An ingrowing toenail
The vast majority of ingrowing toenails are dealt with by chiropodists and podiatrists. The cause is often unclear but once established the vicious cycle of the nail digging in, then infection with skin swelling which produces more digging-in and therefore further swelling can be a difficult one to break. A skilled chiropodist can achieve this by cleaning and padding the nailfold perhaps supplemented by an appropriate antibiotics. The swelling subsides and the skin can heal. Careful instruction on correct nail clipping and foot hygiene can reduce the chances of recurrence.
When such measures fail, the nail sometimes has to be cut along the edge to prevent pressure on the skin. This so called simple wedge resection has usually already been tried by the time the patient is referred to the Foot and Ankle Clinic. Indeed the patients we see have usually been through several cycles of treatment. Surgical methods involve excision of not only the side of the nail but also permanent removal of the corresponding part of the nailbed and root from which the nail edge is growing. This can be done either by surgical excision (Winograd procedure) or application of a chemical (Phenolisation).