Ingrown toenails and PNA treatment

Ingrown toenails are one of the most common conditions that we as podiatrist’s see here at Footrix Podiatry. Speaking from a personal experience, we know just how painful they can be! Ingrown toenails occur when an edge of the nail penetrates into the surrounding skin. At the beginning the pain may only be minor and cause little discomfort but as the nail continues to grow it may grow deeper, causing inflammation and swelling in the surrounding tissue resulting in pain and even infection. Now I am not sure how it works…. But how is it possible that it always ends up being that particular toe that you will stub or it gets trodden on…. OUCH!

There are many reasons that an ingrown toenail may occur:

1.       Natural nail shape: This is where genetics play a part (YAY) Unfortunately some people inherit quite an involuted nail shape which make you extremely prone to ingrown toenails

2.       Footwear: If your shoes are too tight or too narrow at the toe box, it can put increased pressure around your toes

3.       Trauma: Stubbing or dropping something on your toes can change your nail shape or break off your nail leaving a piece behind to grow in

4.       Nail care: We see this one a lot! Especially in teenagers. When you cut your nails too short or pick/peel your nails- this can leave behind little spicules that love to grow into the skin!

A conservative approach to treatment is always the first option when it comes to treatment of ingrown toenails and sometimes seeing your podiatrist on a regular basis is enough to eliminate the ingrown toenail. However, there are times when we have to offer a partial nail avulsion (PNA) due to the chronic nature of the ingrown toenail. This is a permanent solution that is offered after a complete assessment by your podiatrist who will determine if you are eligible for the procedure. This type of procedure is a common treatment that we offer at Footrix Podiatry.

What happens in the PNA procedure?

The procedure all takes place in the clinic room here at Footrix Podiatry by one of our podiatrists.

Local anaesthetic is injected into the affected toe to numb the area. The ingrown portion of the nail is then gently lifted and cut away (it is important to note that we do not cut the skin or suture the area) Both sides or the entire nail may be removed this way. Once the nail is removed a chemical (Phenol) is applied at the base of the nail which permanently prevents that area of nail from regrowing. Using Phenol causes a minor burn to that localised area but not surrounding skin and healing time is quite minimal depending on the patient. The toe is then dressed with a sterile dressing and education on post operative care is given. The procedure takes approximately 15-20 mins and the consultation no more than 1 hour. We will see you a few times over the weeks following the procedure for re-dressing and follow up care. With any surgical procedure there is some risk of complication (such as a post operative infection), however generally this procedure is known to be very safe and effective. There is a small chance of nail re-growth after the procedure over time.

After the procedure

In general, most people are back on their feet by the next day after the PNA. For the first few days after the procedure you may require pain relief, the use of open toed shoes and activity modification, meaning you can be back at work or school pretty quickly. Healing times differ from person to person but our podiatrists will explain all of this in more detail during the consult.

If you are having problems with your feet or toenails, call us here at Footrix Podiatry- we keep you on your feet!