Ingrowing Toenail

What is an ingrowing toenail?

An ingrowing toenail happens when the edge of the toenail grows into the surrounding skin. This causes pain, redness, swelling, and sometimes infection.

It usually affects the big toe, but can happen to any toe.

What causes it?

·       Improper nail cutting (cutting nails too short or curved).

·       Tight or poorly fitting shoes.

·       Injury to the toenail.

·       Natural nail shape or thickness.

·       Sweating or poor foot hygiene.

What problems can it cause?

·       Pain and tenderness along the side of the nail.

·       Redness and swelling.

·       Infection, with pus or fluid discharge.

·       Difficulty wearing shoes or walking comfortably.

What are the treatment options?

Non-surgical treatments

·       Soaking the foot in warm salty water.

·       Wearing comfortable shoes with wide toe space.

·       Antibiotics if infection is present.

·       Lifting or padding under the nail edge.

These may help in early or mild cases.

Surgical treatments

If the toenail is persistently painful or infected, a minor surgical procedure, usually done under general anaesthetic may be recommended under my care.

There are two common procedures:

1.     Partial Nail Removal

o   Only the part of the nail growing into the skin is removed.

o   A chemical (phenol) may be applied to stop that part of the nail growing back.

2.     Total Nail Removal

o   The whole nail is removed (less common, only if needed), and similarly phenol applied to the nailbed edges.

Benefits of surgery

·       Relieves pain.

·       Removes the source of infection.

·       Prevents the problem from recurring (especially with chemical treatment).

Risks and complications

As with any procedure, there are risks, although most people recover well:

·       Infection (usually treated with antibiotics).

·       Regrowth of the nail (may cause recurrence).

·       Persistent pain or tenderness.

·       Change in appearance of the nail (narrower or missing).

·       Rarely, allergy or reaction to anaesthetic.

Recovery and aftercare

·       You can usually go home shortly after the procedure.

·       Keep your foot elevated for the first day to reduce swelling. Leave the bulky bandage on the toe for 24-48 hours afterwards to apply some compression as it can bleed quite a bit afterwards.

·       Change dressings as advised (usually after 24–48 hours).

·       Keep the toe clean and dry for 7 days.

·       Wear open-toed or loose-fitting shoes until comfortable.

·       Most people can return to work or school the next day, but avoid sport for 2–3 weeks.

Healing usually takes 4–6 weeks.

When to seek help

Contact my team if you notice:

·       Increasing pain, redness, or swelling.

·       Pus or discharge that does not settle.

·       Fever or feeling unwell.

·       The toe becomes very cold, pale, or numb.

Frequently asked questions

Will the ingrowing toenail come back? If chemical treatment is used, the chance of regrowth is small but not zero. Without it, there is a higher chance of recurrence.

Is the surgery painful? The toe is numbed with an injection, so you should not feel pain during the procedure. Some soreness afterwards is normal but can be managed with painkillers.

Will my nail look normal afterwards? If only part of the nail is removed, it will look narrower. If the whole nail is removed, it may not grow back or will look different.