Ingrown toenail surgery at The Montefiore Hospital

An ingrown toenail can make every step you take a difficult one. It is caused by the nail growing into the surrounding skin and the big toe is often affected with the nail curling and piercing the skin which becomes red, swollen and tender.

Various things can cause an ingrown toenail, including:

• badly cut toenails which can encourage the skin to fold over your nail and the nail to grow into the skin
• wearing tight-fitting shoes, socks or tights
• sweaty feet
• injury, such as stubbing your toe
• the natural shape of the nail
• a fungal nail infection that makes the toenail thicken or widen.

Symptoms include:

• pain if pressure is placed on the toe
• inflammation of the skin at the end of the toe
• a build-up of fluid in the area surrounding the toe
• an overgrowth of skin around the affected toe
• bleeding
• white or yellow pus coming from the affected area.

Sometimes the problem can be solved by washing your feet regularly, changing your socks regularly, cutting your toenails straight across to stop them digging into the surrounding skin, gently pushing the skin away from the nail using a cotton bud.

However, in some cases surgery is the only solution.

During the operation all or part of the nail is carefully removed and the nail will grow back. Sometimes the underlying nail bed needs to be removed, however, this means the nail will not grow back. It is usually performed as a day-case procedure using local anaesthesia so although you won’t feel anything, you will be awake. Very rarely, the operation is done under general anaesthesia so you will be asleep throughout the procedure and feel no pain.

If you decide to have your procedure with us, you will be looked after by an experienced multi-disciplinary care team.

Our patients are at the heart of what we do and we want you to be in control of your care. To us, that means you can choose the consultant you want to see, and when you want. They'll be with you every step of the way.

All of our consultants are of the highest calibre and benefit from working in our modern, well-equipped hospitals or clinics.

Our consultants have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-specialty surgeries. Many of our consultants have international reputations for their research in their specialised field.

You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.

We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.

We've tried to make your experience with us as easy and relaxed as possible.

For more information on visiting hours, our food, what to pack if you're staying with us, parking and all those other important practicalities, please visit our patient information pages.

Our dedicated team will also give you tailored advice to follow in the run up to your visit.

We understand that having surgery can often be a time of anxiety and worry, but our experienced and caring medical staff will be there for you, holding your hand, every step of the way.

After a local anaesthetic has been given, your surgeon will use the most suitable technique to remove the nail depending on how ingrown it is, whether one or both sides are affected and whether there’s an infection.

Sometimes your surgeon will remove the whole nail or he/she might remove only the small wedge of nail growing into your skin – this is the most common approach. Folds of skin alongside the nail may also be cut away.

Once the nail has been removed, an antibiotic ointment is usually applied to the operated area and the toe is dressed with bandages.

If this is a recurring problem, your surgeon will apply a chemical called phenol after the operation to help stop the problem recurring.

If your nail is infected, a course of antibiotics may be prescribed and any pus will be drained away. Your foot will then be wrapped in a bandage.

This procedure is carried out as a day case so you can expect to go home the same day. After the operation, your toe will be sore but this should ease after a few days and we will give you pain relief medication. Wearing soft or open-toed shoes for the first few days will also help.

Your new nail will be an odd shape and colour and will probably look different to your other toenails.

If your nail bed is treated with phenol, you might develop inflammation inside your toe causing your foot to swell. This is rare. We will give you anti-inflammatory drugs for the swelling and provide you with a 14 day supply of all the medicines your consultant feels you need to take home with you after you've been discharged.

Recovery time

When we discharge you we'll talk to you about whether your dressings need to be removed and we’ll make an appointment to see your consultant again.

You should rest your foot and keep it raised for one to two days after the operation.

You will probably be able to return to your job in a couple of days. Your surgeon will give you advice about when you can return to work, as this will depend on the job that you do. You may not be able to wear hard-toed shoes for a week or two.

To help prevent the problem from coming back, wear shoes that fit properly and remember to change your socks (or tights) every day.

How your loved ones can help

Once you’re ready to be discharged, you’ll need to arrange a taxi, friend or family member to take you home as you won’t be able to drive. You should also ask them if they can run some light errands such as shopping for you as you won’t be feeling up to it for a few days.

Looking after you

Even once you’ve left our hospital or clinic, we’re still here for you.

On rare occasions, complications following ingrown toenail surgery can occur. You may experience any of these symptoms:

• gets more painful after a few days
• looks red, inflamed or swollen
• smells unpleasant
• leaks pus

Your consultant will talk to you about the possible risks and complications of having this procedure and how they apply to you.

If you have any questions or concerns we’re ready to help.

We are committed to delivering excellent individual care and customer service across our network of hospitals, clinics and specialist care centres around the UK. Our dedicated and highly trained team aim to achieve consistently excellent results. For us it's more than just treating patients, it's about looking after people.

Important to note

The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.

Procedures carried out at Spire Healthcare Clinics will be performed under local anaesthetic.