Pulling an ingrown nail off relieves the pain and the nail grows back into exactly the same groove. Lasting correction means narrowing the nail permanently by destroying the small strip of matrix that produces the offending edge.
Ingrown and pincer nail correction removes the problematic edge of the nail and permanently destroys the strip of nail matrix that produces it, using chemical or surgical ablation. The nail becomes narrower but still looks like a nail. This is done under local anaesthetic, takes around twenty minutes, and recurrence after proper matrix ablation is low, unlike simple nail removal which recurs most of the time.
An ingrown nail happens when the edge of the nail plate presses into the skin fold beside it. The skin reacts with swelling and infection, which narrows the space further and worsens the pressure. A pincer nail is a related problem where the nail is excessively curved across its width and pinches the nail bed from both sides.
The nail plate you can see is not where the problem is generated. It is produced by the matrix, which sits under the skin at the base of the nail. Remove the plate and leave the matrix, and within a few months an identical nail with an identical edge grows back into an identical groove. That is why people have the same toe treated three or four times.
Lasting correction means narrowing the nail permanently. A strip is removed along the offending edge, and the matrix that produced that strip is destroyed, usually with phenol, occasionally by surgical excision. The nail regrows slightly narrower and no longer presses into the fold. Most people cannot tell the difference looking at it.
Infection is not a reason to postpone. A phenol ablation can be done with the toe infected, and dealing with the cause usually settles the infection faster than antibiotics alone.
A first, mild episode may settle with conservative care. Recurrence is what changes the plan.
Local anaesthetic is injected at the base of the toe. This is the only uncomfortable part, and lasts seconds.
A narrow strip of nail along the ingrown edge is separated and removed, leaving the rest of the nail intact.
Any overgrown inflamed tissue at the fold is trimmed.
Phenol is applied to the strip of matrix that produced the removed edge, destroying it so that portion of nail cannot regrow.
A simple non adherent dressing. You walk out, in an open or loose shoe.
Mild throbbing for the first evening, controlled with simple painkillers. Keep the foot elevated when resting. Loose footwear.
Daily salt water soaks and a clean dressing. Clear or slightly yellow ooze from the treated edge is expected with phenol.
Ooze settles and the edge heals over. Normal footwear and activity resume.
The nail grows out slightly narrower. If a thin spike appears from surviving matrix, it is easily re-treated.
Recurrence after proper matrix ablation is low, considerably lower than after nail removal alone. The nail is permanently narrower on the treated side and most people do not notice. Healing takes two to six weeks with some ooze from the treated edge, which is normal with phenol and is not infection. A small proportion need a repeat because a fragment of matrix survived and produces a thin spike of nail, which is straightforward to treat.
Small procedure, small risks, but a few worth knowing about.
Salt water soaks and sensible footwear do most of the work.
Rarely. Removing only the offending strip and treating that part of the matrix deals with the problem and leaves a nail that still looks normal.
It comes back when the matrix is left intact. Recurrence after proper matrix ablation is low, which is the whole reason for doing it this way.
Phenol ablation can be performed with the toe infected, and removing the cause usually settles the infection faster than antibiotics alone.
It does not. The nail grows forward from the matrix, not sideways, and cutting the middle changes nothing at the edges.
The reason this problem recurs is almost always that the matrix was left intact. Doing the definitive procedure the first time saves several rounds of temporary relief.
A minor procedure under local anaesthetic, so the cost is modest. Treatment for a symptomatic or infected ingrown nail is commonly covered by health insurance, particularly in diabetic patients where it prevents a more serious foot problem. A written estimate follows assessment.
Usually asked by people on their third recurrence.
Ask your question →Usually not. Only a narrow strip along the problem edge is removed and treated. The nail regrows slightly narrower and most people cannot tell by looking at it.
Almost certainly because the nail was removed but the matrix that produces that edge was left. Nail grows back from the matrix in the same shape, into the same groove. Destroying that strip is what breaks the cycle.
Yes. Phenol works in an infected field, and removing the offending nail edge usually settles the infection faster than antibiotics on their own.
That is normal with phenol. The chemical causes a controlled inflammatory reaction and the edge oozes clear or slightly yellow fluid for a few weeks. Increasing pain, spreading redness or fever would be different and should be reported.
It is often more important in diabetes, because a chronically infected ingrown nail can be the start of a much bigger foot problem. Circulation is checked first, and healing is monitored more closely.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
