What to Expect During Ingrown Toenail Surgery

If you're reading this, chances are you've been dealing with an ingrown toenail long enough to consider having it professionally treated — and the idea of "surgery" is making you nervous. That's completely normal. But here's what almost every patient tells us afterward: "That was it? I wish I'd come in sooner."

Ingrown toenail treatment is one of the most common procedures in podiatry. It's fast (usually under 20 minutes), done right in our office, and the relief is immediate. Let's walk through exactly what happens so you know what to expect.

Before the Procedure

No special preparation is needed. You don't need to fast, and you can drive yourself to and from the appointment. Wear open-toed shoes or sandals so your toe has room afterward — that's the only practical consideration.

When you arrive, we'll examine the toe, discuss your history (how long it's been bothering you, whether it's happened before, any signs of infection), and explain the plan. If the ingrown nail is mild, a simple trim may be all that's needed. If it's recurring or infected, we'll recommend a more definitive approach.

The Numbing — The Part Everyone Worries About

Let's address this directly: the local anesthetic injection is the most uncomfortable part of the entire process, and it lasts about 10–15 seconds. We use a very fine needle and inject near the base of the toe. You'll feel a brief sting and some pressure, and then the toe goes completely numb.

Within a minute or two, you won't feel anything at all in that toe. We always confirm the numbness is complete before we proceed. If you can feel anything, we add more anesthetic. No patient is expected to tolerate pain during this procedure.

The Procedure Itself

For a standard partial nail avulsion — the most common ingrown toenail procedure — here's what happens:

1. We gently separate the ingrown portion of the nail from the nail bed. You'll feel pressure and movement but no pain.
2. The offending nail border is removed cleanly. This is the piece that was digging into your skin and causing all the trouble.
3. If this is a recurring problem, we apply a chemical (phenol) to the nail matrix — the growth center — on that side only. This prevents that specific strip of nail from ever growing back, which eliminates the problem permanently. The rest of your nail looks and grows normally.
4. The toe is bandaged, and you're done.

Total time from numbing to bandage: typically 10–15 minutes.

Does It Hurt After?

The anesthetic wears off in 2–4 hours. Most patients describe the post-procedure sensation as mild soreness — noticeably better than the pain of the ingrown nail itself. Over-the-counter pain relief (acetaminophen or ibuprofen) is usually sufficient. Many patients take nothing at all.

The toe will be tender for a few days. We'll give you clear aftercare instructions: soaking, bandage changes, and what to watch for. Most patients return to normal shoes within a week, and full healing takes 2–4 weeks.

What About Infection?

If your ingrown nail is already infected (red, swollen, draining pus), we can still treat it in the same visit. In fact, removing the offending nail border is the most important step in clearing the infection — it removes the source of irritation that's preventing your body from healing. We may also prescribe a short course of antibiotics if the infection is significant.

Will It Come Back?

If we perform the procedure without chemical matrixectomy (phenol application), there's a chance the nail border grows back and the problem recurs. This approach makes sense for first-time, mild ingrown nails.

If we perform the procedure with chemical matrixectomy, the recurrence rate drops dramatically — well below 5% in most studies. The nail looks cosmetically normal because we only remove a thin strip from the edge. Most patients can't tell the difference once it's fully healed.

What to Tell a Friend Who's Nervous

The entire experience, from walking in to walking out, is usually under 30 minutes. The worst part (the numbing shot) lasts 10 seconds. The relief afterward is dramatic — patients who have been limping for weeks walk out comfortably. And if we do the permanent correction, they typically never deal with that ingrown nail again.

Ingrown toenails are one of those problems where the anticipation is genuinely worse than the reality. Read more about our ingrown toenail treatment approach, or go ahead and schedule your visit. We'll take great care of you.