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.

Last reviewed: 19/11/2012

Next review due: 19/11/2014

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Comments are personal views. Any information they give has not been checked and may not be accurate.

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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