What Is Ingrown Toenail Surgery?
Ingrown toenail surgery is a minor procedure that permanently removes the section of nail that is growing into the surrounding skin. The most common and effective technique is called phenol matrixectomy — sometimes referred to as partial nail avulsion with phenol.
During the procedure, the problematic nail edge is carefully removed and a chemical called phenol is applied to the exposed nail matrix (the tissue that produces nail growth). This prevents that specific section of nail from growing back, while the rest of your nail continues to grow normally.
The procedure is performed under local anaesthetic in a clinical setting. There is no need for a hospital visit, general anaesthetic, or stitches. You walk into the clinic, have the procedure, and walk out again — typically within an hour.
Ingrown toenail surgery is one of the most commonly performed podiatric procedures in the UK. It is suitable for adults and teenagers (generally from age 12–13 onwards) and is recommended when conservative treatments have failed to resolve the problem.
Who Needs Ingrown Toenail Surgery?
Not everyone with an ingrown toenail needs surgery. Mild cases that occur for the first time can often be managed conservatively — with careful nail cutting, salt water soaks, and appropriate footwear.
However, surgery becomes the recommended option when:
The ingrown toenail keeps coming back. If you have experienced two or more episodes of the same nail growing into the skin, conservative treatment is unlikely to provide a lasting solution. The underlying nail shape or growth pattern is the root cause, and surgery addresses this directly.
There is active infection. An infected ingrown toenail — characterised by redness, swelling, pus, and increasing pain — requires professional treatment. While antibiotics can clear the infection temporarily, the nail will almost certainly cause the same problem again without surgical intervention.
The pain is affecting daily life. If you are unable to wear normal shoes, struggling to walk comfortably, or avoiding activities because of toenail pain, surgery can restore your quality of life quickly.
You have already tried other treatments. Patients who have had multiple courses of antibiotics, repeated trimming by a podiatrist, or attempted home treatment without lasting success are strong candidates for surgery.
You have an underlying condition. People with diabetes, circulation problems, or compromised immune systems should not delay treatment of ingrown toenails, as the risk of complications from untreated infection is higher.
How the Procedure Works: Step by Step
Understanding exactly what happens during ingrown toenail surgery helps reduce anxiety. Here is what to expect at each stage:
Consultation and assessment. Before any procedure, Anna will examine your toe, discuss your history, and confirm that surgery is the right approach. This may happen at a separate appointment or on the day of surgery, depending on how clear-cut the situation is.
Local anaesthetic. Two small injections of local anaesthetic are given at the base of the toe. This is the part most patients are apprehensive about — and the part that is over most quickly. The injections take around 30 seconds each. Within 5–10 minutes your toe will be completely numb and you will not feel any pain during the procedure.
Tourniquet application. A small rubber ring is placed around the base of the toe to reduce blood flow to the area. This gives the podiatrist a clear field to work in and ensures the phenol can be applied effectively.
Nail section removal. Using specialised instruments, the problematic edge of the nail is carefully separated from the nail bed and removed. Only the offending portion is taken — the rest of your nail remains intact. This is painless because of the anaesthetic.
Phenol application. Phenol (a chemical cauterising agent) is applied to the exposed nail matrix using small cotton-tipped applicators. This destroys the cells responsible for growing that section of nail, preventing regrowth. The phenol is applied in controlled doses over approximately 2–3 minutes.
Dressing and aftercare instructions. The toe is cleaned, dressed with an antiseptic dressing, and bandaged. Anna will talk you through exactly how to care for the toe at home, when to change dressings, and what to watch for. You will walk out of the clinic immediately — no wheelchair, no crutches, no special footwear.
The entire procedure typically takes 30–45 minutes from anaesthetic to dressing. If both sides of the same nail need treatment, or if multiple toes are affected, the appointment may take slightly longer.
Is the Surgery Painful?
This is the most common question patients ask — and the honest answer is that the procedure itself is not painful, but you will feel the local anaesthetic injections.
The injections. Two injections at the base of the toe, one on each side. Most patients describe this as a sharp scratch lasting a few seconds. The toe area is sensitive, so the injection is noticeable — but it is brief. Many patients say it was less uncomfortable than they expected. Anna uses a slow injection technique to minimise discomfort.
During the procedure. Once the anaesthetic takes effect (5–10 minutes), you will feel nothing. Some patients feel a sensation of pressure or movement, but there is no pain.
After the procedure. When the anaesthetic wears off (1–3 hours later), you can expect some throbbing or discomfort for the first 24–72 hours. This is typically described as mild to moderate and is well-managed with over-the-counter paracetamol. Most patients do not need anything stronger. By day 3–5, most discomfort has subsided.
The first dressing change. Removing the initial dressing 24–48 hours after surgery can be a little tender. Soaking the toe in warm salt water beforehand softens the dressing and makes removal easier.
Compared to the pain of an untreated ingrown toenail — especially one that is infected — most patients report that the post-operative discomfort is significantly less than what they were living with before surgery.
Recovery Timeline
Recovery from ingrown toenail surgery is straightforward, but it does take time for the toe to heal fully.
Day 1 (surgery day). Rest with your foot elevated when possible. Some throbbing is normal as the anaesthetic wears off. Take paracetamol as needed. Keep the dressing clean and dry.
Days 2–7 (first week). Change the dressing daily after soaking in warm salt water. The toe may look red and slightly swollen — this is normal. Most patients return to desk-based work within 24–48 hours. Avoid standing for long periods, heavy exercise, and tight shoes.
Week 2. The toe begins to settle. Redness and swelling reduce. You may attend a follow-up appointment so Anna can check healing. Most patients are able to return to normal daily activities, including light exercise, by the end of week 2.
Weeks 3–6. Gradual healing continues. The nail bed where the section was removed will granulate (form new tissue) and eventually be covered by skin. This area may weep slightly — this is normal and is part of the healing process. By week 6, most toes are healed or very close to it.
Weeks 6–8+. Full healing. The remaining nail continues to grow normally. The treated edge is narrower than before but looks natural and tidy. Long-term, the vast majority of patients have no further problems with that nail.
Important: healing times vary depending on your general health, circulation, and how closely you follow the aftercare instructions. Patients with diabetes or circulation issues may take a little longer.
Success Rates
Phenol matrixectomy has been extensively studied and is recognised as the most effective treatment for ingrown toenails. Published research consistently reports high long-term success rates — significantly better than conservative (non-surgical) treatments, which have high recurrence rates.
It is important to understand that no medical procedure has a 100% success rate. A small percentage of patients may experience partial regrowth requiring a second procedure. This is more common in patients with particularly curved nails or those who have had multiple failed treatments elsewhere.
Anna also sees patients for revision surgery — treating toenails where a previous procedure performed elsewhere has not been successful. If you have already had nail surgery that has failed, this does not mean you are out of options.
Costs and What Is Included
At our Hendon clinic, standard ingrown toenail surgery costs £286 per toe. This is an all-inclusive price covering:
The initial consultation and assessment, the surgical procedure itself, all materials and dressings used during surgery, and two follow-up appointments to check healing.
There are no hidden fees. The price you are quoted is the price you pay.
Emergency surgery (within 24 hours) is available for £500 per toe for patients with severe infection or urgent need. This includes the same comprehensive aftercare.
For patients with private health insurance, Anna is a BUPA Fee Assured provider (Member 310655), meaning BUPA has pre-approved her fees. If you have BUPA cover, you may be able to claim some or all of the cost. Check with your insurer before your appointment.
Compared to hospital-based surgery in London (typically £1,000–£2,000+), private podiatric surgery offers the same procedure at a fraction of the cost, without lengthy NHS waiting lists, and with direct access to the treating clinician throughout your care.
How to Choose a Practitioner
If you are considering ingrown toenail surgery, there are several things to look for when choosing a practitioner:
HCPC registration. Your podiatrist should be registered with the Health and Care Professions Council. This is a legal requirement in the UK — anyone performing podiatric surgery must hold current HCPC registration. You can check registration online at hcpc-uk.org.
Experience with nail surgery specifically. Not all podiatrists perform surgery regularly. Ask how many procedures they carry out and whether they take on revision cases (which require more skill).
Clear pricing with no hidden costs. You should know exactly what you will pay before committing. Be wary of clinics that quote a low initial fee and then add charges for follow-ups, dressings, or the procedure itself.
Aftercare included. Surgery is only part of the process. Good aftercare — including follow-up appointments and ongoing support if you have any concerns — is essential for a successful outcome.
Insurance recognition. If you plan to claim through private insurance, check that the practitioner is recognised by your provider.