Ingrown Toenail

An Ingrown Toenail is quite a common issue, more so in teenagers and young adults. The toenail can grow on one side and sometimes both sides of the toe and occasionally both the toes can be affected.

Ill-fitting shoes are one of the main causes of ingrown toenails. The downward pressure from wearing shoes causes the sideways growing portion of nail to poke into or pinch off a small piece of skin at the outer edge of the toe. Other causes include flat foot (pesplanus). Other common causes include cutting your toenails incorrectly.

Prevention

You can help prevent an ingrown toenail with the following measures:

  • Take care when cutting your toenails. Cut straight across, not too short and not into the corners or edges.
  • Wear comfortable, well-fitting shoes or sandals.
  • At work, wear steel-booted footwear, where appropriate.
  • Avoid tight socks and change them every day, or as soon as your sport or exercise is over.
  • Wash your feet every day, dry well and apply moisturiser to dry skin.

Preparation

You would be seen by the surgeon (Dr Satya Shanbhag) for surgical assessment and discussion about the procedure and possible complications.

Procedures

There are 2 surgical procedures:

1) For mild and non-infected toenails a wedge resection or also called Winograd’s procedure may be enough.

2) Zadeck’s procedure is ideal for inflamed and near destroyed nail and nail grove eating into the skin and flesh of the toe. Zadecks is better because this procedure also removes the nail matrix at the base, therefore destroying any further growth for some years. Recurrence is higher with the Wedge resection procedure.

The toe will receive a ring block analgesia and the procedure will be carried out using a torniquet. Usually one toe is done at each sitting. The toenail edge is lifted up and as mall cut is made at the skin edge to expose the nail germinal matrix (mother pearl). The extra flesh in the toe skin is removed and the whole nail matrix from top to bottom is excised for the affected side.

Complications

Complications are typically uncommon. However early and minor complications can include; minor ooze, swelling, and moderate pain which can be well controlled with analgesics.

Major complications include toeosteomyelitis and gangrene which are fortunately very rare.

Toe infection and disruption of stitch can occur.

Pricing

The price of ingrown nail is dependent on the procedure, edges and toes involved.

  • Wedge single edge of toe –> $400
  • Wedge both edge –> $500
  • Wedge both toes –> $800
  • Zadeks single/both edge–> $500-$700
  • Zadeks both toes –> $950

Please contact reception or schedule an appointment with either Dr Satya or Nurse Edlyn for further information.

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