I am concerned about treatment of an in-growing toenail

What treatment is available?

Non-surgical treatment is always tried first. A short course of antibiotics may be needed to control infection and swelling. The advice of a chiropodist or podiatrist should be sought on the correct technique of cutting toenails and they can also advise on attempting to encourage the nail to grow away from the skin edge. If symptoms are not cured in this way, it may be necessary to consider surgery.

There are a number of surgical procedures used to treat in-growing toenails:

Wedge Resection

This involves removing the edge of the nail that is causing the symptoms. The base of the nail bed is destroyed with a combination of surgical removal and the use of a substance called Phenol. It is sometimes necessary to remove both sides of the nail, resulting in a narrower nail. Occasionally, despite a wedge resection, the in-growing toenail can recur (there is a 20% chance of recurrence). If this happens, a nail ablation (removal) may be necessary.

Nail removal

If recurrent in-growing toenails are a problem, and if wedge resection has failed to cure the symptoms, then it may be necessary to completely remove the nail and prevent its re-growth. This is known as nail ablation and will usually cure the problem. Surgery itself is relatively straight-forward and can be carried out as a day case, often under local anaesthetic. Dressings will be changed regularly post-operatively until the wounds have healed. Despite the ablation there remains a small risk of recurrence of the problem. False nails can be worn if the whole nail is removed.

What are the complications of in-growing toenail surgery?

As with all surgery, there is a risk of infection. This is common with this type of surgery, as the surgical site is often infected as a result of the in-growing nail. Dressings will be changed regularly in the post-operative period and it may be necessary to have a short course of antibiotics to settle any infection. It can take a few weeks for the surgery to fully heal. In-growing toenail surgery carries a risk of recurrence. Should this occur, it may be necessary to re-operate with a more invasive procedure.