Ingrowing toenail surgery

An ingrowing toenail that has been cut out at home three times will come back a fourth. The only lasting answer for most people is to remove the narrow edge of nail that is digging in and stop it growing again, which is a small procedure done in the clinic under local anaesthetic. It takes about fifteen minutes, you walk out in a sandal, and it works about nineteen times in twenty.

Nail surgery starts with an assessment, which can be your first appointment: we look at the nail, check that your circulation and health make it safe, and explain exactly what will happen, including the small risk of regrowth and the healing time. If careful cutting will solve it instead, we say so and do that. If surgery is right, we book a forty-five-minute slot, usually within a fortnight.

On the day the toe is numbed with a local anaesthetic injection at its base, which is the only part that hurts, and the toe is then completely numb for two to three hours. A tourniquet goes on, the edge of the nail is cut back to the root and removed, and phenol is applied to the root for three minutes to stop that strip regrowing. A bulky dressing goes on and you go home in an open shoe, with a lift if possible.

You come back at two to three days and again at a week for redressing, both included, and we see you at six weeks to check it has healed. Most people are back in normal shoes in a week and back to sport in two to four. The edge of the nail is permanently narrower and nobody can tell. If it ever does regrow, which is about one in twenty, we treat it again at no charge.

What is included

• An assessment first, and surgery only if it is the answer
• Local anaesthetic; the toe numb throughout
• Phenol to the root so the edge does not regrow
• Two redressings and a six-week review
• Back in a shoe in about a week
• Regrowth retreated free

What it costs

£340 for one side of a nail (partial nail avulsion with phenol), £420 for both sides, including the local anaesthetic, two redressing appointments and a review at six weeks. Total nail avulsion quoted at the assessment. The prices page has every price in the clinic and at home; the symptom finder says which appointment fits what is bothering you.