An ingrown toenail is one of those problems people tolerate for far longer than they should. It is painful, it makes ordinary shoes unbearable, and it very rarely resolves on its own once the nail edge has broken the skin.
When soaking it is no longer enough
Early on, warm salt-water soaks, correct nail cutting and roomier shoes can settle things. Come in when the problem has moved past that point, which usually looks like:
- Pain when anything touches the toe, including bedsheets
- Redness, swelling or discharge along the nail fold
- Fleshy overgrowth beside the nail that bleeds easily
- The same toe becoming a problem again and again
Why they happen
The usual causes are cutting nails in a curve rather than straight across, shoes that squeeze the toes, sweaty feet that soften the skin, a knock or injury, or simply the natural shape of your nail. The last of these is why some people get them repeatedly through no fault of their own.
What the procedure involves
The toe is numbed with local anaesthetic injected at its base. The injection stings for a few seconds; after that you feel pressure but no pain.
Only the offending strip of nail is removed – not the whole nail. This is the single most common misconception, and it is why people put the procedure off for years. The nail continues to look normal.
Where the same toe has been a repeat offender, the small area of nail-forming tissue behind that strip is treated at the same time so that particular edge does not grow back. That step is what turns a temporary fix into a permanent one.
Any infected or overgrown tissue is dealt with in the same visit, sometimes using electrocautery.
Afterwards
- A dressing goes on, and you walk out.
- Keep it dry for the first day or two, then follow the dressing instructions you are given.
- Elevate the foot when you can for the first evening; simple pain relief is usually enough.
- Wear a wide, soft shoe for about two weeks. No football boots, no narrow heels.
- A review appointment checks healing.
If you have diabetes or circulation problems
Say so when you book. Foot problems in diabetes and peripheral vascular disease carry a higher risk of poor healing and infection, so they are managed with more caution and closer follow-up. Above all, do not attempt to cut it out at home, and do not have it dug at during a pedicure.
Why they keep coming back
Most people arriving for surgery have already had the same toe treated once or twice – soaked, trimmed, drained at a pharmacy, or cut at a salon. It settles, then returns within months. The reason is simple: unless the strip of nail-forming tissue at that edge is dealt with, it keeps producing the same offending nail edge.
That is the difference between temporary relief and a permanent fix, and it is why the procedure described here is done in one visit rather than repeatedly.
What causes ingrown toenails
| Cause | What to change |
|---|---|
| Cutting nails curved to follow the toe | Cut straight across, not into the corners |
| Narrow or pointed shoes | Wider toe box, especially for long days standing |
| Sweaty feet softening the skin | Alternate shoes, dry between toes, breathable socks |
| Trauma – a knock, a dropped object, sport | Protective footwear where relevant |
| Naturally curved nail shape | Nothing – this is why some people recur through no fault of their own |
Before the procedure
- Eat normally – this is a local anaesthetic procedure, not a general one.
- Bring or wear an open or wide shoe for going home.
- Arrange not to be on your feet all afternoon if you can.
- Mention blood thinners, diabetes or circulation problems when booking.
- Do not attempt to trim or dig at it in the days beforehand – it makes examination harder and increases infection risk.
The first 48 hours
- Keep the dressing dry and intact for the period you are told.
- Elevate the foot when sitting on the first evening; it reduces throbbing considerably.
- Take simple pain relief before the anaesthetic wears off rather than waiting for pain.
- Expect some oozing onto the dressing – that is normal.
- Follow the dressing change instructions exactly; this is where most avoidable infections come from.
Longer term
Where the nail edge has been treated to prevent regrowth, that strip stays narrower permanently – the nail looks slightly slimmer and functions normally. Healing continues over several weeks, and you will be reviewed. Report increasing pain after day three, spreading redness, significant swelling or fever rather than waiting.
What not to do at home
Almost everyone tries something before coming in, and a few of those attempts make the problem considerably worse:
- Do not dig the corner out. It provides brief relief, tears the nail fold, and is the commonest route to infection.
- Do not cut a V into the middle of the nail. This is widely repeated advice and it does nothing – nails do not grow towards a notch.
- Do not have it dug at during a pedicure. No anaesthetic, no sterile instruments, and no treatment of the nail matrix means a short reprieve at best.
- Do not push cotton wool under the nail edge repeatedly. It traps moisture and bacteria against already broken skin.
- Do not ignore spreading redness or fever. That is infection, not just an ingrown nail.
Preventing the other toes going the same way
- Cut nails straight across, leaving the corners visible rather than rounding them into the fold.
- Do not cut them too short – the nail should still reach the end of the toe.
- Choose shoes with genuine room across the toes, particularly for long days on your feet.
- Dry thoroughly between the toes; softened skin is easier for a nail edge to pierce.
- Deal with any fungal nail infection, since thickened distorted nails ingrow more readily.
A note on recurrence
Where the nail-forming tissue at that edge has been treated, recurrence at that site is uncommon. Where only the nail was removed – as happens with home attempts and quick fixes elsewhere – it regrows in the same shape and the problem returns within months. If you have had it “done” before and it came back, that is almost certainly why.
After the nail edge has been treated
The treated edge stays permanently narrower, so the nail looks slightly slimmer. It still grows, still functions, and most people stop noticing within a few months. Full healing of the nail fold takes several weeks, during which the area may look pink and slightly raised – that settles. Keep cutting the remaining nail straight across, because the untreated edges follow the same rules as before.
Recovery timeline at a glance
Day one: numbness wears off over a few hours, mild throbbing settles with simple pain relief and elevation. Days two to three: dressing changed as instructed, some oozing normal, most people back in ordinary wide shoes. Week one to two: discomfort largely gone, avoid sport and narrow footwear. Weeks three to six: the nail fold finishes healing and the area stops looking pink. Any increase in pain after day three, rather than a steady decrease, is worth reporting.
Who performs the procedure
Dr Nancy Omwenga performs it herself, in the clinic, under local anaesthetic and with sterile instruments. That combination is what separates it from the version done at a salon or attempted at home, and it is the reason recurrence and infection rates are so different.
If both sides of the same toe are affected
Both edges can be treated in the same visit where needed. It does not double the recovery time meaningfully, and it saves going through the process twice. Mention it when booking so enough time is allowed.
Coming back for review
A short review appointment checks that the nail fold is healing cleanly and that no infection has set in. It takes a few minutes and it is worth attending even if everything feels fine – the commonest complications are easy to correct early and irritating to correct late.
Ingrown toenail surgery – common questions
Will the whole nail be removed?
Almost never. In most cases only the narrow strip of nail digging into the skin is removed. The nail continues to look like a nail.
Does it hurt?
The anaesthetic injection at the base of the toe stings briefly. After that the toe is numb and the procedure itself is painless. Simple pain relief is usually enough afterwards.
How soon can I walk?
You walk out of the clinic. Most people manage normally within a day or two in a wide, soft shoe. Avoid football boots, heels and long walks for about a fortnight.
Will it grow back and do this again?
Not if the nail-forming tissue behind that strip is treated at the same time, which is what we normally do. Without that step, recurrence is common.
I have diabetes. Can I still have it done?
Yes, but tell reception when you book. Foot problems in diabetes are managed with extra care and closer follow-up, and you should never attempt to cut or dig at the nail yourself.
Can I just have it done at a salon or pedicure place?
Please do not. Digging out an ingrown nail without anaesthetic, sterile instruments or treatment of the nail matrix tends to produce a short reprieve, a nasty infection, or both.
Can I drive home afterwards?
Usually yes, though the toe is numb for a few hours. If it is your right foot and you drive a manual, consider arranging a lift for the first journey.
Will I need time off work?
Most people do not, provided the job does not involve being on their feet all day or wearing safety boots. If it does, plan for a day or two and mention it when booking so you get realistic advice.
Can both feet be done at once?
It is usually better not to. Having one foot comfortable while the other heals makes the first few days considerably easier.
Related treatments at the clinic
Book ingrown toenail treatment in Nairobi
Tell reception it is an ingrown toenail when you call, so a longer slot is set aside and it can usually be dealt with the same visit. Call 0728 566990.
Book an Appointment WhatsApp UsBook with Dr Nancy Omwenga
Same-day appointments and walk-ins where available. Most medical insurance schemes accepted, plus cash, card and M-Pesa.
Book an Appointment Call 0728 566990Clinic details
SkinByDrNancy
Landmark Plaza, 2nd Floor, Argwings Kodhek Rd, Nairobi
Mon – Fri 7:00am – 6:30pm
Sat 7:00am – 12:00pm
Sunday closed
info@skinbydrnancy.com