Ingrown Toenail Removal Surgery

Ingrown Toenail Treatment Methods

The treatment for an ingrown toenail depends on the severity of the condition. In mild cases, conservative treatments and home remedies can be helpful to relieve the symptoms. However, in severe cases, medical or surgical treatment may be necessary to resolve the problem effectively. Here are some of the common treatment methods for ingrown toenails: 

• Soaking the Foot: Soaking the affected foot in warm water for 15 to 20 minutes, two to three times a day, can help reduce pain and swelling. Adding Epsom salt or other disinfectants to the water can also help to prevent infection.
• Lifting the Nail: The doctor may use a cotton swab or dental floss to lift the edge of the ingrown toenail and place a small piece of cotton or dental floss under the nail. This can help the nail grow above the skin and relieve the pressure.
• Antibiotics: If there is an infection present, the doctor may prescribe antibiotics to help fight the infection.
• Partial Nail Removal: In more severe cases, the doctor may need to remove the part of the nail that is digging into the skin. This is a minor surgical procedure that can be done under local anesthesia.
• Total Nail Removal: In extreme cases where the ingrown toenail is recurrent or very severe, the entire nail may need to be removed. This procedure is also done under local anesthesia and is usually reserved for chronic or severe cases.

Seeking medical attention as soon as possible can help prevent complications and ensure effective treatment.

Techniques Used for Ingrown Toenail Surgery

Several techniques are used for ingrown toenail surgery, and the choice of technique will depend on the severity of the ingrown toenail. Here are some of the common techniques used for ingrown toenail surgery:

• Partial Nail Avulsion: It is the most common technique used for ingrown toenail removal. This technique involves removing the edge or corner of the toenail that is digging into the skin and the nail bed underneath it. The remaining part of the nail is left intact.
• Total Nail Avulsion: This technique involves removing the entire toenail, including the nail bed underneath it. It is usually reserved for severe cases of ingrown toenails or cases where the condition is recurrent.
• Chemical Matricectomy: In this technique, a chemical, mostly phenol, is used to destroy the nail matrix (the tissue that produces the nail) in the affected area. Phenol is a caustic agent that destroys the matrix cells and prevents the nail from growing back in the exact location. 
• Laser Surgery: Laser surgery can remove the ingrown toenail and cauterize the tissue to prevent regrowth. The laser energy destroys the tissue and seals blood vessels, reducing bleeding and post-operative pain. This technique is not commonly used and is typically reserved for more severe cases.
• Radiofrequency Ablation: This technique uses a special device that delivers a high-frequency electrical current to the affected area, which destroys the tissue and prevents the ingrown toenail from growing back.

The surgeon will choose the safest and most effective technique for ingrown toenail removal. It’s also advisable to understand the risks and benefits of each technique to make an informed decision.

Risks & Complications of Toenail Removal Surgery

Though ingrown toenail removal surgery is not complex, it has the following risks and potential complications – 

• Infection: It is the most common risk of surgical procedures. If the patient fails to keep the wound clean and dry, there will be a higher risk of infection. 
• Bleeding: Mild to moderate bleeding is common in toenail removal surgery and it is typically controlled with pressure or a cauterizing agent. However, in some cases, especially in diabetic patients, there is a risk of excessive bleeding during the procedure. 
• Scarring– Usually, the scarring after toenail removal is minimal, but if the patient’s healing abilities are impaired, the wound may not heal properly, which can cause major scarring on the toe. 
• Numbness or Tingling Sensation– Nerve damage is very common during surgical procedures, including toenail removal. And when the nerves are damaged, the patient may experience numbness or tingling sensation in the toe temporarily or for the long term. 
• Anesthesia Reaction- Some patients may also experience reactions to anesthesia, such as nausea, dizziness, vomiting, disorientation, etc., for a few days. 

It’s important to discuss the risks and potential complications of toenail removal surgery with the doctor before the procedure and to follow their instructions for post-operative care to reduce the risk of complications.

What to Expect After Toenail Removal?

Some common things that the patient should expect after toenail removal surgery include the following- 

• Pain and discomfort for which medications will be prescribed by the doctor. 
• Swelling in and around the treated area for several days. The patient is advised to keep the foot elevated to manage and reduce the swelling. 
• Leg or foot movements will be limited for a while after the surgery. The patient is advised to avoid physical activities and putting weight on foot. 
• Disorientation or nausea are also common to expect after surgical treatment. 

Most of these will resolve on their own in a few days after surgery. The doctor or his/her team will give detailed instructions for post-surgery care and a follow-up schedule to monitor the recovery. 

Recovery After Ingrown Toenail Removal Surgery

The ingrown toenail surgery recovery time can be around 3 weeks to 3 months, depending on the severity of the ingrown toenail and the type of surgery performed. Throughout the recovery period, the patient will have to follow the guidelines below for a smooth and quick recovery – 

• Take the prescribed pain medications as directed by the doctor to manage the pain and discomfort. The doctor will adjust the dosage as the toe heals. 
• Don’t forget to take antibiotics, anti-inflammatory medications, and other medicines to manage the swelling, bruising, and redness in the treated area. 
• The dressing needs to be changed frequently during the initial healing period. Follow the instructions given by the doctor to change the dressings. 
• Also, keep the dressing and wound clean and dry to prevent infections. 
• Avoid putting weight on foot for the first few days after surgery and gradually resume normal activities when the pain becomes manageable. 
• Take proper rest and keep the foot elevated as much as possible in the initial days after surgery. 
• The nail may take several months to regrow, which is normal. Be patient and take proper care of the foot, and maintain hygiene. 
• Take regular follow-ups with the doctor to monitor the healing and look out for early signs of complications, if any. 

In most cases, patients get back to normal activities within a week or so after toenail removal, but others may require longer if the condition is severe. 

Benefits of Ingrown Toenail Treatment

Ingrown Toenail Treatment provides the following benefits- 

• Long-lasting relief from pain and discomfort caused due to ingrown toenails. The surgery removes the cause of the problem, which gives immediate relief. 
• Once the ingrown nail is treated, the risk of developing infection in the affected area will be reduced. 
• Ingrown toenails often impact mobility and the individual’s ability to walk and wear shoes comfortably. Surgery will address these concerns and improve mobility and the patient’s ability to perform normal activities without discomfort. 
• Surgical treatments are known to reduce the chances of recurrent ingrown toenails. 
• As a result of surgery, the patient will become more aware of foot hygiene.

Ingrown Toenail Surgery Cost in India

Generally, the ingrown toenail surgery Cost in India can range from around Rs. 10,000 to Rs. 50,000 or more. The overall cost varies for each patient due to the following factors- 

• The location or city where you are getting treatment
• The choice of hospital or clinic and related expenses 
• Technique used for treatment 
• Severity of the condition
• Doctor/surgeon’s fee 

Other expenses may include pre-operative consultations, diagnostic tests, medications, and post-operative care. These additional expenses can also add to the total cost of the surgery.

Stages of Ingrown Toenails

Stage I- Inflammatory Stage

Mild edema and pain are present at this stage, but the nail fold doesn’t extend over the nail plate. General measures or conservative techniques are used for treatment at this stage. Excision of spicule and partialmatricectomy may be recommended for adults and Type I Diabetes Mellitus. 

Stage II- Abscess Stage 

Pain, edema, erythema, hyperesthesia, and infection are present at this stage. The nail fold extends over the nail plate and measures less than 3 mm. In young patients and in controlled diabetics, this stage is managed by chemical partial matricectomy with phenol. 

If the hypertrophic nail fold extends over the nail plate and measures more than 3 mm, the nail fold and toenail are removed by wedge resection to perform the aesthetic reconstruction. 

Stage III- Hypertrophic Stage 

Chronic hypertrophy is present at this stage, and granulation may also start to occur. The overgrowth on the lateral nail plate is done through the Winograd technique, which involves wedge resection of the toenail and nail fold. 

Stage IV- Distal Hypertrophic Stage 

This is the most severe stage in which chronic toenail deformity is present in both lateral and distal nail folds. The hypertrophic tissue entirely covers the lateral, medial, and distal nail plate. In young patients, wedge resection is done using the Winograd technique. And in adults, total matricectomy with phenol is recommended.