Ingrown toenail surgery in Barcelona

When is an ingrown toenail infected?

A toe with an infected ingrown toenail may have pus.³ The signs of infection or complication are a painful, swollen toe with pus, very severe pain, redness, swelling and a high temperature or chills.²³ In severe cases, the infection can spread to the toe and the bone.²

How is an ingrown toenail treated, at home and in the clinic?

A mild ingrown toenail is treated at home with soaks and nail care, and if it does not heal or recurs, with surgery in the clinic. According to MedlinePlus, at home it is advisable to soak the foot in warm water 3 to 4 times a day, place a small piece of cotton or dental floss under the nail, cut the nails straight across and not try to trim the buried part yourself.²

The NHS suggests soaking the foot in lukewarm salty water, keeping it dry for the rest of the day, wearing wide shoes, taking paracetamol or ibuprofen for the pain and not cutting or picking at the nail.³ Over-the-counter products relieve the pain but do not treat the problem.²

When surgery is considered and who does it

If the nail does not heal or comes back, part of the nail can be removed after injecting anaesthetic into the toe, and antibiotics may be prescribed if there is infection.² The NHS says that a podiatrist can offer to cut away part of the nail or remove it entirely, with a local anaesthetic injection to numb the toe.³ If you are thinking about having surgery, consult a registered podiatrist and ask what they propose in your case.

What the evidence says about operating versus not operating

The Cochrane review notes that there is no consensus on a standard first-choice treatment.¹ With 24 studies and 2826 participants, it concludes that surgery is more effective than treatments without surgery at preventing the ingrown toenail from coming back.¹

In a study of 117 participants, partial surgery with phenol (a chemical applied to the root of the nail) had 14% recurrences compared with 41% without phenol. The authors warn that it is a single comparable study and that more are needed.¹

After the operation, none of the care options studied (antibiotics or manuka honey, povidone-iodine with paraffin, hydrogel with paraffin or paraffin gauze) changed infection, pain or healing time, so the cited evidence does not favour paying for these products.¹

How long does it take to recover and for the nail to grow back?

After part of an ingrown toenail is removed, the nail takes 2 to 4 months to grow back, according to MedlinePlus.² Treatment generally controls the infection and relieves the pain.² The cited sources do not detail how many dressings or follow-up visits are needed after the operation or when you can return to normal activity.

What are the risks of treating or operating on an ingrown toenail?

The cited sources do not detail the risks of the operation, of antibiotics or of painkillers, so the professional should explain them to you before any intervention. What they do report is this:

• Recurrence: the condition tends to come back if the feet are not looked after properly,² and it also depends on the technique: in one study it was 14% with phenol and 41% without phenol.¹
• Home care: it is not recommended if you have diabetes, nerve damage, poor circulation or infection.²
• Products after the operation: they did not change infection, pain or healing time in the studies.¹

To stop it growing in again, the NHS advises not cutting the nails too short, cutting them straight across without touching the edges, not wearing shoes that are too tight and keeping the feet clean and well dried.³

When should you seek care for an ingrown toenail without waiting?

Seek care without waiting for an ingrown toenail if you have diabetes, nerve damage in the foot or poor circulation, or if there is infection around the nail, because in those cases it can be serious.²

For any adult

1. Signs of infection: pus, a painful and swollen toe, high temperature or chills.³
2. Very severe pain, redness, swelling or fever.²
3. No improvement with home care: home treatment does not help or you cannot trim the nail yourself.²³

With diabetes, nerve damage or poor circulation

1. Seek care immediately, without treating it at home, because the condition can be serious in these patients.²
2. An infection around the nail is also a reason to seek care immediately.²