Last updated: April 2023
Next review: April 2025

In-growing toenails occur when the nail digs into the skin. They can cause pain, difficulty walking or wearing shoes, and there is also an infection risk.

Nail surgery is a surgical procedure using local anaesthetic (an injection into your toe to numb it) to resolve in-growing or painful nails, and therefore carries the same risks as any other surgery.

This leaflet will attempt to answer all of your questions however, please feel free to ask the podiatrist about any other concerns you may have.

Nail surgery

• The podiatrist has discussed nail surgery with you. This leaflet is to remind you of the main points.
• Nail surgery is a simple routine procedure carried out under local anaesthetic.
• It is mainly used to treat painful in-growing toenails, curved nails or nails that are thick. You may see a different podiatrist to the one you see at your clinic.

Possible Risks/Things to Consider

• There is a chance the nail may regrow. This regrowth is often not problematic but, in the few cases that regrow, the procedure can be repeated if needed.
• The toe may get infected, and you may require antibiotics from a doctor.
• Post-operative bleeding – it is important that you rest the foot and keep it elevated after the surgery.
• The appearance of the remaining nail may be altered.
• You may have an allergic reaction to the anaesthetic (anaphylaxis) which is extremely rare.

Comments, Concerns or Complaints?

You can contact us via telephone on 0300 124 5855

Email: sirona.podiatryadvice@nhs.net

Possible complications

With any surgical procedure there may be complications, which you should be aware of with nail surgery, which might include:

• Re-growth: For a small percentage of patients the operation may not be successful and further treatment may be necessary.
• Infection: Very occasionally the toe may become infected after surgery and may require antibiotic treatment. Your podiatrist will advise you if necessary.
• Pain: There may be slight residual pain after the toe has healed, especially if tight shoes are worn.
• Loss of sensation: There may be prolonged numbness after the surgery, which usually resolves over time.
• Nail Deformity: For a small percentage of patients there can be some damage to the remaining nail after surgery.
• Skin Burns: There is a small risk of burning to the surrounding skin, from the introduction of the chemical used for cauterisation.

What does it involve?

• You will be given an injection of local anaesthetic. This will prevent any pain in the toe.
• The whole nail or the part of the nail that is causing the problem will then be removed and a chemical applied to the nail bed. This should prevent the nail from growing back.
• A bulky dressing will then be applied to your toe. Sandals, flip-flops, or slippers are the best footwear after surgery. You will be seen within 48 hours for a re-dressing.
• The toe will take between six and 12 weeks to heal. During this time, it will be necessary for you to change the dressings as advised by your podiatrist. You will be provided with dressings for the first week only.
• The anaesthetic will gradually wear off after a few hours. You may experience some pain or throbbing. Pain killers can be taken for this. Do not use aspirin or brufen based pain killers as they can prolong the bleeding.
• You will need to organise a lift home after surgery as you will not safely be able to drive your car. Your car insurance will also be invalid as your toe/s will be numb.
• Once you are home we advise you to rest with your foot up for a minimum of two to three hours.
• The following day you will be able to walk and drive but you should relax as much as possible.
• Prolonged standing or walking may cause your toe to be more painful, but generally you will be well enough to go back to school or work the next day.
• For children under 16 years old a consent form must be signed by the parent or legal guardian before the surgery can be done.
• It is very important that you eat prior to your nail surgery. You may also like to bring a drink with you.
• Take your medication as prescribed unless advised otherwise.

Aftercare

You will be given:

• One further follow-up appointment to instruct you on how to look after your toe.
• Regular salt foot-baths and applying a new clean dressing.
• A small kit containing one week worth of dressings. When these dressings run out you will have to purchase the items you require.
• If you do not normally access the Podiatry service for foot care, you will have an open appointment for 6 months following your surgery.  After this time you will be discharged from the service.
• It is advisable to refrain from high impact or contact sports or swimming, but you will probably be able to return to most normal activity the day after your first redressing appointment.