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Nail Surgery : Treatment, Procedure, Cost And Side Effects

Last Updated: Jul 25, 2024

What is the treatment of Nail Surgery ?

In some cases apart of the nail or the toenail is to be removed so as to ensure that the nails are growing properly without any infection or discomfort. This removal is done via Nail surgery. The toenail can grow into the flesh of the finger and it can occur due to wearing too tight shoes around a toe, or by cutting toenails with too much of curve or due to a toenail injury or due to any fungal infection or due to a naturally grown curve. In all these cases this toenail may bring in discomfort. Similarly the nail may get injured and can get infected. In such cases there is a need to remove the part of the nail or the entire toenail so as to eliminate the infection growth and bring down the discomfort. This is done through nail surgery.

The surgery is done under the effect of local anesthesia so that the patient doesn’t feel any discomfort while undergoing the procedure. When the Nail has been successfully removed a particular chemical substance is applied on the nail bed so as to ensure that there is no regrowth of bad cells. Thus the regrowth of the nail cells is destroyed though the application of the chemical but in some cases a regrowth may take place. The surgery is a very simple process and the entire process can take a time period of 1 hour. The recovery time is shall be in between 4 to 8 weeks so that the entire healing of the affected area takes place.

How is the treatment done?

The Nail surgery is done by Podiatrist at a podiatry clinic. The Nail surgery is a simple procedure and it lasts for nearly 1 hour or less than it. It is done under the effect of local anesthesia.

The doctor shall examine the condition of the nail and then shall recommend for the nail surgery. The procedure for the Nail surgery is as follows:

  1. The doctor shall first clean the affected area to prepare the area for the surgery.
  2. Local anesthesia injection shall be injected to numb the area. The process of giving anesthesia may be painful.
  3. Once the toe has been fully anaesthetized, an elastic tight band will be applied to the toe to prevent bleeding during the procedure. A wedge may be used under the nail to hold the ingrown section.
  4. The doctor then shall use scissors and other special tools to separate the grown toenail from the nail bed by making a vertical cut from the ingrown side down to the cuticle. A cut section then shall be removed. If required the entire nail may be removed if there are ingrown nails from both sides.
  5. The doctor shall make use of heated electrical device known to be as cautery or an acidic chemical solution like phenol to ensure that there is no regrowth of the nail. This shall also stop the bleeding from the nail.
  6. After the surgery, the elastic band will be removed, the toe will be checked for return of your blood supply to the toe and a sterile dressing will be applied.

The patient shall be asked to remain for a short period of time in the clinic with your foot up. Finally the bandage shall be checked to make sure there is not too much bleeding before you leave the clinic. After the surgery the patient may be given medicines for pain relief and antibiotics for healing the infection.

Who is eligible for the treatment? (When is the treatment done?)

Patients who have in grown toenails, or are having nails which are injected due to either bacterial infection or fungal infection, or who are having naturally curved grown toenail, or have suffered an injury of the nail are eligible for the treatment of the nail surgery. The decision to go for the nail surgery shall be diagnosed by the Podiatrist after examining the affected area.

The general symptoms where in the Podiatrist shall suggest for the Nail surgery thus are as follows:

  1. if there is a pain around the toenail edges
  2. if there is a buildup of fluid around the toenails
  3. if there is a thickening in the skin around the toenail
  4. if there is a redness and swelling around the toenail
  5. if there is an infection with draining pus around the toenail
  6. if the toenail is curved naturally
  7. if the toenail or nail part is injured.

If these symptoms persists than the doctor shall recommend the person for the nail surgery.

Who is not eligible for the treatment?

Persons who are not having any of the issues related to the nail or in grown toenail and thus are not having any difficulty of any infection or walking need not avail this treatment and thus are not eligible for the treatment. Patients with Diabetes and High blood pressures, those on blood thinner medicines are restricted to undergo such surgery. These patients require other medical treatments before availing this surgery.

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Are there any side-effects?

Side effects are rare though some of the side effects can be nervousness, dizziness, blurred sightedness, drowsiness, in some rare cases one may get fits, loss of consciousness, breathing difficulties, low blood pressure, and slow heartbeat. In extremely low case there can be rashes and other problems due to local anesthesia. If anything like this is noted, then it is advised that the patients quickly rush to the clinic and inform the doctor. They will do the needful to fight with the side effects.

What are the post-treatment guidelines?

The post-treatment guidelines are as follows:

  1. The toe may remain numb for 4 to 5 hours. One is required to give as much rest to the toe as much possible for the next 24 to 48 hours. This can be done by placing the toe on pillow or cushion.
  2. The feet must be raised for the next 24 to 48 hours and try not to put much pressure on the foot. The skin under the nails is delicate and with even a small disturbance, they can get affected. This may lead to the discharge of blood.
  3. Keep taking the painkillers as assigned by the doctors. Don't take any unassigned medicine.
  4. Try to keep the dressing and the area dry and in-place. Don’t panic if there is a small amount of fluid discharge or blood.
  5. Don't drink alcohol.
  6. Take leave from your work or school.
  7. The first redressing will be undertaken within seven days of the surgery. The bulky dressing will be replaced by a much thinner sterile dressing.
  8. Do not use any antiseptic creams, solutions or dressings as these may affect the wound healing process

    If you experience a sudden increase in temperature, pain or excessive inflammation/swelling this may indicate that the toe has become infected. Moreover in case there is a lot of blood flow out then rush to the hospital. Thus in both the cases contact the doctor immediately.

How long does it take to recover?

The recovery time varies from person to person complexity and the medical condition. Though it takes around 8 weeks for the settlement of the skin and for the entire healing process after the nail surgery. The dressing must be done properly. There is a possibility of nail regrowth. In this case, one should quickly rush to the clinic and meet their surgeon.

What is the price of treatment in India?

The price of nail surgery in India varies from the region to region. On an average the cost of the nail surgery in India is from 2000 to 5000 INR. There may be an extra charge for medication and extra facilities in the hospital.

Are the results of the treatment permanent?

The removal of the toenail and the outcome of the nail surgery are positive in nature. A chemical substance is applied on the nail bed so as to ensure that the nail does not grows back again. But in some case the nail can grow back again and requires treatment. Thus, it can be stated that the tretment outcome is postive but in some cases the growth of the nail can reoccur and thus it requires a re treatment.

What are the alternatives to the treatment?

The alternatives to the Nail surgery is as follows:

  1. Pre-issue care for the nails. Simple tasks like nail cuts and cleaning of nails must help. If the cracks in the nails are seen, it is a sign to start taking better care of nails.
  2. If there is a nail problem soak your foot in warm water multiple times a day for at least 15 to 20 minutes. Through this there shall be a reduction in pain and swelling.
  3. One can make use of cotton ball or dental floss under the ingrown edge of your toenail. This shall help in the proper growth of the nail.
  4. Carefully cut off the ingrown edge of the toenail if possible but do it with high care.
  5. Always clean your toenail and cover your ingrown toenail with an over-the-counter ointment, so that it is protected as it grows out.
  6. Don’t wear any uncomfortable shoes and socks. Always wear shoes which have plenty of room for your toenail.
  7. Take the medicines whenever required and consult the doctor if there is pus and other infection.

References

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Written ByDr. Amit Agarkar MD - Dermatology,FCPS - Dermatology, Venereology & Leprosy,MBBSDermatology
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