Overview

Nail surgery is a routine minor procedure, done under local anaesthetic, to relieve discomfort from ingrown and painful toenails. This is done by removing the section causing the problem. Sometimes we remove the whole toenail and treat the root to prevent it from growing back.   

Benefits of nail surgery

Thick, distorted or ingrown nails can cause pain and sometimes infection. Treatment in a clinic might relieve the symptoms for a while, but they often come back when the nail starts to regrow. Nail surgery generally provides a permanent and safe answer to painful ingrown toenails.

Risks of nail surgery

There are a few risks you should be aware of before you have nail surgery. 

Re-growth

Sometimes the removed section of nail might regrow and need to be removed again. This happens in less than 5 in every 100 cases. 

Infection

An infection of the site during healing can happen, as with any surgery. Sometimes, antibiotics are required.

Pain

It is normal to have some mild pain or soreness when the anaesthetic has worn off. It is unusual for this to be severe or to last longer than 24 hours. 

Nerve damage

In some extremely rare cases, temporary or permanent painful nerve damage occurs.

Allergic reaction

You could have a severe allergic reaction to the local anaesthetic.

Other treatment options

Routine podiatry treatment, such as cutting back the corner of the nail or following our self-care advice, might help in the short term. However this is unlikely to be a permanent solution if the problem has been recurrent, or has existed for a long time. 

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have the procedure or treatment, we will ask you to sign a consent form. This says that you understand what is involved and agree to have the treatment.

Read more about our consent process.

While you wait for surgery

If your ingrown toenail is producing discharge, keep it covered with a clean, dry dressing, and change it each day to reduce the risk of infection while you wait for surgery.

Please come to one of our emergency podiatry clinics if you have any concerns about your nail surgery. 

Preparing for nail surgery

You should arrange to have the day off work, or school, on the day of surgery, so that you can rest afterwards.

You should not drive on the day of the surgery.

It is not advisable to take public transport or walk home as this can increase bleeding.  We recommend that you organise a taxi or for someone to take you home afterwards. You can have someone with you on the day.

You must tell the podiatrist if you think you are pregnant. This also applies to anyone accompanying you into the clinic room, due to the chemicals we use. 

On the day of surgery

You should eat and drink as normal before the procedure.

Take all your medicines as usual (unless you have been advised otherwise). Please bring a list of all your medicines with you.  

The dressing is bulky, so bring open-toed footwear, such as flip-flops, to wear afterwards.

Please note that if you are under 16 years of age you will need to be accompanied by your parent or legal guardian, who will be asked to sign consent on your behalf.

Local anaesthetic 

This surgery is done under local anaesthetic. If you have any local anaesthetic in the 24 hours before your nail surgery (for example at the dentist) we might not be able to do your surgery. It depends how much anaesthetic was used, so please bring these details with you. 

Your surgery appointment 

Your nail surgery appointment will last about 1 hour. 

It will be done at either one of these locations:

Lambeth

Akerman Podiatry Clinic
Akerman Health Centre (2nd floor)
60 Patmos Road, Oval 
SW9 6AF 

Southwark 

Artesian Foot Health Centre
94 Alscot Road
Bermondsey
SE1 3GG 

If you can’t keep your appointment, please let us know as soon as possible. 

During surgery

The affected toe is injected with a local anaesthetic to prevent you feeling any pain during the procedure. When the toe is completely numb, a tight rubber band (tourniquet) is placed around the affected toe to prevent bleeding. The part of the toenail is then loosened and removed before a liquid chemical (phenol) is applied to the nail root to prevent that portion of nail from growing again in the future. The tourniquet is then removed and a bulky dressing is applied. Normal feeling will return 2 to 3 hours after your procedure.

Leaving hospital

Please take a taxi or arrange for someone to take you home. You should not drive.  

Be careful until normal feeling returns, as you could injure your toe without realising.

Do not remove the dressing yourself. Keep it dry until your re-dressing appointment. 

After care

Bleeding 

When you are home, remove your footwear and rest with your legs raised for 2 to 3 hours. This reduces the likelihood of bleeding. You should then try and rest as much as possible for the remainder of the day. It is normal for spots of blood to sometimes appear through the dressing. Do not worry, this will dry. You can apply another dressing over the top if you want to.

Pain

If you have any discomfort after the anaesthetic has worn off, take regular painkillers, such as paracetamol. 

Re-dressing appointment

A re-dressing appointment is normally booked for 1 to 4 days after your surgery. If this has not been booked, you should attend one of our emergency podiatry clinics. At this appointment your podiatrist will apply a smaller dressing and advise you how to look after your toe until it is fully healed. You can wear your normal footwear again after this appointment.

Please continue to re-dress your toe as shown until it is fully healed (usually 4 to 6 weeks). You will not normally need any further appointments unless we have any concerns.

When to get help

Emergency podiatry clinics

Southwark

Artesian Foot Health Centre
94 Alscot Road, SE1 3GG
Monday, Wednesday and Friday, 1.30pm to 3.40pm

Lambeth

Manor Health Centre
86 Clapham Manor Street, SW4 6EB
Monday, 1.20pm to 3.40pm

Gracefield Gardens
2-8 Gracefield Gardens, SW16 2ST
Tuesday, 1.20pm to 3.40pm

Elmcourt Health Centre
214 to 218 Norwood Road, SE27 9AW
Wednesday, 9.40am to 12 noon

Mawbey Brough Health Centre
39 Wilcox Close, SW8 2UD
Thursday and Friday, 1.20pm to 3.40pm