Paediatric Surgery
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Ingrowing Toe Nail Leaflet PIAG 039 (263kB)
Frequently Asked Questions
What is an ingrowing toe nail?
An ingrowing toe nail is when the edge of the nail grows down into the skin. It normally occurs on the big toe on either side of the nail.
What effect does an ingrowing toe nail have?
To start with it may not cause any problems. However, it can go on to cause pain and eventually infection in the affected toe.
What causes an ingrowing toenail?
There are a number of reasons why toe nails ingrow:
- Wearing shoes that don’t fit
- Injury to the toe nail
- Fungal nail infections
- Being very sporty or active
- Inheriting fan shaped nails
Is there anything I can do at home?
If the toe nail is not too infected or painful it is possible to try to keep the skin edges away from the nail by inserting small pieces of cotton wool under the nail. This will encourage growth over the skin edge and stop the nail from digging in.
Make sure the nail is cut straight across and that any footwear is not too tight.
Keep the foot clean and dry by washing the foot and changing socks every day.
Is there any medication that can be taken?
No medication will make the toe nail normal again, but pain killers such as Ibuprofen and
antibiotics can be helpful if it becomes infected.
How can you treat the ingrowing nail (are their alternatives to surgery)?
Your GP or podiatrist can treat the nail without an operation by cutting the nail back or lifting the nail. If it is particularly severe, a small operation can be performed at the hospital to remove the affected nail edge.
What happens if I need an operation?
What will happen on the operating day?
You will be seen by a nurse who will ask about your health and carry out some routine tests such as temperature, pulse and blood pressure. You will then be asked if you would like to be put to sleep (have a general anaesthetic) while the operation is performed or to have a numbing injection in your toe instead. If you choose to be asleep when the procedure takes place you will be given information about the general anaesthetic before the operation. A surgeon will answer any questions that you have and obtain written permission from whoever has parental responsibility to carry out the procedure.
How is the operation performed?
The edge of the nail that is digging in is removed . A special instrument is then used to destroy the root of the removed nail to stop it growing back. A dressing is then applied to stop any bleeding. The whole operation takes roughly 10 minutes.
Are there any risks in the procedure?
For one in ten patients, a further operation is required because the removed nail edge grows back (Farrelly et al, Simple Operative Management of Ingrown Toenail Using Bipolar Diathermy, European Journal of Pediatric surgery, 2009)
What are the benefits?
The nail edge will be removed preventing the constant irritation and infection.
Will it hurt?
The toe will be tender for roughly a week afterwards.
What happens if the patient chooses not to have the operation
If you choose not to have the operation then the ingrowing toenail will remain.
After the operation
How long will it be before the toe nail gets back to being normal?
The toe nail will always be narrower after the operation but it should be fully healed in 6 weeks.
How soon will it be before I am able to go to school, play sports?
You can go back to school once you feel comfortable walking, and play sport once you feel able to run.
Will a further appointment at Alder Hey be required or will I go to my GP?
If the toe nail re-grows please contact your GP who will arrange for a further appointment.
Simple steps and advice for when you return home
- Leave the dressing in place for one day
After one day remove the dressing.
- After the dressing is removed keep the toe open to the air.
This allows the area to dry out and heal more rapidly.
Ideally wear open toed footwear and no socks for one week
- Watch out for signs of infection
If there is increasing redness or pain or starts to leak pus from the toe seek medical
advice from your GP as it may require a course of antibiotics .
- Pain Relief
Over the counter medication such as Paracetamol and Ibuprofen should be adequate to treat pain after the operation. Do not exceed the recommended dosage.
- Keeping the toe clean.
Wash the foot daily in a bowl of lukewarm salty water. Remember to dry the foot properly afterwards.
If you require further information please ask your surgeon on the day of surgery.
This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.
This information can be made available in other languages and formats if requested.
Alder Hey Children’s NHS Foundation Trust
PIAG: 039