Ingrown Toenail Surgery: Everything You Need to Know

Introduction

An ingrown toenail is a painful condition where the nail grows into the surrounding skin, most often affecting the big toe. While mild cases can be managed at home with warm soaks and careful nail trimming, severe or recurring ingrown toenails may require surgery. Ingrown toenail surgery is a safe and effective procedure that provides long-term relief and prevents repeated infections.

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Why Is Surgery Needed?

Surgery may be recommended if:

• The toenail repeatedly grows into the skin

• There is severe pain, swelling, or pus (infection)

• Home treatments have failed

• The nail is thick, curved, or difficult to trim properly

• The patient has medical conditions like diabetes, which increase infection risk

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Types of Ingrown Toenail Surgery

1. Partial Nail Removal (Wedge Resection)

   • Only the ingrown portion of the nail is removed.

   • The doctor may also remove part of the nail bed to prevent regrowth in that area.

2. Total Nail Removal (Avulsion)

   • The entire toenail is removed if the problem is severe or involves the whole nail.

3. Matrixectomy

   • In addition to removing part or all of the nail, the nail matrix (the base where the nail grows) is destroyed using chemicals (like phenol), laser, or cauterization.

   • This prevents the ingrown portion of the nail from growing back.

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The Procedure: Step by Step

1. Preparation – The toe is cleaned and sterilized.

2. Local Anesthesia – A numbing injection is given at the base of the toe.

3. Nail Removal – The ingrown nail or section is carefully cut and removed.

4. Matrix Treatment (if needed) – The root of the nail is treated to prevent recurrence.

5. Dressing – The wound is cleaned, and a bandage is applied.

The entire procedure usually takes 15–30 minutes and is done on an outpatient basis, meaning you can go home the same day.

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Recovery and Aftercare

• Rest and Elevation: Keep your foot elevated for the first 24 hours to reduce swelling.

• Pain Management: Mild pain can be managed with over-the-counter painkillers.

• Bandage Care: Change dressings as instructed by your doctor.

• Avoid Pressure: Wear open-toed or loose shoes until the toe heals.

• Healing Time: Usually 2–4 weeks for partial removal; longer if the entire nail is removed.

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Risks and Complications

Ingrown toenail surgery is generally safe, but possible risks include:

• Infection at the surgical site

• Regrowth of the nail (if the matrix isn’t fully destroyed)

• Delayed healing in people with diabetes or circulation problems

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Prevention After Surgery

• Trim nails straight across (not rounded).

• Avoid cutting nails too short.

• Wear properly fitting shoes with enough space for toes.

• Keep feet clean and dry.

• Check feet regularly if you have diabetes or circulation issues.

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Conclusion

Ingrown toenail surgery is a simple, effective, and long-lasting solution for painful or recurring ingrown nails. With proper aftercare and preventive measures, most people recover quickly and avoid future problems. If you suffer from frequent or severe ingrown toenails, consulting a doctor about surgical options may be the best step toward lasting relief.