Have a reccurent ingrown toenail and dont know what to do?
Considering ingrown toenail surgery and want to learn more?
Everything about how to treat an ingrown toenail, ingrown toenail surgery recovery and the options available to you. At The Foot Hub, Sydney, we take care of your feet.
Ingrown toenails are a common foot problem we see at The Foot Hub. It is reported that about 20% of people who present to a doctor for advice for a foot problem have an ingrown toenail. The treatment methods vary depending on how advanced the problem is and the individual needs of the patient too, so we’ll always tailor a treatment to you.
For patients whose ingrown toenail issues are long-term and recurring, ingrown toenail surgery is likely to be the best option. When conservative and non-invasive treatments are unsuccessful, surgery removing the nail edge (which doesn’t grow back) can be a better permanent solution to avoid continual discomfort and pain.
If your ingrown toenail problem is not chronic or recurring, visit our ingrown toenail treatment page to see some of the non-permanent options that are available to you.
INGrown toenail surgery is indicated for:
Types of Ingrown Toenail Surgery
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.
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.
Prior to booking in ingrown toenail surgery, patients should have a pre surgery assessment discuss suitability for surgery.
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 post-operative 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 procedure for use with diabetic patients or those suffering from vascular disease. Although there has not been much supporting evidence to suggest there are risk factors, the use of phenol treatments is not advised for pregnant or breastfeeding patients.
It is a quick and simple solution for painful ingrown nails. Once the toe is numbed, there are just four steps to follow.
- Step one – After the toe is numbed, a tourniquet is applied to limit blood flow (for better visibility and phenol efficacy) and the nail edge is cut and split from the nail plate.
- Step two – The cut nail edge is gently removed from the nail fold and any remaining fragments are removed. Extra tissue that has grown over the site will also be removed at this point.
- Step three – The phenol acid is applied to destroy the nail matrix (in three, 20 second applications) and the toenail is flushed with a clean solution.
- Step four – The tourniquet is removed, the toe dressed with an antibiotic ointment and bandaged, and you can go home and relax.
This is a crucial step that is never ignored, ensuring that your ingrown toenail surgery is as comfortable as possible. We know that not everyone is a fan of needles, but our skill and expertise will make the process fast and painless. We do these procedures on a daily basis and know just how to help you relax, and get it right first time.
If you have any anxiety around needles and injections, discuss this with your podiatrist. The Foot Hub also offers local anaesthetic without a needle, using the Comfort Injection Technique. If you prefer this option, make sure to mention this during your pre-surgery assessment.
Don’t like injections?
Don’t worry, we offer needless injection for local anaesthetic.
Comfort-in ™ is a spring-operated needle-free injection system. This system is a type of medical injecting syringe that uses high pressure – it uses the narrow jet of the injected liquid instead of a hypodermic needle to penetrate the epidermis (skin). With this we can deliver needleles local anaesthetic to the toe and be able to perform ingrown toenail treatment.
Don’t let the fear of injections stop you from getting rid of your ingrown toenail.
Download our guide on some steps you can do to overcome needle phobia.
Preparing for your ingrown toenail surgery
So you’ve had your pre-surgery assessment and your surgery date is scheduled – what do you need to do before the day?
Ingrown Toenail Surgery Aftercare
Do you want to make sure you get your nail removal surgery recovery right? When you leave the clinic after your surgery, we will provide you with the dressings to keep your toe clean and healing well, as well as information about how to apply them effectively. We will also schedule a follow-up appointment within 48 hours to ensure a successful post-surgery recovery. You’ll notice the difference in your ingrown toenail before and after surgery
There are some important things to keep in mind after your surgery.
Follow up appointments
You will have a follow-up appointment with your podiatrist after 48 hours, and this is also when you’ll have your first dressing change. Your first dressing will be removed and the toenail will be flushed with saline solution and an antiseptic dressing applied to ensure good healing. You’ll also receive a complimentary pack of dressings as well as clear instructions on how to apply them to avoid toenail fungal infection.
Until your podiatrist discharges you, weekly reviews are necessary to monitor healing and recovery – and it is all part of our inclusive and friendly surgery package. In order to achieve the fastest and most effective healing possible, and avoid post-surgery complications, we ask all our patients to attend each of their planned appointments.
Ingrown Toenail Surgery Recovery
Nail Avulsion surgery has a 98.5 per cent success rate. For The Foot Hub patients who have had ingrown toenail surgery and in the rare case it grows back, we will redo the surgery at no charge.
We can perform ingrown toenail surgery on most patients, and the procedure is quick and safe, however we do not recommend surgery if the following applies to you:
- You are pregnant or breastfeeding
- You have diminished blood supply to your feet (Peripheral Vascular Disease)
- You are allergic to local anaesthetic
- Your toenail is severely infected – we advise a one to two-week course of antibiotics to ensure the surgery is as effective as possible
The most common side-effect of ingrown toenail surgery is pain. With the majority of patients this is mild and can be managed with over-the-counter painkillers like paracetamol.
Post-operative infections can also be present, normally within the first few days after the procedure. These are normally caused by bacteria (Staphylococcus aureus) or fungus (Candida).
On rare occasions the surgery is not as effective as desired and ingrown toenails can re-occur.
Cost Ingrown Toenail Surgery
Ingrown toenail surgery cost is dependent on how many toenails are being operated on. Please see detail pricing below:
One Toe/ Two Sides
Partial Nail Avulsion With Phenolisation
One toe/ One Side
Partial Nail Avulsion With Phenolisation
One Toe/ Entire Nail Plate
Total Nail Avulsion With Phenolisation
Frequently Asked Questions
We recommend you keep your toenail dry for seven days after your operation. After this, you can swim and get it wet, preferably with a waterproof dressing. To prevent infection and to maximise healing, ensure that debris like beach sand is cleaned from the area.
Recovery normally takes between four to six weeks. Walking is possible immediately, and patients can return to work after 48 hours. Our advice is to wear open-toe shoes for seven days after the surgery to promote healing and comfort.
If you are eligible under the Chronic Disease Management plan, you can receive a rebate of $53.80 from Medicare under the Enhanced Primary Care Programme. Only your GP can refer you on this plan and you would need to meet the inclusion criteria.
Yes it does; with private health insurance you can claim for your ingrown toenail surgery. See our relevant pricing table and item codes to be able to accurately communicate with your insurer. Our clinics are registered HICAPS terminals, and can offer on-the-spot rebates. We also accept AfterPay for ingrown toenail surgery too.
Yes absolutely – multiple research studies have proven Partial Nail Avulsion with phenolisation to have a success rate of 98.5 per cent.
Partial Nail Avulsion and phenolisation have lower post-operative pain compared to more aggressive ingrown toenail surgery methods. There may be some post-operative pain once the local anaesthetic wears off, and this should be managed by over-the-counter painkillers like paracetamol.
We suggest you wait two weeks before resuming vigorous physical exercise, to assist in the healing process.
As Partial Nail Avulsion involves removing only a small portion of the nail, most patients will retain a cosmetically satisfactory result. If you have an especially small or delicate nail plate, then extra care will be taken to give the best possible cosmetic result.
Total Nail Avulsion surgery removes the entire toenail, and this procedure normally results in a good appearance with limited scarring.
We recommend you wear open-toe shoes for the first 48 hours. You should also avoid wearing constricting shoes until the nail has fully healed, for the best result.
Although your toe will be numb after the procedure, you can still walk out of the clinic. We recommend that you rest and avoid activity for the rest of that day to minimize pain and ensure good healing.
Although our surgery methods have a 98.5 per cent success rate, there are rare cases where the nail grows back. At The Foot Hub, we are here to look after you, so if this happens after your ingrown toenail surgery, we will re-do the procedure at no extra cost.
From start to finish the whole procedure only takes an hour. If there are more toenails being operated on, the procedure may take longer.
We recommend a minimum of 48 hours off work. Your podiatrist will be able to write a medical certificate if needed.
No. You will be able to walk after your ingrown toenail surgery. We recommend not to drive to and from your surgery. And we also recommend to raise your feet after your surgery.