Ingrown Toenail

when to see a doctor

See your health care provider if you:

• Experience severe discomfort in a toe, pus or inflamed skin that seems to be spreading

• Have diabetes or another condition that causes poor blood flow to the foot

causes

Causes of ingrown toenails include:

• Wearing shoes that crowd the toenails

• Cutting toenails too short or not straight across

• Injuring a toenail

• Having very curved toenails

• Nail infections

• Diabetes

• Hyperhidrosis xs sweating

risk factors

Factors that increase your risk of ingrown toenails include:

• Being an adolescent, when feet tend to perspire more, which softens the nail and skin

• Having nail care habits that encourage the nail to grow into the skin, such as cutting the nails too short or rounding the corners

• Having a reduced ability to care for your nails

• Wearing shoes that constrict the toes

• Participating in activities, such as running and kicking, that put your toes at risk of injury

• Having a condition, such as diabetes, that causes poor blood flow

complications

Complications can be especially severe if you have diabetes, which can cause poor blood flow and damaged nerves in the feet. So a minor foot injury — a cut, scrape, corn, callus or ingrown toenail — may not heal properly and become infected.

surgery preparation

So you’ve had your pre-surgery assessment and your surgery date is scheduled – what do you need to do before the day?

• Arrange for someone to drop you off, or book a taxi

• Take enough time off work – we recommend a period of 48 hours of limited weight-bearing after the surgery

• We advise the use of open-toe shoes for a week after the procedure

• If your job requires safety footwear then this period can be reduced to 48 hours

• Have a meal before your surgery

• Bring open-toe shoes to wear after the procedure

• Mention all known medical allergies during your assessment

• Provide an emergency contact to the clinic

• Stay off YouTube! If you need more information or have questions, simply ask Dr. Morison

surgery aftercare

When you leave the clinic after your surgery, we will provide you with the dressings to keep your toe clean and healing well and information about how to apply them effectively. We will also schedule a follow-up appointment within 48 hours to ensure a successful post-surgery recovery. You’ll notice the difference in your ingrown toenail before and after surgery. There are some important things to keep in mind after your surgery:

• You won’t be able to drive home, so book a taxi or ask someone to take you, driving with the local anaesthetic still active is not advisable

• We will apply the first dressing, however, it’s quite normal that some bleeding can become visible after the procedure

• Leave the dressing intact and apply another over the first, then rest and elevate your foot above hip-height

• Keep the toe dry and clean until your first dressing-change appointment

• That first dressing will be quite bulky, so make sure you wear open-toe shoes that can accommodate a little extra

• Sometimes patients experience a little pain and discomfort after the local anesthetic wears off so you can take paracetamol for the pain

• If the pain is severe, please contact the clinic immediately

• Attend your free follow-up appointments until your podiatrist discharges you

• Avoid wearing tight-fitting shoes that put pressure on the toe

• Avoid weight-bearing and strenuous activity (including the gym and weight-lifting) for two weeks after your surgery

surgery recovery

• Nail avulsion surgery has a 98.5 per cent success rate, but in the rare case that the surgery is unsuccessful, we will organise to re-do the procedure at no extra cost to you.

• Depending on your medical history and whether there is an infection due to the ingrown toenail, healing can vary from person to person.

• Most patients can return to work after 48 hours of rest, especially if they take all the advised post-surgery steps.

• Full healing of the surgical site can take between two to six weeks, and in some cases longer. The most common post-surgery complication is infection, especially if there was an infection present before the procedure. We will help you treat any infection with oral antibiotics.

• We work to give our patients the best cosmetic outcome possible, particularly in the case of partial nail avulsion surgery (where a small section of the nail is removed). For larger toes, the change in size and shape is unlikely to be very noticeable, although smaller nail plates may be more affected. If you have concerns about how your toe will look post-operation, talk to your podiatrist about this during your pre-surgery assessment.

contradictions

Dr. Morison can perform ingrown toenail surgery on most patients, and the procedure is quick and safe, however, we do not recommend surgery if the following applies to you:

• You are pregnant or breastfeeding

• You have diminished blood supply to your feet (Peripheral Vascular Disease)

• You are allergic to local anaesthetic

• Your toenail is severely infected – we advise a one to two-week course of antibiotics to ensure the surgery is as effective as possible

side effects

• The most common side-effect of ingrown toenail surgery is pain. With the majority of patients this is mild and can be managed with over-the-counter painkillers like paracetamol.

• Post-operative infections can also be present, normally within the first few days after the procedure. These are normally caused by bacteria (Staphylococcus aureus) or fungus (Candida).

• On rare occasions the surgery is not as effective as desired and ingrown toenails can re-occur.