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What is an Ingrown Toenail?
Onychocryptosis, or an ingrown toenail, is a condition of the toe whereby the edge, corner or side of a toenail curls down and grows into the skin next to the nail. It’s most common for this to occur on the big toe and patients report redness, swelling, heat and discomfort in the area.
If other remedies used to resolve the problem have not been effective, then we can treat patients with ingrown toenail surgery.
Types of Ingrown Toenail Surgery
There are two types of podiatrist ingrown toenail surgery – one where the whole nail is removed and another where only a portion of the nail is taken off.
Partial Toenail Avulsion
Partial Nail Avulsion with phenolisation (PNA) is a procedure which permanently removes only the ingrown section of the toenail and the rest of the nail remains. The part of the nail which has been removed does not grow back again but because only a small section is removed, the appearance of the toe can be relatively normal. This is the most common of the two procedures and is performed in our Ferntree Gully Clinic.
Total Toenail Avulsion
A total nail avulsion (TNA) procedure involves the safe removal of the entire toenail. This option might be recommended where both sides of the toenail continue to regrow after multiple previous procedures and/or the nail naturally grows in a curve, causing the issue to recur. Once the nail is entirely removed, it can grow back as normal. This usually takes about 12 months.
Preparing for Ingrown Toenail Treatment
Preparation is minimal and the ingrown toenail surgery, which takes less than an hour, is performed whilst the patient is still fully awake.
On the day of the surgery, we might suggest taking some over the counter painkillers after the procedure to help manage any discomfort once the anaesthetic wears off.
Patients should also bring open-toe shoes to wear immediately after and for three days following the procedure until the dressing is removed.
We also recommend arranging transport home from our Clinic as it may not be safe to drive yourself.
How to Treat Ingrown Toenail
The ingrown toenail removal process has eight steps which are described in our blog post. These can be summarised as follows:
- clean and numb the area
- remove part of the nail
- dress the area so the patient can start to recover.
After the toe is numbed with a local anaesthetic, the nail is separated from the nailbed so that the edge can be cut away vertically from the ingrown side down to the cuticle. This is then split off from the nail plate and removed using special tools. At the same time, any tissue that has grown over the area is removed and a piece of cotton is placed under the remainder of the nail. This prevents the nail from regrowing back into the skin again.
Finally liquid phenol* acid is applied to destroy the area beneath the cuticle that produces nail-creating cells (the nail matrix). This stops the nail from growing back. It is for this reason that we try to remove as little of the nail as possible – so that the toenail is only slightly narrower than it was originally.
Ingrown Toenail Surgery Recovery
In order to prevent infection, at the end of the procedure, the area is cleaned with a betadine solution and a bandage is used to dress and cover the toe.
Ingrown nail surgery recovery involves rest and elevation of the foot for two days after the procedure. We advise patients to rest at home with their foot raised above hip-height.
Patients should wear open toe or very loosely fitting shoes for one-two weeks post-surgery, avoid putting pressure on the toe or any strenuous activity which might prevent it from healing properly. Patients are also advised that daily warm salt water foot baths can help prevent infection.
Why Choose Your Foot Clinic?
Ingrown toenail surgery is a common and effective 30 – 90 minute procedure performed in our Ferntree Gully Clinic to permanently correct chronic in-growing toenails.
Book an appointment today
*Phenol is safe and approved for use by the Therapeutic Goods Administration (TGA) in Australia.
