Ingrown toenail - Treatment 

Treating an ingrown toenail 

If your ingrown toenail symptoms are mild, you can treat them using self-care measures. More severe cases may require surgery.

Self-care measures

If your ingrown toenail is in the early stages and it is mildly inflamed, there are a number of things you can do to prevent it getting worse. These include:

  • practising good foot hygiene by taking care of your feet and washing them regularly using soap and water
  • trimming the nail straight across to help prevent it continuing to dig into the surrounding skin
  • gently pushing the skin away from the nail using a cotton bud (this may be easier after using a small amount of olive oil to soften the skin)
  • wearing comfortable shoes that are not too tight and provide space around your toes
  • painkillers, such as paracetamol, can be used to help relieve any pain (children under 16 years of age should not take aspirin)

Nail surgery

If your toenail does not improve, your GP or podiatrist may recommend that part or all of your toenail is surgically removed.

Partial nail avulsion

Partial nail avulsion, where part of your toenail is removed, is the most common surgical procedure for treating ingrown toenails. It is about 98% effective.

The procedure is carried out under local anaesthetic (painkilling medication), which is injected into the base of your toe. The edges of your toenail are cut away to make the toenail narrower and give your nail a straight edge. This makes it less likely to dig into the surrounding skin.

After the edges of your toenail have been cut, a chemical called phenol will be applied to the affected area. This prevents the nail growing back and stops an ingrown toenail developing in the future.

During the procedure, any pus will be drained away from your toe to prevent the area becoming more infected. If your nail is infected, a course of antibiotics may be prescribed.

Total nail avulsion

Total nail avulsion involves removing the whole of your toenail to reduce the risk of an ingrown toenail developing in the future.

The procedure may be recommended if your nail is thickening and pressing into the skin surrounding your toe. As with partial nail avulsion, total nail avulsion is carried out using local anaesthetic.

During the procedure, your toenail will be removed and you will be left with the indentation (the concave area of skin) where your toenail used to be. It is perfectly safe for you not to have a toenail and your toe will continue to function normally.

After nail surgery

After having nail surgery, your toe will be wrapped in a large sterile bandage. This will help stem any bleeding and prevent infection. You should rest your foot and keep it raised for 1-2 days after the operation.

After the anaesthetic has worn off, your toe may be sore and tender. To help reduce any pain, you may need to take a painkiller, such as paracetamol, and wear soft shoes or open-toed sandals for the first few days following surgery.

You can remove the bandage two days after having nail surgery. Soaking your toes with salt water will help the area heal.

Page last reviewed: 19/11/2012

Next review due: 19/11/2014

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Comments

The 10 comments posted are personal views. Any information they give has not been checked and may not be accurate.

palinoy said on 23 November 2014

Absolutely ridiculous!! I'm in the worst pain I've ever felt in my life; and I have had my appendix removed and many other surgeries! Three days after this surgery and I'm still in unbearable pain! No medication is working- no antibiotics, no pain relievers, NOTHING. The stitches are killing me!! I have not been able to walk at all. I keep my foot up high and crawl to the bathroom when necessary. Worth mentioning that I HAVE done this surgery twice actually- one surgical and one laser treatment. Both hurt after the surgery but the pain did not last as it is lasting with me now! I'm sick of this, and regret the decision I took to do this stupid surgery!!! Bottom line, TRY EVERYTHING before you do this ''minor' surgery which on fact hurts more than most major surgeries! Tomorrow I have a checkup with the doctor, and I can't even stand up! This pain is unbearable.

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lea86 said on 03 January 2014

I had the whole toe nail removed after two years 47 appointments 3 failed attempts under local, under General. Any doctor that says they won't do it under General is lying. All I can say is I've had no pain other then feeling little shocks of pins and needles, to which is completely normal I was back on my feet day after but am still having dressing changes every other day but looks and feels amazing couldn't ask for anything more. Best thing I ever did !!

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Lemon82 said on 26 September 2013

I have had a partial toe nail removal performed twice in the last 2 months. The first time it grew back so I had to have it removed again. The second time the doctor was insistent that more nail needed to be removed, I really didn't want this but didn't feel I was given a choice. On both occasions silver nitrate was used on the nail bed rather than phenol. I don't know why. Every article I read suggests that phenol should be used. Tonight I realised that the nail is growing back again. I'm scared to go back to my doctors surgery because I think they'll just keep cutting more away and repeating a duff procedure.
Is there another option to get a second opinion without having to change doctors?

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Jessica3001 said on 18 August 2013

On Thursday 8th of August I had my whole toe nail removed. Before this I had 6 lots of antibiotics which didn't help at all. It was swollen and red beforehand and also had a lot of pus coming out from the cuticle/bottom of nail. The nail was quite thick and yellow in colour and eventually pulled away from the cuticle.

After looking at my toe today after 10 days there's like a semi-circular part of my nail half way up my toe which is normal but... What I want to know is why there is still a gap inbetween my cuticle and the nail?!!? I'm really worried now and annoyed if this shouldn't be the case, can someone put my mind at ease please!!:(

Thank you!

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Therightone said on 05 August 2013

They say if it's infected they cannot treat it so to get the infection out I find it better if you manipulate the infection by forcing it out from bottom to top and focusing on the area where the infection is at its biggest like a solid lump of infection blood is ok because it is part of the infection and it's good that it's coming out so after you have done that you need to put some antiseptic cream on it and using a plaster and dressing to cover it up and then wrap it tightly. Expect it to be more swollen soon after you have done so and do that until the infection has gone keep the plasters on how this is helpful.

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ZP86 said on 29 July 2013

I had the partial nail removal on both feet about 3 months ago and I wish I had done it years ago.
The actual operation is unpleasant but not unbearable, the needles are the worst part but once that's done you don't feel anything.
After the surgery there was slight stinging in one foot but nothing in the other. I followed advice and stayed off my feet for the rest of the day and didn't shower until the next day. I changed the dressings as advised until the wounds had stopped weeping- this took about 2-3 weeks. You are not allowed to go swimming during the healing time.
I saw the nurse about 5 weeks after the operation on a separate matter but asked her to have a look and she said they had healed totally. I now have no pain and they look great.
I was worried my toenail would be left really narrow but you can't even see where it's been removed. I would recommend this surgery if you have been having problems with ingrown toenails.

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Flora Grace said on 13 July 2013

I had the partial nail removal surgery done almost a year ago now where I had both sides of both big toes removed. I was discharged from the after care and told they were fully heald. However, a year on and they don't seem to be improving. The nails are now very brital, discoloured and coming away from the nail bed and I am becoming concerne that if the nails come off that they won't re grow, will that be the case?

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lizzychappell said on 15 February 2013

6 days after this 'relatively minor surgery' I am still in pain and it is still being dressed by a nurse every couple of days. I have been on strong analgesics the whole time and I am not expecting to return to work any time soon.
The local anaesthetic was wearing off by the time I was called back in to the room for the operation and I felt most of it.
The whole experience has been absolutely horrendous. I have an average pain threshold having experienced both natural childbirth and post operative pain from abdominal surgery and this beats both. If it happens to any other toe I will live with it. Be warned

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mk2197 said on 26 November 2012

Sure the Dr. will ask prior what meds you are taking as aspirin, warfarin cause prolonged blood clotting times and then you'd have special instructions.

It's a relatively minor surgery so alot of blood loss would not be expected.

Apply direct pressure with gauze and add layers and you should have no problems even if on a blood thinner he would probably tell you not to take it several days prior but direct pressure and gauze should work anyway just take longer to clot.

Of course if you cant get the bleeding to stop with direct pressure you'd have to call and get further instructions.

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Pete R said on 13 November 2012

Perhaps some guidance on what to do if bleeding continues after total avulsion would be helpful?

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