activities, including sports.

    • Nail regrowth (if applicable) begins in 3–6 months.

 

With proper care, most patients recover quickly with minimal discomfort.

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