Font Size

Ingrown Toenails (cont.)

Surgery for Ingrown Toenails

Patient Comments

If an infection is present, then surgical removal of either part of the nail or the whole nail and drainage of the abscess will be needed. This is performed in the doctor's office or in the emergency department. The extent of the procedure will depend on the severity of the infection, any other medical problems, and if this is a recurring problem.

  • How ingrown toenails are surgically removed
    • A tetanus immunization will be given if it has been longer than five years since the last one. With an ingrown toenail, there is a chance the open wound could develop tetanus.
    • Sometimes a preoperative X-ray will be taken to make sure that the infection hasn't spread to the bone (osteomyelitis).
    • The doctor will inject anesthetic medicine at the point where the toe joins with the foot. This will make the entire toe numb.
    • The doctor will then drain the infection from the end of the toe or remove the extra tissue that has grown around the end of the nail.
    • At this point, the doctor will remove a portion of the nail so that the skin or infection can heal without the nail pushing on it.
    • The doctor may decide to destroy some of the cells that make the nail grow back by applying a chemical (silver nitrate sticks, phenol, or sodium hydroxide) to the skin under the nail. Adding phenol at the end of the procedure decreases recurrence rates but can be associated with increased infections. Some alternative methods of ablating the cells include surgical curettage, laser, electrocautery, or extreme cold. This is performed so that the edge of the nail that caused the problem will not return, which is more likely with severe or recurring infections.
    • For very severe or recurrent cases that have already failed traditional surgery, a complete destruction of the nail matrix can be performed.
    • A lateral matricectomy is a procedure that surgically removes a portion of the nail bed and is usually performed by a specialist. It is considered the usual treatment for chronic or recurrent ingrown nails.
    • There are several newer types of surgery that don't alter the nail bed at all, instead they removes a portion of the soft tissue beside and/or underneath the nail in order to make more room for the nail to grow out. These types of surgery have shown promise but are not yet the standard of care, as they are still being studied. A flexible tube can also be slid along the side of the nail after removal of the extra tissue to help it heal properly.
    • Antibiotics are usually not prescribed for this problem because draining the abscess will take care of the infection.
    • The toe will then be covered with ointment and gauze.
Medically Reviewed by a Doctor on 2/17/2015

Must Read Articles Related to Ingrown Toenails

Abscess An abscess is has several causes and can appear on many parts of the body, such as the dental, vaginal, and rectal areas. In general, home remedies or cures are...learn more >>
Antibiotics Antibiotics are prescribed to individuals to cure disease by killing bacteria. There are over 100 antibiotics. The main classes of antibiotics include penicilli...learn more >>
Chemotherapy Chemotherapy or "chemo" is a treatment for cancer. Depending on the type of cancer an individual has, it can cure cancer, control cancer. or ease cancer symptom...learn more >>

Patient Comments & Reviews

The eMedicineHealth doctors ask about Ingrown Toenails:

Ingrown Toenails - Surgery

Please share your experience with your ingrown toenail surgery.

Ingrown Toenails - Symptoms and Signs

What symptoms and signs did you experience with ingrown toenails?

Ingrown Toenails - Effective Treatment

What treatment has been effective for your ingrown toenails?

Read What Your Physician is Reading on Medscape

Toenail, Ingrown »

Ingrown toenails (unguis incarnatus) are a common toenail problem of uncertain etiology.

Read More on Medscape Reference »

Medical Dictionary