Perth: Fix Your Ingrown Toenail with Surgery – Today!

What is an Ingrown Toenail?

Onychocryptosis, commonly known as an ingrown toenail, occurs when the nail begins to dig into the surrounding skin (known as the Sulci). This condition can be painful and debilitating if left untreated. Ingrown toenails can lead to symptoms such as swelling, redness, heat, and pus, which are signs that an infection has started. Therefore, prompt treatment with Ingrown Toenail Surgery is essential.

Causes of Ingrown Toenails:

1. Damage to the Nail: Trauma, such as dropping something on the toe, can alter the way the nail grows.
2. Incorrect Footwear: Tight or narrow shoes can compress the toes and contribute to ingrown nails.
3. Genetics/Hereditary Factors: Blame your parents.
4. Incorrect Nail Cutting: Blame yourself.
5. Fungal Nail Infection: Left too long can alter the way the nail grows.

Conservative vs. Surgical Treatment:

Conservative Treatment:

• Cutting the Nail Back: Trimming the ingrown edge of the nail.
• Resolution of Infection: Treating any bacterial infection.
• Wound Care: Proper wound management.

Surgical Options:

• Partial Nail Avulsion (PNA) with Phenolisation:

  • Removal of the side of the toenail from the foot.
  • Application of phenol to prevent regrowth.
  • Most commonly recommended and performed.

• Total Nail Avulsion (TNA) Surgery:

  • Rarely recommended.
  • Entire nail removal.
  • Reserved for severe cases (e.g., severe paronychia or fungal infections).

When do I need Ingrown Toenail Surgery?

• Typically if you’ve tried conservative cutting treatment and it’s returned, 
• Unsuccessfully tried antibiotics from your Perth GP (If You don’t already have one – We Recommend Bassendean Family Practice) or;
• Have just left it so long that the skin has taken over the nail – it’s time to cut out the underlying cause with ingrown toenail surgery completed by a qualified Podiatrist. 

Remove Your ingrown toenail today!

Ingrown Toenail Surgery Complications

Just like undergoing any minor procedure there are always risks. When undergoing a partial or total nail surgery there are 3 main risks that you should be aware of:

1. Bleeding – You will bleed and it is less of a risk more of a reminder because you are awake for the procedure.
2. Infection – If for whatever reason the infection doesn’t settle with removal of the ingrown nail antibiotics will be needed.
3. Reoccurrence – If a single or multiple nail matrix cells (the cells that harden into your nail) aren’t removed fully or neutralised by the phenol then a revision surgery may be required.

Ingrown Toenail Allergies to Be Aware Of:

There are 3 main allergies that your Podiatrist needs to be asking you about:

1. Allergy to Local Anaesthetic – we use the same local anaesthetic your dentist uses so if you’ve survived a dental procedure – you’ll find you Podiatric procedure is a toe-tal breeze.
2. Allergy to Tapes – we use hypoallergenic dressings so this is typically not a concern but still important to be aware of.
3. Allergy to Panadol – we recommend paracetamol for pain management because it doesn’t affect your time to clot. Aspirin or ibuprofen can still be used if required – you’ll just tend to take a little longer to stop bleeding.

Ingrown Toenail Surgery Procedure:

1. Numbing the Toe: Local anaesthesia using a digit block.
2. Tourniquet Application: Stops bleeding.
3. Nail Edge Removal: Cut all the way to the nail matrix and lift from the nail plate.
4. Nail Removal: Remove the cut nail and any remaining fragments.
5. Phenol Application: Prevents regrowth by applying phenol to the area.
6. Saline Flush: Neutralises the acid.

How Will My Toe and Remaining Toe Nail Feel After Surgery?

Depending on which surgery you undergo there are 2 main things to expect in the days after surgery:

1. Freedom from Ingrown Toenail Pain!
   1. Immediately After – You will be numb for 1-2hrs (Yay!)
   2. Few Hours After Procedure – You will feel a minor discomfort that Panadol will be enough to manage.
   3. Day After Procedure – Most patients report 0 pain. A small number report 1-3/10 pain which is gone the following day.

1. You have a wound to care for that takes:
   1. 48 hours to form an impenetrable barrier to bacteria – keep covered
   2. 1-2 weeks to stratify and turn into a protective barrier from direct pressure – keep covered.
   3. 6-8 weeks to ‘look normal’ much like a large scab on your skin if you cut yourself

When Can I return to work or sport or normal activity?

The answer largely depends on you. Most adults can return to work straight after the procedure. Most kids like to take the remainder of the day off school (but don’t NEED to). Remember the nail pushing into your skin has been removed so you’ll actually be feeling A LOT better even with direct pressure or in shoes. BUT you will bleed if you irritate and split the wound, so typically I recommend waiting 48 hours before vigorous activity but the only risk is that you will bleed creating a portal for bacteria to infect the new wound.

When Can I Swim or Shower after my surgery?

You can swim or shower after the procedure it’s just recommended to keep the dressing on the toe to prevent bacteria washing down into the new wound. After the showering or swimming – follow normal after-care of washing the toe out with saline solution (read salt water), applying a topical antiseptic and covering with suitable dressings.

What Dressings should I use on my Ingrown Toenail after Surgery?

All the dressings you need after your surgery will be provided – no need to go shopping for special medical-grade dressings or topical antiseptics.

Don’t let an Ingrown toenail slow you down!

Book an appointment with our expert podiatrists today and take the first step towards pain-free steps. Your feet deserve the best care, and we’re here to provide it.