Patient information · Minor surgery
Ingrown toenail
why it keeps coming back, and how it is fixed properly
An ingrown toenail happens when the edge of the nail grows into the skin beside it, causing pain, swelling and often infection. Home remedies help mild cases. Recurrent ones need the nail edge removing permanently — a ten-minute procedure that stops the cycle for good.
Seek same-day assessment if you have
- spreading redness up the foot, or red streaks
- fever, or feeling generally unwell
- an ingrown toenail and diabetes, poor circulation or a weakened immune system
- numbness in the foot, or a toe that is pale, blue or cold
- severe pain, or pus tracking under the nail
In diabetes or peripheral arterial disease a minor toe infection can progress rapidly and is a leading route to serious foot complications. Do not attempt home treatment — be seen the same day.
Cutting a V in the middle of the nail does nothing
This is the most persistent myth in foot care. Nails do not grow inwards from the centre, and cutting a notch has no effect on the edge that is digging in. Nor does cutting the corner down into the nail fold — that leaves a spike buried in the skin, which is the commonest cause of recurrence. Cut nails straight across, level with the end of the toe, and file the corners smooth rather than rounding them off.
Why it happens
- cutting nails too short, or curving down at the corners
- tight or narrow shoes, and sport that pushes the toe forward — running, football, dancing
- naturally curved or thick nails, which often run in families
- sweaty feet, which soften the skin so the nail cuts in more easily
- injury to the toe, or repeated pressure
Home care for a mild one
- Soak the foot in warm salty water for 10 to 15 minutes, two or three times a day.
- Dry thoroughly, especially between the toes.
- Gently push the skin fold away from the nail edge with a cotton bud after soaking. Do not dig under the nail.
- Wear open or wide shoes and avoid anything pressing on the toe.
- Take paracetamol or ibuprofen for pain, and keep the toe clean and covered.
Give this a week or two. If it is not settling, is recurring, or there is pus or proud flesh forming, it needs treating properly.
The procedure
Partial nail avulsion with phenolisation is the standard treatment and is highly effective, with recurrence rates of only a few per cent.
- Local anaesthetic is injected at the base of the toe. This is the only uncomfortable part and lasts seconds.
- The offending edge of the nail — usually 2 to 3mm — is removed, along with its growing root. The rest of the nail is left alone.
- Phenol is applied to prevent that strip regrowing. This is what makes it permanent.
- The whole thing takes about ten to fifteen minutes and you walk out.
- The nail afterwards looks slightly narrower. Most people cannot tell.
Afterwards
- Keep the dressing dry for 24 to 48 hours, then redress daily after a salt-water soak.
- Expect clear or straw-coloured discharge for two to six weeks — this is a normal effect of the phenol, not infection.
- Keep the foot elevated for the first day; expect some throbbing as the anaesthetic wears off.
- Wear open or roomy shoes for a week or two. Avoid running and sport for two weeks.
- Healing is usually complete in four to six weeks.
- Contact us for spreading redness, increasing pain after the first few days, fever, or a foul-smelling discharge.
Why come to us. We treat ingrown toenails in clinic under local anaesthetic, usually the same week, with no referral and no waiting list — you book, attend, and walk out treated. Our fees are published in full so you know the cost before you come. We are open seven days a week, 9am–7pm, which suits people who cannot take time off, and we are equipped to manage the higher-risk feet — diabetes, poor circulation — that need more careful handling.
Treated in clinic, usually the same week
Local anaesthetic, ten minutes, published fees. Seven days a week.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.