What Can I Do If My Ingrown Toenail Comes Back After It Is Removed?

 

The removal of ingrown toenails is a common podiatry office procedure and is even performed to some degree by some family doctors and emergency room physicians. The procedure, when done fully and properly, is designed to remove the ingrown toenail permanently. However, under certain circumstances, the toenail root can survive the procedure, leading to a return of the ingrown nail, or something worse altogether.

The traditional procedure to remove an ingrown toenail involves removing the side of the nail and using a strong acidic chemical, commonly called phenol, to chemically burn the nail root. Other techniques that are less commonly used include much older techniques to surgically cut out the nail root, as well as laser or electricity to burn the tissue.

Many family doctors and emergency rooms will not perform the second part of the procedure, usually because they simply do not stock a specialized chemical like phenol in their office, which has little use outside of this procedure. Without the second step, the nail will simply regrow back in a couple of months. Unfortunately, the damage possibly caused to the nail root when the side is forcibly cut out can potentially lead to the growth of an abnormal nail border, taking on a greater curved shape, a thickened shape, or a shape that grows upward or outward. This piece can even remain separate from the main plate of the nail.

However, performing the second part of the procedure does not necessarily guarantee that the nail border will never return. A small percentage of the time, the nail root can survive the procedure. The most common reason for this is the presence of too much blood or body fluid that can neutralize the acid before it can act. Physicians do take steps to limit the presence of blood as best as possible, however, some people simply have a lot of vein congestion, and blood is retained at the nail surgery site. Another reason for the failure of the procedure is a phenol that has lost its effectiveness due to product age or improper storage. This is much less common and is usually limited to offices that do not perform the procedure frequently enough. Finally, it is possible to miss a small group of nail root cells during the procedure, especially if the nail root area is unusually deep or irregularly shaped. This can lead to a small piece of nail returning in the months following the procedure.

The good news is that the procedure can easily be repeated to destroy the nail root. It is very uncommon for a nail border to survive a second procedure, and the procedure and its recovery is easy enough that repeating it is a simple and easily tolerated matter.

If you have had a prior procedure to remove an ingrown toenail and it has grown back and is causing discomfort, be sure to give our office a call.  We can take care of this for you, no matter where or when you had the procedure originally performed.

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