When conservative treatment such as trimming and/or soaking are unable to alleviate the pain, discomfort or infection from an ingrown toenail, surgery is indicated. These are done in the office/clinical setting.
This is where the offending nail border is clipped and removed without anesthesia usually involving the very end corner or tip of the nail.
The partial nail avulsion is typically recommended for the first time an ingrown nail occurs on one border(side of the nail). This procedure is done under local anesthesia. The offending nail border is removed back to the root (matrix).
Also done in the office under local anesthesia. This procedure is indicated when the complete nail needs removing because of infection or both borders of the nail are involved.
These procedures are indicated when the ingrown nail has become chronic or recurring or the patient simply wishes not to have the possibility of recurrence in the future.
These procedures are the same as the above avulsions however included a chemical cauterization or removal of the matrix cells which grow the nail to prevent recurrence. In some cases a sharp dissection of the skin surrounding the nail border maybe necessary as well.
These procedures have a very high patient satisfaction rate.