Your Podiatrist should be the first point of contact when it comes to a painful ingrown toenail. On a daily basis, Podiatrists manage many ingrown toenails. It is unfortunate that some painful ingrown nails presenting to the clinic have been through a variety of different treatments and multiple antibiotic courses with hardly any relief. If the nail remains to pierce through the skin, antibiotics will be ineffective. We can either gently trim the nail away, or can numb the toe and remove the problematic edge on the day of your treatment – no fuss!!
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What is an ingrown toenail?
By definition an ingrown toenail is a nail that has pierced through the skin. It is often highly painful due to the sharp edge of the toenail pushing through the soft skin on the sides of the nail. Infection is often present and you may notice redness, pus discharge, swelling and bulging tissue on the side of the nail. Please see your Doctor IMMEDIATELY should you notice redness tracking away from your toe.
What are some causes of ingrown nails?
- Poor nail trimming techniques
- History of ingrown toenails
- Curled or pincer nails
- Thick toenails
- Genetics (curved nails, fan shaped nails)
- Smoking
- Tight fitting footwear
- Pointed toed shoes
- Trauma to the nail plate or nail fold
Treatment options
Your Podiatrist will assess the toe and let you know what is the best method of treatment.
If the nail is minimally infected and can be managed through a gentle clearing of the nail edge they will perform this immediately.
If the nail is more advanced with infection or pain is preventing clearing the nail edge, a local anaesthetic will be used to numb the toe, and the problematic edge will be gently trimmed away. To avoid future incidences of the nail ingrowing, your Podiatrist will use a chemical which will destroy the problematic nail edge to cease it from growing again. After this, your nail will grow back normally just without that pesky ingrown edge! This is an in clinic procedure and is usually completed in less than an hour. It does not involve stitches or deep cuts into the skin which results in fast healing.
Read more about ingrown toenails here.
Ingrown Toenail Surgery Is Indicated For:
- Chronic ingrown toenail
- Recurring ingrown toenail despite frequent conservative care
- Ingrown toenails that are negatively impacting your lifestyle, causing significant pain and footwear use problems
Is Nail Surgery An Option For My Ingrowing Toenails?
Types Of Ingrown Nail Surgeries:
During your pre-surgery assessment, your podiatrist will explain the different surgery options, and work out the best plan for your ingrown toenail removal as there are various options available. Both of these surgical procedures will be performed under local anaesthetic.
Partial Nail Avulsion
PNA surgery permanently removes the side of the nail that is causing damage to the skin. It is a quick and routine procedure, normally used in simple cases of ingrown toenails that can’t be resolved with conservative treatments. It’s also preferred by podiatrists as the majority of the nail can be left attached.
Benefits:
- A quick procedure – just 45 to 60 minutes
- A normal-looking nail is left after healing
- 90% success rate
- Fixes the issue permanently
- A quick recovery time
Total Nail Avulsion
TNA surgery permanently removes the entire nail, normally carried out only when a severely damaged or thickened toenail causes recurring problems that the more simple PNA surgery will not fix. This is not the preferred treatment, but in rare cases it can be necessary to avoid future problems.
Benefits:
- A permanent solution for the nail, which won’t grow back
- 90% success rate
- A simple and quick procedure – just 45 to 60 minutes
- Rapid recovery rates
What is Phenolisation?
Partial Nail Avulsion with phenolisation is the most common solution for ingrown toenails. Safe, simple and effective, it uses phenol (a mild acid) to destroy the nail matrix, with low levels of postoperative pain and infection. With a high success rate (98.5 per cent) and a natural-looking nail, this is the preferred treatment for the majority of our patients.
The liquid phenol is applied to the problem area for at least one minute, allowing the mild acid to destroy the nail matrix and remove the cause of the pain and discomfort. Phenol is safe and approved for use by the Therapeutic Goods Administration (TGA) in Australia.
It’s a safe surgical procedure for use with diabetic patients or those suffering from vascular disease.
Please chat to your Podiatrist further about this option for advice specific to your situation.
Why persevere with pain? Get your ingrown nail fixed today!
