As we discussed last week, ingrown toenails can be a painful side effect of wearing ill-fitting shoes or cutting your toenail too low. Today, we’ll examine the treatment options for ingrown toenails, and what you can expect if you have to have your toenail surgically removed.
Non-Surgical Treatment
We lightly glossed over some prevention tips in last week’s post, but today we’ll provide some in-depth non-surgical treatment options. If you believe you are starting to develop an ingrown toenail, it is important to try some in-home remedies to alleviate the pain before it gets worse. Begin by:
- Soaking your foot in warm water for 10 minutes. Do this at least 3-4 times throughout the day.
- Once the nail is softened, gently lift the corner of the nail.
- If possible, place some cotton under the nail in the affected region. This will keep the area dry, which can help decrease the likelihood of infection. Remove the cotton before you re-soak your foot.
- After you’re done, try to keep your foot as dry as possible throughout the rest of the day. Avoid wearing tight socks or shoes. If possible, switch to sandals or go barefoot to give your toe plenty of room to breath.
- Take NSAIDs or pain relievers like ibuprofen or acetaminophen to help manage pain throughout the day.
Repeat these steps for 5-7 days. If your condition shows no improvement, schedule a visit with a medical professional.
Surgical Treatment
Surgical treatment for an ingrown toenail is a common and rather simple operation. That said, there are many different ways a doctor might attempt to correct the problem. Your doctor may choose to:
- Partially remove the nail
- Completely remove the nail
- Remove a portion of the underlying nail bed
- Remove some of the soft tissue around the nail
However your doctor decides to operate, the goal will be to stop the nail edge from growing into the fleshy side of your toe. If your toenail continually becomes ingrown even after a few operations, your doctor may ask if you want to have the nail permanently removed.
In a routine removal of part of the big toenail, your doctor will begin by placing a small tourniquet around your big toe. This is done to prevent anesthesia from moving throughout your foot, and it will ensure your toe is numb during the procedure. After the tourniquet is in place, the doctor will administer anesthesia. Once the numbing agent has kicked in, your doctor will take a pair of surgical scissors and begin cutting away the ingrown part of your toenail. Usually this is done by cutting a straight line down your nail, and in most cases about 60-70% of the original nail is left intact.
Thanks to the anesthesia, the operation will be mostly painless. You will feel some slight pressure as the surgeon cuts your nail. If you feel any sensation other than light pressure, tell your doctor. He may decide to inject more anesthesia, or simply wait until the first dose has had more time to kick in. Once you’re satisfied that the anesthesia has set in, your doctor will finish removing the ingrown nail.
Post-Op Protocol
It is important to take care of your toe after the operation is complete. Your nail helps prevent infections from setting in, and without a portion of the nail, you will be more susceptible to germs.
Similar to the non-surgical techniques described above, you’ll want to soak you foot for 10 minutes, 3-4 times a day. Once you remove your foot from the water, dry your foot and gently brush away any coagulated blood or debris in the area. Try to avoid socks or closed toe shoes for the first week after surgery. For an in-depth look that the procedure from start-to-finish, check out this guy who documented his surgery from pre-op to full recovery.
Related sources: AAOS, TDHurst.com