In-growing Toenails (Onychocryptosis) - Fact Sheet

How can I tell if I have an ingrown toenail?

Signs and symptoms vary, here are just some of the many which patients have reported:

• Painful swelling and tenderness at edge of the big toe
• Infection may be present in the form of a small yellow blister (see diagram)
• Weeping (discharge), may be present
• The nail may feel like it is ‘digging’ into the skin

Ingrown toenails need to be treated as soon as they are recognised. If the skin is red, painful, swollen on the sides of the nails, an infection may be present. This occurs because the ingrown nail is in warm, often moist and bacteria rich environment. With the nail in the skin, it provides a convenient entry for germs that can cause infection. At first, the skin around the nail may be only mildly red or inflamed. Untreated, the nail can go under the skin, causing a more severe infection. In either case the ingrown nail needs to be cured. People who attempt to fix the ingrown nail themselves normally only make things worse.

What causes an ingrown toenail?

• Family history of ingrown nails
• Poor choice of shoes, or shoe pressure
• Curved (involuted) nails
• Fungal nail infection
• Tight hosiery around the toes
• Single nail trauma or repeated trauma to the nail via recurrent jamming of the nail into the shoes
• Being born with wider than average nails

Why have nail surgery?

If you have recurring ingrown toenails, you will know the familiar signs of pain. When your toe is really sore you will grab the toenail clippers and try to cut the corner of the nail. Quite often the pain continues. This is because the nail might be ingrown all the way along the side and not just the tip. Nail surgery can be used to correct this problem. Some patients decided to have nail surgery for cosmetic reasons for example the removal of fungally infected nails; some patients can be severely allergic to the drugs, which are used to treat this condition. Other patients want immediate pain relieve, others for correction of previously failed nail surgery.

An ingrown toenail can be a very painful condition and because the fear of surgery many people are put off seeking treatment until the nail has deteriorated to a chronic state. Many ingrown toenails can be treated without the need of nail surgery, although conservative measures may mean that you have to visit a  Podiatrist at regular intervals. If surgery is needed then you will not need to be admitted to hospital. Many ingrown toenails can be removed within the comforts of the Podiatrists clinic.

The procedure is carried out under local anaesthetic, which offers a more convenient solution than going into hospital , there are very few side effects and these are rare. To stop the offending part of the ingrown nail from reoccurring, a chemical (phenol) is applied to the tissue from which the nail grows. This method leaves NO SCARS on the skin and leaves most of the nail in place resulting in a very good cosmetic appearance. Healing is slightly slower by this method, but there is usually less post-operative pain than with other procedures. Surgery usually takes 30-45 minutes and it is painless.  You will be able to walk in and walk out of the surgery!

Before Surgery Two Weeks Later

Can my medical insurance cover this procedure?

Yes, in many instances  medical insurance companies will cover this type of work. Some companies may only pay a portion of the cost of the surgery whilst others will fully reimburse you. You will need to check your policy before agreeing surgery. Please note that Yorkshire Foot Surgery & Biomechanics Clinic will not be held responsible for errors regarding your health insurance claim.