Ingrown Toenail Surgery

Ingrown toenails are a painful and frustrating foot problem that plague many people for years by continuing to grow back. We treat ingrown nails and stop them growing back for good using specialised ingrown nail surgery performed by our Brisbane podiatrists.

An ingrown toenail develops when part of your toenail pierces the skin that surrounds it and starts growing into it. Think of it like a splinter in your skin - and with each step, the movement of the piece of nail around the skin can cause pain, making walking and wearing shoes very uncomfortable. While some causes of ingrown nails are hereditary, like a curved nail shape, others are self-inflicted - like the way that the toenails are trimmed or cramming the feet into tight, narrow footwear that pushes the skin of the toe closely against the nail. This is why many people continue to get ingrown toenails over many years - and where ingrown nail surgery can help them finally get that permanent relief.

Do I Need Surgery For My Ingrown Toenail?

We offer two primary kinds of ingrown toenail treatments: nail surgery and conservative ingrown nail care. Conservative ingrown nail care is best suited for people who don’t have a history of ingrown toenails, and their current ingrown nail was caused by a one-off cause - like a specific pair of tight shoes that they’re not wearing again. In this case, simply removing the ingrown nail edge without surgery will help alleviate the pain and allow the nail to heal.

Ingrown nail surgery is recommended for those who have a history of ingrown toenails, or those whose ingrown nail is likely to recur, like if their involuted nail shape was the likely cause of the problem. It’s not uncommon to see patients who have had ingrown toenails conservatively treated several times before opting for the nail surgery.

Types of Ingrown Toenail Surgery

There are two primary types of ingrown nail surgery that we perform:

Partial Nail Avulsion (PNA)

A PNA is the most common ingrown nail procedure that we perform. It involves removing a small part of the nail edge that has ingrown into the skin. The next step is called a chemical matrixectomy, where a chemical called phenol or sodium hydroxide (NaOH) is applied to destroy the nail-growing cells at the base of the nail, meaning that the small problematic nail edge won’t grow back. The procedure is performed under local anaesthetic so is painless for you. The process takes approximately one hour, with the nail edge removal taking only approximately 20 minutes.

Total Nail Avulsion (TNA)

A TNA involves removing the entire toenail as a way of managing the ingrown nail. This option is usually selected by those who are also unhappy with their toenail. This may be from the nail sustaining damage or becoming deformed, infected, thickened, or if the nail itself is also causing discomfort alongside the ingrown portion of the nail. Once the nail is removed, a new nail will grow and replace it unless you opt for a chemical matrixectomy to prevent regrowth. 

Benefits Of Toenail Surgery

• The procedure is done in one appointment in our clinic - not hospitals or day stays
• It is performed quickly over a one hour appointment, with the nail surgery procedure typically taking around 20 minutes
• The procedure is pain-free under local anaesthetic
• You do not need to take any additional time off work or school following the procedure and can go home immediately
• You do not need any special boots or braces while the toe heals
• We dress your toe, provide you with a take-home dressing pack and re-dressing instructions
• Your procedure is completed by experienced podiatrists who monitor your progress to ensure it is healing well with redressing appointments

How To Decide If Surgery Is Right For You

The best way to decide if ingrown toenail surgery is the right option for you is to book in for an appointment with our podiatrists. We’ll assess your toe, review your history, and discuss both your surgical and non-surgical treatment options so that you have all the information you need to make an informed choice.

Toenail Surgery Procedure

Our nail procedures are performed in a sterile environment, and your health and safety is always put first. For the partial nail avulsion:

• We start by preparing your foot and applying iodine (a disinfecting agent) to the area
  
• We inject the toe with local anaesthetic using a thin needle, and confirm it has numbed the area
  
• We apply a tourniquet to limit any bleeding as we remove the small nail section
  
• We use surgical tools to cut down the side of the nail, and free the small section of nail containing the sharp nail spicule, performing checks to ensure that all of the nail has been removed
  
• We perform the chemical matrixectomy, applying phenol or sodium hydroxide to the base of the nail and then neutralising it
  
• Once the procedure is complete, we dress the toe using antiseptic and sterile dressings

After your procedure, we go over what you can expect at home and teach you how to care for your feet over the coming weeks as your toe heals and recovers. We will see you to redress your toe and check on its progress 2-3 days after your procedure, and again the following week. In between appointments, we will provide you with everything you need to continue to dress your toe at home.

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