Ingrown Toenails

Balance Podiatry_Nail SurgeryWhat are ingrown nails?
An ingrown nail is caused by a piece of nail protruding into the side of the nail sulcus skin, or into the nail bed itself. This allows for the entry of bacteria into the area which causes an infection in the toe. Ingrown nails are often painful and can limit your ability to exercise, work and wear enclosed shoes.

What causes ingrown nails?
An ingrown nail (onychocryptosis) can be caused by some of the following:|
• Trauma
• Involuted (Curved) Nails
• Ill-Fitting Footwear
• Poor Nail Care
• Nail Picking
• Poor Hygiene


In the first instance we will remove the offending nail particle and drain the infection. This will provide instant pain relief. It is common for the nail to grow back and when this occurs our Podiatrists will then perform a minor surgical procedure under local anaesthetic. This provides a permanent solution in greater than 99.7%* of cases.*Source: Annals of Family Medicine, Vol 10, 2012.

Balance Podiatry_Nail SurgeryA Partial Nail Avulsion (PNA) is a minor nail surgery procedure that permanently removes a section of nail plate. Basic steps to this procedure are

  • Local anaesthetic is skilfully administered so the procedure is pain free
  • In a sterile environment, the offending section of nail is removed and the nail matrix/root is prevented from regrowing using a chemical technique called phenolisaton.
  • A thick, absorbent aseptic dressing is applied and the anaesthetic will be effective for just long enough for the patient to get home comfortably and settled.
  • No sutures (stitches) are required, and therefore in most cases minimal pain is experienced post-operatively
  • The patient will be required to return for couple of dressing changes and a final check, normallay at 24 hours post-op and then at one week.
  • Healing time is rapid, with full recovery usually within 3 – 6 weeks. Closed footwear should be avoided on the day of the surgery, but there are few other side effects. Most people can return to work the following day.In nearly all cases, only one edge of the nail needs to be removed.
  • In most cases, we only need to remove one edge of the nail. Once the toe is healed the toenail simply looks slightly narrower, and it can be difficult to tell that there has been any surgery.

In more severe cases, where the nail is severely deformed and causing pain on both edges of the toe, we may recommend a Total Nail Avulsion (TNA) removing the entire toenail to achieve the best result.