A persistent or recurrent ingrown toenail is treated by removing the affected edge of the nail and chemically destroying the underlying nail-forming tissue with phenol. This is a brief outpatient procedure performed under local anaesthetic, typically the most reliable cure for recurrent ingrown nails.
ℹ️ For most patients, no formal pre-assessment is required. The procedure is done under local anaesthetic, with minimal preparation needed.
You will be advised to attend wearing open-toed shoes or sandals as a thick bandage will be applied afterwards. Bring a list of any medications, including blood thinners, and let the team know if you have diabetes or peripheral vascular disease.
Because the procedure uses local anaesthetic only, you can eat and drink normally beforehand.
Continue most medications as usual. Blood thinners are usually continued, though specific advice may be given.
You can walk home but you may prefer not to drive immediately afterwards due to discomfort.
If you have diabetes, peripheral vascular disease, or impaired healing, tell your team. The procedure can usually still be performed but extra care is taken with aftercare.
ℹ️ You will be given a specific arrival time. Do not eat or drink (other than clear water up to 2 hours before) from midnight the night before. Bring your medication list and any documents sent by the hospital.
You will be admitted to the ward or day surgery unit, change into a gown, and be seen by the nursing, anaesthetic, and surgical teams before theatre.
Your surgeon will confirm the procedure, mark the operative side, and you will sign a consent form before going to theatre.
You will meet the anaesthetist in the anaesthetic room. Once anaesthesia is established, the procedure will begin.
After surgery you will wake in the recovery room where nurses monitor your vital signs until you are stable and comfortable.
Most foot and ankle surgery is performed as a day case, meaning you go home the same day. More complex procedures such as ankle replacement or flat foot reconstruction usually require 1-3 nights in hospital. Before discharge, the team will check your pain is controlled, give you wound care instructions, and confirm your follow-up appointment.
You will be given oral pain relief before discharge. Take it regularly for the first 48 hours rather than waiting until pain is severe.
A nurse will check the wound before you leave and explain how to keep it clean and dry.
You will be shown how to use crutches and given clear instructions about weight-bearing on your operated foot.
You will receive a letter for your GP and details of your next outpatient appointment, usually at 2 weeks for a wound check.
Arrange for a family member or friend to collect you. You must not drive after a general anaesthetic or sedation.
⚠️ Important: Some pain on the day of procedure as local anaesthetic wears off is normal, take paracetamol or ibuprofen as advised. Report increasing redness, pus, or fever as these may indicate infection.
Keep the foot elevated above the level of your heart for as much of the day as possible during the first 2 weeks. This significantly reduces swelling and helps healing.
Avoid getting the wound wet until it is fully healed, usually 10-14 days. Use a waterproof cover when showering.
Do not wait until pain is severe before taking medication. Regular simple analgesia (paracetamol, ibuprofen if appropriate) is more effective than taking it only when needed.
This is usually 2 weeks after surgery. Sutures or clips will be removed if used.
Seek urgent advice if you develop increasing redness, warmth, swelling, discharge from the wound, calf pain or swelling (possible DVT), shortness of breath, or a temperature above 38°C.
Toe wrapped in a thick bandage. Keep the foot elevated and dry. Some oozing of blood/phenol is normal.
Dressing changed at the GP surgery or at home. Clean daily with salt water and re-dress.
Continue daily salt-water soaks and dressing changes. Wear open-toed shoes if comfortable.
The treated nail edge heals over with skin. Most patients return to normal shoes and activities by 2-4 weeks.
The toenail looks slightly narrower than before but otherwise normal.
No, only the affected edge of the nail is removed. The rest of the nail remains intact.
The nail will be slightly narrower than before. Cosmetic results are usually very good.
Success rates exceed 95%. Recurrence is uncommon after phenolisation, which is what makes this approach preferred over simple nail edge removal alone.
Usually 1-2 days for desk work; up to 1-2 weeks for jobs requiring prolonged walking or safety boots.
Plain-English answers to the things people most often ask, grounded in published guidance. Tap a question to open it.
The offending edge of the nail is removed and the nail bed is treated with phenol to stop that part regrowing. It is done under local anaesthetic.
Most of the nail is kept, so the toe looks largely normal afterwards.
Treating the nail bed with phenol greatly reduces the chance of recurrence compared with simply removing the nail.
Good nail-cutting habits help keep it away.
A local anaesthetic injection numbs the toe (a ring block). You are awake and the toe is numb.
It wears off over a few hours.
Expect dressings and salt-water soaks, with healing over a few weeks. Some clear discharge as it heals is normal.
Open or roomy footwear is helpful at first.
Discomfort is usually mild and settles with simple pain relief once the anaesthetic wears off.
Keeping the foot up on the first day helps.
Spreading redness, throbbing, increasing pain, pus beyond the expected, or a temperature suggest infection and need review.
This is more important to watch for if you have diabetes or poor circulation.