What is an ingrown toenail?
An ingrown toenail is a common condition that causes a great deal of pain, distress and even disability. It occurs when the toe nail pierces the skin of the toe resulting in pain, swelling, redness and infection. It is most common in the big toes, but it can also affect the smaller toes. Ingrown toenails can present in a variety of ways. For example, in the early stages, there may be a little pain, redness and swelling. As the condition becomes more persistent, there can be chronic infection and the formation of excess skin called hyper-granulation tissue.
How do ingrown toenails occur?
The condition can be caused by a combination of many factors. An ingrowing toenail can occur as a result of normal nail that has been cut incorrectly, by wearing socks or shoes that are too tight or through damaging the nail. It can also occur in people with an abnormal nail shape. In this case, increased pressure on the nail leads to curvature, which causes it to dig in. This most often happens in adults.
How are ingrown toenails treated?
Where possible, we try and treat the problem with conservative measures. However, more persistent ingrowing toenails may return in time and require further treatment. Where the nail consistently in-grows and becomes painful, a more permanent treatment may be required.
Where conservative treatment has failed or isn’t appropriate, nail surgery is a safe, simple and effective procedure that can cure your painful ingrown toenail. This will allow you to walk pain free, wear the shoes you want to wear and to take part in the activities .In our centre we perform less invasive technique known as a wedge excision.
What are the benefits of nail surgery?
Are there any complications of nail surgery?
Like any procedure, there are some risks. Complications are very rare, and every care is taken to minimise them. These can include regrowth of the nail, wound infection, delayed wound healing, bone infection, post- operative pain and rarely people have an allergic reaction with the product used, specially with phenol.
The anaesthetic used is very safe but very rarely people have an allergic reaction with the local anaesthesia, please let our doctor know if you are allergy with any products or anaesthesia.
Significant post-operative bleeding is uncommon, however there can sometimes be signs of strikethrough bleeding though the dressing. It can also be helpful to elevate your legs and put your feet up to reduce any further bleeding.
There is a small risk of infection as, by removing the nail, we create a small wound.
The condition of your toe after surgery will be closely monitored, Even with the chemical removal of the nail bed, there is a small chance that the nail could regrow . Your doctor will apply the (chemical phenol) for the recommended exposure time to prevent regrowth while also being mindful of phenol burns and reducing any unnecessary damage to the surrounding skin.
Should I have a partial or total removal?
Whether you have the whole nail removed or just part of the nail depends on the extent of the ingrown nail. This can be discussed with the doctor and you will be advised which is likely to be more successful for your circumstances. A partial nail removal is more cosmetically appealing for most people.
How much does it cost?
The cost of nail surgery starts at £300 for one nail and £495 for 2 nails.
On the day of your Surgery
Our doctor will do the clinical assessment and talk you through the nail surgery procedure, discussing the intended benefits, outcomes, potential risks or complications.
You will be also given a consent form to read, understand and sign is a very important component. We ensure you have all the information you need and fully comprehend the purpose of the nail surgery, before you sign the consent form.
We will ensure you fully understand the benefits and risks of the nail surgery and are happy to proceed and make sure that any questions you have are answered.
You could also bring a friend or family member into the room if you wish.
Firstly, the doctor will clean the area with antiseptic and the local anaesthetic will be administered to numb the affected toe, a tight band will be placed around your toe to minimise any bleeding. Next an antiseptic solution will be applied to your toe to minimise the chance of infection, adhesive film will be applied and the offending nail/piece of nail will be removed. To stop the nail from re-growing the chemical phenol will then be applied.
A protective dressing will be applied, and the operation is complete. The whole thing is over and done with from start to finish in around 45 minutes.
You will be advised about the analgesia if required and a follow up appointment will be arranged with you so that the doctor can assess and re-dress the toe.
It is recommended following surgery that you go home and put your feet up, to minimise bleeding. It is also important that you do not drive until the local anaesthetic has fully worn off.
It usually takes around 4-8 weeks for the toe to heal completely. This varies between individuals, but it is important that you continue to clean and redress the toe until it is completely healed. The toe will need to be re-dressed every 2-3 days, and must be kept dry between times.