What exactly is an ingrown toenail?

If the skin next to the toenail is red, inflamed, and draining, we advise you to be seen within 1 to 2 days for treatment.  In the meantime, soaking in warm water with anti-bacterial soap or epsom salts for 15 minutes several times will help facilitate  drainage of the infection and keep the area clean.  The area should then be covered with a band-aid.

Toenail Surgery.

If the surrounding skin is infected, the portion of the nail plate needs to be removed to resolve the infection.  Antibiotics are typically not necessary unless the patient is severely infected or if the patient is considering surgery to permanently remove the nail border.

There are two types of procedures for an “ingrown” toenail:

Total Nail Removal.

Sometimes a toenail becomes so painful and deformed that the best treatment option is to remove the toenail permanently.  This typically involves a nail that has become so severely infected by fungus, or nail that has suffered irreversible damage from trauma.  The procedure is the same as a matrixectomy, except we remove the entire toenail plate.  After the area has healed, the nail bed that is exposed it not sensative, appears smooth and clean, and most of all is not painful.  For cosmetic purposes, an artificial nail can be applied, or the skin can simply be painted with nail polish.

PreOp

3 months after surgical removal

What type of Recovery is involved?

Recovery involves soaking the toenail in warm water and either epsom salts or antibacterial soap for 20 minutes twice a day.  The nail is then covered with a band aid and neosporin.   MIssing work is usually not necessary and we allow our patients to begin exercising again in 24 to 48 hours.  Please realize that this does vary with each individual patient.

For Runners?

I typically let runners run within 24 hours after a toenail avulsion.  Surprisingly it is less painful after the procedure then before when the nail is ingrown.  The incurvated nail border is like having a foreign body in your toe and you can imagine the relief when it is removed.