Foot care
Treatment for painful, inflamed and recurring ingrowing toenails.
An ingrowing toenail can start as a small irritation at the side of the nail but can quickly become surprisingly painful.
The surrounding skin may become red, swollen and tender and, in some cases, infected. Even something as simple as wearing shoes, walking or exercising can become uncomfortable.
At Colpod Therapies, we can assess the nail, relieve the immediate problem where possible and discuss how to prevent it from repeatedly returning. Treatment can range from simple nail care through to a minor surgical procedure for more persistent ingrowing toenails.
An ingrowing toenail develops when the edge or a sharp section of the nail presses into or breaks the surrounding skin.
This creates irritation and inflammation and can lead to pain, redness and swelling. Once the skin has been broken, the area can also become infected.
The big toe is most commonly affected, although an ingrowing nail can occur on any toe.
Some people experience a single episode that settles with straightforward treatment. For others, the same edge of the nail repeatedly grows into the skin and becomes an ongoing problem.
There isn’t always one single cause.
Common contributing factors include:
Sometimes it is simply the combination of the shape of the nail and the shape of the toe that makes the problem keep returning.
Early symptoms can include tenderness or sensitivity along one side of the nail.
As the problem progresses you may notice:
You don’t have to wait until the toe becomes severely painful before seeing us.
Treating the problem earlier can sometimes prevent a relatively straightforward ingrowing nail from becoming much more inflamed and difficult to manage.
That depends on the nail and how severe the problem has become.
A mild or first-time ingrowing nail may simply require the troublesome edge or sharp piece of nail to be carefully removed. We can then give you advice about nail cutting and footwear to help prevent it happening again.
If the nail is very painful, infected or repeatedly grows into the same area, simply cutting it back may only provide temporary relief.
In these cases we may recommend nail surgery to permanently remove the troublesome section of nail.
The important thing is that not every ingrowing toenail automatically needs surgery.
We will assess the toe first and discuss the most appropriate option with you.
For less severe ingrowing toenails, surgery may not be necessary.
Your podiatrist can carefully assess the nail and remove the section that is pressing into the surrounding skin where appropriate.
It is important to ensure regular routine maintenance appointments to avoid unessessary discomfort.
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If your ingrowing toenail keeps returning, has become particularly painful or conservative treatment isn’t solving the problem, nail surgery can provide a longer-term solution.
Nail surgery is a relatively straightforward procedure performed under local anaesthetic, so the toe is numb during treatment.
In most cases we don’t need to remove the whole toenail. We can simply remove the small section along the side that is causing the problem.
Local anaesthetic is injected around the base of the toe.
We then wait for the anaesthetic to work and make sure the toe is completely numb before beginning the procedure.
You may feel movement or pressure during the procedure, but you shouldn’t feel the nail being removed.
A small section of nail is carefully separated and removed from the affected side.
This is called a partial nail avulsion.
Removing only the problematic section means that most of your toenail remains in place.
Once the section of nail has been removed, a chemical called phenol is applied to the nail bed.
The aim is to stop that particular section of nail regrowing and causing the same problem again.
Once the procedure is complete, a dressing is applied to protect the area.
The procedure itself usually takes around 30 minutes, although your overall appointment will be longer to allow time for preparation, the local anaesthetic to work and dressing the toe afterwards.
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FAQs
Sometimes a very mild problem may settle if the pressure on the nail is removed.
However, if a sharp section of nail has penetrated the skin, the problem may continue until that section of nail is removed.
If the same edge repeatedly becomes painful, simply waiting for it to settle may result in repeated flare-ups.
No.
Many ingrowing nails can initially be managed by carefully removing the troublesome nail edge and relieving pressure on the surrounding skin.
We generally consider surgery when the problem repeatedly returns, conservative treatment hasn’t worked or the nail is causing significant ongoing problems.
The part most people are understandably concerned about is the local anaesthetic injection.
This can sting briefly while it is being given.
Once the anaesthetic has worked, the toe should be numb before we start the procedure. We will check this before proceeding.
Usually not.
For a typical ingrowing toenail, we can often remove only a narrow section from the troublesome side.
Occasionally removing the whole nail is more appropriate, particularly if it is very thick, damaged or causing problems on both sides.
An inflamed ingrowing toenail can sometimes produce discharge or pus.
Removing the section of nail that is penetrating the skin is often an important part of resolving the underlying problem.
Your podiatrist will assess the toe and advise you if additional medical treatment is required.
Not every red or inflamed ingrowing toenail requires antibiotics.
Often the nail itself is continually irritating the skin, so dealing with the offending nail edge is important.
If we are concerned about infection or think you require additional medical treatment, we will discuss this with you.
We recommend arranging for somebody else to take you home following the procedure.
The local anaesthetic can leave part of your foot numb for several hours and the initial dressing can also be relatively bulky.
This depends on your job.
Someone working from home or in a mainly seated role may need very little time away. If you spend all day standing, wear safety footwear or have a physically demanding job, you may need to make some temporary adjustments.
We can discuss this with you before your surgery.
Walking and normal daily activities can usually be gradually resumed as comfort allows.
We recommend being more cautious with running, football, hiking and other activities that repeatedly load or knock the toe while it is healing.
Your podiatrist can advise you when it is appropriate to return to your particular activity.
Some mild cases may settle, but a nail that continues to penetrate the skin can become increasingly painful and inflamed.
You may develop swelling, bleeding, discharge or excess tissue around the nail.
If the problem is repeatedly returning, it’s worth having it assessed rather than continually trying to cut the corner out yourself.
Yes. Ingrowing toenails are common in younger people as well as adults.
We can assess the nail and discuss conservative treatment or nail surgery depending on the severity of the problem.
