Is There A Surgery To Permanently Remove Ingrown Toenails

Ingrown toenails are a common yet painful condition affecting people of all ages. When left untreated, they may cause discomfort, infections, or even difficulty walking. While conservative treatments may provide temporary relief, many wonder: Is there surgery to permanently remove ingrown toenails?

This article explores this question, exploring various treatment options, their effectiveness, and when surgery becomes necessary.

Short Answer: Yes

Yes, surgical procedures are available to permanently remove ingrown toenails. Treatments like Partial Nail Avulsion (PNA), Matrixectomy, and Laser Surgery are designed to address the root cause and prevent the toenail from regrowing improperly. 

These procedures are highly effective, especially for chronic or severe cases, and they provide a long-term solution to this painful condition.

Types Of Surgery For Ingrown Toenails

Ingrown toenails are common and often painful. When conservative treatments fail, they can require surgical intervention. The type of surgery performed depends on the severity and recurrence of the condition. Below are detailed descriptions of the surgical procedures available to treat ingrown toenails permanently.

1. Partial Nail Avulsion (PNA)

What Is Partial Nail Avulsion?

Partial Nail Avulsion (PNA) is a minor surgical procedure in which only the problematic, ingrown portion of the toenail is removed. This method is often paired with phenolisation, where a chemical like phenol is applied to prevent the nail from regrowing along the affected edge.

Procedure Steps

1. Anesthesia: A local anesthetic is injected into the toe to numb the area completely, ensuring a painless procedure.
2. Nail Removal: The ingrown nail segment is carefully cut and removed using specialised surgical tools.
3. Chemical Application: Phenol or a similar agent is applied to the exposed nail matrix (the tissue responsible for nail growth). This helps to prevent regrowth of the ingrown portion, reducing the chance of recurrence.

Recovery And Effectiveness

• Recovery Time: Patients can resume normal activities within a few days, with proper care to prevent infection.
• Effectiveness: PNA is minimally invasive and boasts a high success rate, making it a preferred option for many cases of ingrown toenails.

2. Total Nail Avulsion (TNA)

What Is Total Nail Avulsion?

Total Nail Avulsion (TNA) involves the complete removal of the toenail. This procedure is less commonly performed and is typically reserved for severe cases where the nail is extensively damaged, deformed, or infected.

Procedure Steps

1. Toe Preparation: The toe is sterilised, and a local anesthetic is administered to ensure comfort.
2. Complete Nail Removal: The entire nail plate is carefully lifted and removed, ensuring no fragments are left behind.
3. Healing Process: Depending on the extent of matrix damage or destruction, a new nail may or may not regrow. If the matrix is intentionally destroyed, the nail will not regenerate, offering a permanent solution.

Indications

This procedure is often used for cases involving:

• Severe fungal infections.
• Chronic ingrown toenails with extensive deformity.
• Recurrent infections are resistant to other treatments.

3. Matrixectomy

What Is A Matrixectomy?

A Matrixectomy targets the nail matrix, the tissue under the nail bed responsible for nail growth. By removing or destroying the matrix this procedure prevents the regrowth of the problematic portion of the toenail. It is a definitive solution for recurrent ingrown toenails.

Types Of Matrixectomy

1. Chemical Matrixectomy: Phenol, sodium hydroxide, or other chemicals are applied to the nail matrix to destroy its ability to produce nail tissue. This is less invasive and often combined with Partial Nail Avulsion.
2. Surgical Matrixectomy: The nail matrix is physically removed through surgical excision. This method is more invasive and may involve cutting away the matrix tissue completely.

Long-Term Results

Matrixectomy offers a permanent solution to ingrown toenails. Once the matrix is destroyed or removed, the ingrown nail cannot regrow, significantly reducing recurrence rates.

4. Laser Surgery

How Does Laser Surgery Work?

Laser surgery is a modern and highly precise technique for treating ingrown toenails. A laser is used to remove the ingrown section of the nail and destroy the nail matrix, preventing regrowth in the affected area.

Advantages Of Laser Surgery

• Minimal Invasiveness: The laser’s precision minimises damage to surrounding tissues.
• Reduced Risk of Infection: The heat from the laser sterilises the area, reducing the risk of postoperative infection.
• Faster Recovery: Compared to traditional surgical methods, recovery is typically quicker and less painful.
• Cosmetic Benefits: Laser surgery often results in a cleaner and more aesthetically pleasing outcome.

Procedure Steps

1. Preparation: The toe is cleaned and numbed with local anesthesia.
2. Laser Application: The laser precisely removes the ingrown portion of the nail and ablates the nail matrix.
3. Post-Surgery Care: Patients may experience mild discomfort, but this method generally requires minimal downtime.

Non-Surgical Treatments For Ingrown Toenails

Before exploring surgical options, it is worth noting the conservative treatments available. These methods often resolve mild cases of ingrown toenails.

1. At-Home Remedies

For minor cases, some home remedies can alleviate symptoms:

• Warm Soaks: Soaking your foot in warm, soapy water or Epsom salt can reduce swelling and soften the skin.
• Proper Nail Trimming: Ensure the nail is cut straight across to prevent it from growing into the skin.
• Toe Protection: Using a cotton ball or dental floss to lift the nail can relieve pressure.

2. Medical Interventions

If home remedies are ineffective, podiatrists may recommend:

• Antibiotics: To treat infections.
• Toenail Bracing: A non-invasive method to guide the nail’s growth.
• Corticosteroid Creams: To reduce inflammation.

Choosing The Right Procedure

The choice of surgery depends on the severity of the ingrown toenail and the patient’s medical history. Factors to consider include:

• Severity: Partial Nail Avulsion suits mild to moderate cases, while severe cases may require Total Nail Avulsion or Matrixectomy.
• Recurrence: Matrixectomy or laser surgery is recommended for recurrent ingrown toenails.
• Cosmetic Concerns: Patients seeking a less invasive and cosmetically favourable option may prefer laser surgery.

Recovery And Aftercare Following Surgery

Regardless of the procedure, proper aftercare is essential for successful healing.

1. Post-Surgical Care Tips

1. Keep the Area Clean: Wash the foot gently and apply prescribed antibiotic ointments.
2. Wear Open-Toed Shoes: To avoid pressure on the healing toe.
3. Follow-Up Visits: Regular check-ups with the podiatrist ensure proper recovery.

2. Healing Time

• Most patients recover within 2-6 weeks, depending on the procedure.
• Mild discomfort and swelling are common but manageable with over-the-counter pain relievers.

Risks And Complications Of Surgery

Though surgical procedures for ingrown toenails are generally safe, they are not without risks.

1. Potential Complications

• Infection: Rare but possible if aftercare instructions are not followed.
• Recurrence: Though unlikely, the nail may regrow in some cases.
• Permanent Nail Loss: Some procedures prevent the nail from regrowing entirely.

2. Minimising Risks

Choosing a skilled podiatrist and adhering to post-operative care instructions greatly reduces the risk of complications.

Conclusion

Surgical options for ingrown toenails offer effective, long-lasting solutions for those dealing with chronic or severe cases. Procedures like Partial Nail Avulsion, Total Nail Avulsion, Matrixectomy, and Laser Surgery are tailored to individual needs, ensuring relief from pain and preventing recurrence. 

While the decision to undergo surgery depends on the severity of the condition and personal preferences, consulting a qualified podiatrist can help determine the best course of action. With proper aftercare, most patients experience a smooth recovery and can return to daily activities comfortably and confidently.

Frequently Asked Questions

Does Surgery Hurt?

Surgery is performed under local anaesthesia, ensuring minimal pain during the procedure. Post-operative discomfort is typically mild and manageable.

How Much Does Surgery Cost?

Costs vary depending on the type of surgery and healthcare coverage. In Australia, some procedures may be covered by Medicare or private health insurance.

Can Ingrown Toenails Grow Back?

While recurrence is rare after procedures like a matrixectomy, it can happen if the matrix is not entirely destroyed.

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