Understanding Nail Surgery: Your Guide to Ingrown Toenail Procedures

Jane Gillingham

At both of our New Forest foot clinics we have carried out more nail surgery procedures in the last 2 years, than any other year. There is a wait for referral to the NHS at the present time, but we are here to help you.

What Is Nail Surgery?

This is a term that covers a variety of procedures that our podiatrists carry out under local anaesthetic to remove painful problem nails. We can do a medial or lateral partial nail avulsion (removal of one side) and bilateral partial nail avulsion (removal of both sides of the nail) or a total nail avulsion (removal of the whole nail plate). A product called phenol is then applied (3 timed applications of 1 minute) to the nail bed which is a chemical cauterisation of the nail bed) to prevent the problematic nail portions from re-growing.

What Causes and Ingrowing Toenail?

Unfortunately, some people are simply unlucky and a very curved (involuted) nail shape runs in their family and often, talking to patients during their assessment, they have family members who have also undergone the procedure. Trauma from sport e.g. rugby, football or other sports can damage the nails, stubbing the toe and having the toe trodden on by a cow, horse or human being will not help. Ill-fitting footwear can also be a contributory factor.

What Can I Do?

Firstly, bathe the foot in warm water with a tablespoon of salt dissolved in it for about 5 minutes. Towel dry the foot with a towel that has not been used on any part of the body and then apply a clean dry plaster. Repeat this daily. If you have a shower - leave the plaster on and then carry out the re-dressing afterwards. Why? Because all the dirt from the top of your head lands on your feet. If you have an Ingrown Toenail it can become infected if the nail has pierced the skin and created a portal for infection. Then phone your Podiatrist!

How Quickly Will I Be Seen?

We will always prioritise an ingrowing, infected toenail. Ideally, if you can email us a photograph of your toe - we can give you the best advice. If antibiotics are needed - we will discuss this with you and we can arrange this for you.

What If I Need Surgery?

We will always prioritise surgery. If a patient requires ingrown toenail surgery, then we will aim to book the surgery in within 1-2 weeks of the assessment and patient wishing to book. If a foot infection is present, it is often necessary for the patient to have a weeks’ worth of antibiotics and active infection can delay - or even prevent a local anaesthetic from taking effect.


As with any procedure involving an anaesthetic - an initial consultation is always required and you will be provided with all the information you need when considering surgery. Patients cannot drive themselves to / from surgery on the day of the procedure as a numb toe will certainly invalidate your car insurance! Open-toed shoes are a must - as there is a significant dressing applied post procedure.

As part of the nail surgery package, we see our patients 24 hours, 2, 4 & 6 weeks postoperatively.

Are you suffering from painful nail problems? Don’t delay – click here to book your assessment today or call us on 02380 814903.