Ingrown Toenails: Expert Treatment & Advice from a Specialist Podiatrist
What Are Ingrown Toenails?
Ingrown toenails affect up to 5% of people and happen when the nail edge grows into or pierces the surrounding skin. This often causes pain, swelling, and, if left untreated, infection. Common causes include tight or ill-fitting footwear, excessive sweating, improper nail cutting, genetics, and trauma. Treatments vary from simple conservative care to more advanced procedures like partial nail avulsion.
For more detailed information and videos, visit our YouTube channel or read on below!
Conservative Ingrown Toenail Treatment: Nail Spike Removal
In many cases, ingrown toenails can be effectively treated without surgery. The images below demonstrate a conservative treatment where only the painful nail spike is carefully removed under local anaesthetic — a quick, comfortable procedure that provides immediate relief.
The nail spike is gently removed using sterile tools, under local anaesthetic.
After removal, the area is smooth and free from pressure, helping the toe to heal naturally.
Watch: Step-by-Step Removal of an Ingrown Nail Spike
This video shows the real-life conservative treatment of an ingrown toenail caused by a sharp nail spike digging into the skin. The toe has been safely numbed with local anaesthetic, and you’ll see the step-by-step removal process performed in a sterile clinical setting.
This treatment is often suitable for milder ingrown toenails and can provide immediate relief without needing a full nail procedure. If you’re unsure what your toe needs, watching this may help you feel more informed and at ease before your appointment.
Common Symptoms
1. Pain - Discomfort or tenderness along the sides or corners of the nail, often making walking or wearing shoes painful.
2. Swelling - The surrounding skin may become red, swollen and tender.
3. Infection - typical signs of infection are pain, reddening, swelling, increased heat, pus, and malodour.
If you’re experiencing any of the symptoms above, it’s important to have your toe assessed by a podiatrist. In some cases, the issue can be resolved with a simple conservative nail treatment under local anaesthetic, where a small spike of nail is gently removed. However, in more persistent or severe cases, a partial nail avulsion (PNA) procedure may be the most effective solution.
What is a Partial Nail Avulsion?
Partial nail avulsion is the most common surgical treatment for ingrown toenails. After numbing the toe with local anaesthetic, the nail is trimmed along the affected side. A chemical called phenol is often applied to the nail root to prevent regrowth in that area. This results in a permanently narrower nail, reducing the chance of the ingrown nail returning.
Visual Guide: How Partial Nail Avulsion Works
This diagram is from one of our educational videos, where we explain the Partial Nail Avulsion (PNA) procedure using a clear visual walkthrough. It’s ideal if you want to understand what’s involved without seeing the medical procedure itself.
Watch: Talk-Through of the Ingrown Toenail Procedure
In this short explainer video, I walk you through how Partial Nail Avulsion works — using a pen and paper to show what we do during treatment. It’s a helpful, non-clinical overview for anyone nervous about the process or just wanting to learn more before their appointment.
See the Procedure in Action (Viewer Discretion Advised)
If you're curious about what actually happens during a Partial Nail Avulsion, this video shows the real clinical procedure being performed by a qualified podiatrist. It’s filmed in a calm and professional setting and gives you a clear view of each step — from anaesthetic to nail removal and dressing.
Watching this can help reduce anxiety by showing how straightforward and gentle the process really is — but only watch if you feel comfortable doing so.
Ready to Treat Your Ingrown Toenail?
Ingrown Toenails on Smaller Toes
While most ingrown toenails affect the big toes, smaller toes can also be affected. These often require the same targeted treatment. Watch our quick procedure video below to see how we handle a fourth‑toe ingrown nail with confidence and care.
4th Toe Ingrown Nail Treatment
Severe Ingrown Toenails and Hypergranulation Tissue
In severe cases of ingrown toenails, you may develop hypergranulation tissue — a bright red, soft, and easily bleeding tissue that forms as the body reacts to the nail pressing into the skin. This tissue can make the condition more painful and difficult to heal.
Below, you can see an example of a chronic ingrown toenail with severe hypergranulation tissue, shown before treatment, during the procedure, and one month after healing. The treatment involved a partial nail avulsion with phenolisation, combined with removal of the excess hypergranulation tissue to promote proper healing.
What Does a Severe Ingrown Toenail Look Like Before and After Treatment?
These clinical photos show the progression of a severe ingrown toenail with hypergranulation tissue — before treatment, during the procedure, and one month after healing. This helps you understand what to expect if your condition is advanced and requires surgical care.
Understanding the Ingrown Toenail Procedure: What to Expect
Your treatment experience will vary depending on the severity of your ingrown toenail and the procedure required. Here’s a step-by-step overview of what typically happens — from assessment to full recovery.
Step 1: Personalised Assessment and Planning
Your treatment starts with a thorough assessment to confirm the best approach for your ingrown toenail. We’ll discuss all options, explain what to expect before, during, and after treatment, and answer any questions you have.
Step 2: Toe Preparation and Local Anaesthetic
The toe is cleaned thoroughly before we administer a local anaesthetic to both sides. This ensures the entire toe is comfortably numb, so you don’t feel pain during the procedure.
Step 3: A Quick and Precise Procedure
Once numbness is confirmed, the procedure is carried out. It’s usually very quick — most treatments take around 10 minutes or less.
Step 4: Protective Dressing Application
After the procedure, we apply a sterile dressing that fits comfortably inside a running shoe or sandal. We’ll give you full aftercare instructions before you leave.
Step 5: Home Aftercare and Dressing Changes
Keep the dressing on for 24–48 hours, as advised. Then remove it, soak your toe in warm salty water for five minutes, and reapply a clean dressing. Continue this daily routine for about one week, or up to three weeks if phenol (a chemical to stop regrowth) was used.
Step 6: Follow-Up and Monitoring
We’ll see you one week after the procedure to check your progress and rule out infection. Additional reviews are typically done at three weeks and two months to ensure proper healing and long-term success.
How to Prepare for Your Ingrown Toenail Treatment
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Wear suitable footwear: On the day of your procedure, choose roomy sandals or trainers to comfortably accommodate the dressing and avoid pressure on your toe.
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Arrange transport in advance: You shouldn’t drive home after the treatment, as your toe will be numb. Walking long distances may also increase bleeding. Consider booking a taxi or asking a friend or family member to accompany you.
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Remove any nail polish: Please make sure the affected toenail is clean and free of nail polish before your appointment.
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Have pain relief ready at home: Most patients manage well with over-the-counter Paracetamol. Taking a dose before the anaesthetic wears off can help manage pain better.
Frequently Asked Questions About Ingrown Toenail Surgery
1. Do local anaesthetic injections hurt?
Most patients find the injection manageable. It feels similar to a quick pinch or blood test. The slight sting is caused by the anaesthetic’s acidity, which can briefly irritate the tissues. Pain varies by individual, but generally, it’s well tolerated.
2. How long does ingrown toenail surgery take to heal?
Healing time depends on the treatment type. Nail spike removal or partial nail avulsion without phenol usually heals in about 7 days. If phenol is used, healing takes around 3 weeks. Your podiatrist will provide a personalised estimate.
3. How do I care for my ingrown toenail after surgery?
After surgery, you'll usually be advised to soak your toe in warm, salty water for 5 minutes each day, then apply a fresh dressing. Continue this routine until the area looks dry and healed. It's also important to wear wide-fitting shoes or sandals to avoid putting pressure on the toe while it recovers.
4. Can I drive after the procedure?
No. Your toe will be numb, which can affect your ability to drive safely. We recommend arranging a taxi or asking someone to accompany you.
5. Will the procedure be painful?
The procedure is performed under local anaesthetic, so you won’t feel any pain during the treatment. You may feel mild discomfort once the anaesthetic wears off, but most patients manage this easily with Paracetamol.
6. When can I return to work or school?
Many people return the next day, especially if their job or school activities are not physically demanding. However, if your work involves standing, walking, or tight footwear, you may want to take a couple of days off.
7. Will the nail grow back?
If we use phenolisation, the edge of the nail is usually permanently removed, meaning it should not grow back. There is a very small chance of regrowth but this method is the most effective.
8. Can I shower or bathe after the procedure?
You should keep the dressing dry for the first 24–48 hours. After that, you can soak your toe in warm salty water, as advised.