Ingrown Toenail Removal
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Ingrown Toenail Removal

(Removal, Ingrown Toenail)

En Español (Spanish Version)

Definition

This is surgery to remove a toenail that has curled and grown into the skin, causing pain.

Ingrown Nail

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Parts of the Body Involved

Toe and toenail, usually the big toe

Reasons for Procedure

The entire nail or only a portion of the nail growing into the skin may be removed. It is most often done to:

  • Relieve pain
  • Relieve swelling (inflammation or infection)
  • Remove a deformed nail
  • Correct abnormal nail growth

Risk Factors for Complications During the Procedure

What to Expect

Prior to Procedure

Your doctor will likely:

  • Examine of the area
  • Try other measures before surgery

The day of your procedure:

  • Wear comfortable clothing and loose-fitting shoes.
  • Arrange for a ride home.

Anesthesia

Local anesthesia

Description of the Procedure

A local anesthetic is used to numb the area, usually the whole toe. The doctor will pull the nail up and cut along the edge that is growing into the skin. A chemical may be used to prevent the nail from growing back in the same area.

During total nail removal, the doctor eliminates the nail, nail bed, and nearby tissue. Stitches are used to close the area. In some cases, your doctor may use a laser to destroy the tissue or a chemical to kill the nail's growth cells.

How Long Will It Take?

Less than 1 hour

Will It Hurt?

Because of the anesthesia, you won't feel pain during the procedure. But, it is painful when the anesthetic is injected. This is because of the tight skin and many nerve endings on your toes. Your doctor may first spray with a topical anesthetic to reduce pain.

Possible Complications

  • Infection
  • Excessive swelling or bleeding

Average Hospital Stay

None

Postoperative Care

  • Do not put weight on the affected toe.
  • If needed, take pain medication.
  • During the first day, keep your foot elevated.
  • Soak your toe in warm water for 10-20 minutes, 2-3 times a day for one week. This will decrease pain and swelling.
  • Keep a clean, dry dressing over the toe.
  • Wash your hands before caring for the nail area or changing the dressing.
  • Wear white, cotton socks and loose fitting shoes for about two weeks.
  • Do not run or engage in strenuous activities until your doctor says you can (usually two weeks).

If your toe is infected:

  • Use the prescribed antibiotic cream or ointment to treat the infection.
  • Do not touch the antibiotic with your finger. Instead, put a small dab of the cream on a clean dressing and use that to touch your toe.
  • For severe infections, you may need to take an antibiotic by mouth. If so, take all of the pills. Do not stop the medication, even if the toe looks better.

To avoid future ingrown nails:

  • Do not wear high heels or shoes that fit poorly.
  • Trim your toenails straight across. Do not pick or tear at them.
  • If you have diabetes, foot care is important. Let a doctor trim your nails and routinely examine your feet.

Outcome

If needed, stitches are usually removed in about 10 days. Complete healing takes about 2-3 weeks, but does not interfere with most activities.

If the entire nail was removed, your body will generate a hard skin in its place. After the skin has covered the sensitive area, you can resume normal activities.

Call Your Doctor If Any of the Following Occurs

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Chalky white, blue, or black appearance to skin of toes or foot—Call for help right away.

RESOURCES:

Family Doctor.org
http://familydoctor.org/

Foot Physicians
http://www.footphysicians.com/

CANADIAN RESOURCES:

Nurses Entrepreneurial Foot Care Association of Canada
http://www.nefca.ca/news.php

Podiatrists in Canada
http://www.footdoctors.ca/

References:

Ingrown toenail removal. Healthfinder website. Available at: http://www.healthfinder.gov/hg/files/?id=14825 . Accessed October 14, 2005.

Ingrown toenails. American College of Foot and Ankle Surgeons website. Available at: http://www.footphysicians.com . Updated March 2008. Accessed June 10, 2008.

Ingrown toenails. Family Doctor.org website. Available at: http://familydoctor.org/online/famdocen/home/common/skin/disorders/208.html . Updated May 2007. Accessed June 10, 2008.

Roberts JR, Hedges JR, Custalow C. Clinical Procedures in Emergency Medicine. 4th ed. Philadelphia, PA: Elsevier Health Sciences. 2004; chap 52.



Last reviewed December 2007 by John C. Keel, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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