MIS SURGERY · INGROWN TOENAIL · ALICANTE

Ingrown toenail: a lasting, pain-free solution

Q: Does an ingrown toenail heal on its own?

No. A Stage I ingrown toenail may improve temporarily with saltwater soaks and a change of footwear, but in most cases the problem recurs if the underlying cause (a splinter, ingrown nail, or improper trimming) is not addressed. If you’ve had more than one episode, it’s advisable to consult a healthcare professional to explore a permanent solution.

Q: Why does this always happen to the same finger?

This is because the cause is usually anatomical: an abnormal nail shape (excessively curved nail), an underlying bony protrusion (subungual exostosis), or a repeated habit of improper trimming. As long as the predisposing factor persists, the nail will continue to become an ingrown toenail. Partial matricectomy removes the responsible portion of the matrix and breaks the cycle.

Q: Can children get ingrown toenails?

Yes. It is relatively common in children aged 8–10 and older, especially among those who play soccer or wear tight athletic shoes. In children, the initial approach is usually conservative. If the condition recurs, a partial matricectomy can be performed under local anesthesia, just as in adults, with excellent results.

Q: Does surgery for an ingrown toenail hurt?

The procedure is performed under digital local anesthesia, so you will not feel any pain during the procedure. The injection of the anesthetic may cause brief discomfort (2–3 seconds). After surgery, any discomfort is mild and can be managed with oral pain medication (acetaminophen or ibuprofen). Most patients describe the postoperative period as “much less painful than they expected.”

Q: How long does it take to heal?

Complete healing usually occurs within 2 to 4 weeks. During this time, patients perform simple home care using an antiseptic (Betadine). Most patients return to work within 2 to 3 days and can wear closed-toe shoes starting in the second week.

Q: Can it reincarnate after the surgery?

According to the medical literature, the recurrence rate for partial phenol matricectomy is less than 5%. Without matricectomy (spiculectomy alone), the recurrence rate can exceed 70%. At Clínica San Román, we perform selective matricectomy to achieve a definitive result.

Q: Will the nail look bad after the procedure?

No. Since this is a partial matricectomy, only the lateral portion of the matrix responsible for the recurrence (2–3 mm) is removed. The nail grows back looking virtually normal, though slightly narrower. The vast majority of patients are satisfied with the cosmetic result.

Q: Do I have to remove the entire nail?

False. Total avulsion (removing the entire nail) is an outdated procedure for ingrown toenails. It has a 30% recurrence rate, and the nail may grow back deformed. Partial matricectomy is much more effective, less invasive, and preserves most of the nail.

Q: Does cutting your nails into a V-shape prevent ingrown toenails?

False. This is one of the most widespread myths. Cutting a V-shape in the center of the nail does not change the direction of growth or relieve pressure on the sides. In fact, it weakens the nail and can create sharp edges that are more likely to dig into the skin.

Q: Does putting cotton under the nail solve the problem?

It may temporarily relieve pressure, but it is not a solution. The cotton can become damp and turn into a source of bacterial or fungal infection. In mild Stage I cases, it can be used as a temporary measure alongside other treatments, but if the problem recurs, a partial matricectomy is the definitive solution.

Minimally invasive partial mastectomy. No stitches. No time off work. No recurrences.

If your ingrown toenail keeps coming back—if you’ve already had the tip trimmed, used cotton balls, and tried antibiotics, but the pain persists—you need a permanent solution. At Clínica San Román, we perform a minimally invasive partial matricectomy that eliminates the root cause of recurrence. Local anesthesia, 20 minutes, and you’re walking the same day. Recurrence rate less than 5% according to scientific evidence.

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Ingrown Toenail Treatment — Clínica San Román Alicante

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What is an ingrown toenail?

An ingrown toenail (onychocryptosis) occurs when the side of the nail plate grows into the soft tissue of the nail fold. It primarily affects the big toe (first toe) and is one of the most common podiatric conditions: it is estimated to affect 2.5–5% of the general population and is particularly prevalent among adolescents and young adults.

The process usually begins with pressure from the edge of the nail against the skin. If left untreated, it progresses through three classic stages (Heifetz classification): from mild inflammation (Stage I) to infection with a pyogenic granuloma and deformity of the nail fold (Stage III). At this point, conservative treatment is rarely effective, and surgery is needed to resolve the problem definitively.

What many people don’t realize is that trimming the tip of the nail at home actually makes the problem worse. When you trim the nail into a V-shape or cut it too short, it creates a sharp splinter that grows inward, perpetuating the cycle of pain and infection.

Anatomy of an ingrown toenail — inflamed periungual fold

Symptoms of an ingrown toenail — pain and swelling in the big toe

Symptoms: When Should You See a Podiatrist?

An ingrown toenail progresses through three stages. The sooner you take action, the easier and faster the treatment will be:

Stage I — Mild inflammation: pain when pressing on the edge of the nail, slightly red and swollen skin. You may experience discomfort when wearing closed-toe shoes.
Stage II — Infection: The pain worsens, pus forms, and the skin fold becomes more swollen and red. This may make it difficult to walk normally.
Stage III — Granuloma: A pyogenic granuloma (excessive fleshy tissue growing over the nail) forms, accompanied by frequent bleeding and constant pain even at rest. The finger may have a foul odor due to the chronic infection.

⚠️ Seek medical attention immediately if you notice pus, excess skin growing over the nail, or a fever. In patients with diabetes, peripheral vascular disease, or immunosuppression, an untreated ingrown toenail can lead to serious complications (cellulitis, osteomyelitis).

Why do ingrown toenails occur?

Onychocryptosis does not have a single cause, but rather a combination of factors that contribute to the nail edge digging into the skin:

Mechanical factors

Improper cutting: cutting nails in a curved shape, cutting them too short, or leaving sharp edges on the sides.
Tight-fitting shoes: pointed-toe shoes, heels that squeeze the toes.
Trauma: repeated impacts (soccer, running, ballet), dropping a heavy object.

Anatomical and systemic factors

Involute nail: genetically determined roof-tile-like morphology (excessive transverse curvature).
Hyperhidrosis: Excessive sweating softens the skin and makes penetration easier.
Obesity: increased pressure on the toes.
Medications: Some drugs (retinoids, indinavir) affect nail growth.

Our treatment: minimally invasive partial mastectomy

The ultimate solution for recurring ingrown toenails.

At Clínica San Román, we perform a minimally invasive partial matricectomy: an outpatient procedure lasting 15–30 minutes in which, under local anesthesia, the portion of the nail matrix responsible for the recurrence is selectively removed. It is the gold standard treatment backed by scientific evidence, with a success rate of over 95% and a recurrence rate of less than 5%.

What does the procedure involve?

Digital local anesthesia: Anesthetic is applied to the base of the finger. From that point on, you won’t feel anything in your finger.
Removal of the splinter: The piece of nail embedded in the skin is removed, immediately relieving the pressure.
Partial matrixectomy: 88% phenol is applied (chemical matrixectomy) or mechanical ablation is performed on the lateral portion of the matrix, selectively destroying the germinal cells responsible for the problematic edge. The rest of the nail is left untouched.
Bandaging and discharge: A compression bandage is applied, and you walk out on your own two feet.

Key Benefits

No pain during the procedure (local anesthesia).
No stitches or sutures.
No sick leave required: most patients return to their normal activities within 2–3 days.
Final result: The recurrence rate following partial phenol matricectomy is <5%.
Excellent cosmetic results: the nail looks practically normal.
Suitable for people with diabetes and vascular patients (with appropriate precautions).

Minimally Invasive Surgery for Ingrown Toenails — Clínica San Román

Matricectomy vs. Other Treatments for Ingrown Toenails

*Los resultados pueden variar en función de cada caso.*
	Spiculectomy alone	Partial mastectomy (phenol)	Complete nail avulsion
Recurrence	High (50–70%)	Very low (<5%)	Moderate (30%)
Postoperative pain	Mild	Mild	Moderate to intense
Final appearance	Normal (but recurrent)	Pretty much normal	A nail may grow in a deformed shape
Sick leave	1–2 days	2–3 days	1–2 weeks
Indication	Stage I: On schedule	Stage II–III or recurrent	Severe onychodystrophy

Prevention: How to Prevent It From Happening Again

If you’ve ever had an ingrown toenail or want to prevent one, these habits are key:

Proper cut

Cut your toenails straight across, without rounding the corners. Use a straight-edged nail clipper (not a manicure clipper). Cut the nail to the length of the free edge of the toe— never shorter. Gently file the edges to prevent sharp points.

Appropriate footwear

Wear shoes with a wide toe box that don’t squeeze your toes. Avoid wearing high heels and pointed-toe shoes for long periods of time. When exercising, make sure there is 1 cm of space between your longest toe and the front of the shoe.

Hygiene and Hydration

Wash and dry your feet thoroughly every day, especially between your toes. If you have hyperhidrosis, wear socks made of cotton or breathable technical fabrics. Moisturize the skin around your nails (not the nail plate) to keep it supple.

Proper Footwear to Prevent Foot Problems — San Román Clinic

First podiatry consultation at Clínica San Román in Alicante

Your first appointment with us

The initial consultation is free and requires no obligation. We’ll explain exactly what’s wrong with your nail, what stage it’s at, and what the best treatment option is for you:

Clinical examination: We assess the extent of the condition, the presence of infection, the nail’s appearance, and any potential contributing factors.
Personalized diagnosis: We determine whether your condition can be treated with conservative therapy (spiculectomy + orthonyxia) or whether you require matricectomy.
A clear plan of action: we’ll explain the procedure, recovery time, and post-operative care. No surprises.

📞 +34 965 921 156 · ✉️ info@clinicasanroman.com

Frequently Asked Questions About Ingrown Toenails

📋 About the condition

Does an ingrown toenail heal on its own?

No. A Stage I ingrown toenail may improve temporarily with saltwater soaks and a change of footwear, but in most cases the problem recurs if the underlying cause (a splinter, ingrown nail, or improper trimming) is not addressed. If you’ve had more than one episode, it’s advisable to consult a healthcare professional to explore a permanent solution.

Why does this always happen to the same finger?

This is because the cause is usually anatomical: an abnormal nail shape (excessively curved nail), an underlying bony protrusion (subungual exostosis), or a repeated habit of improper trimming. As long as the predisposing factor persists, the nail will continue to become an ingrown toenail. Partial matricectomy removes the responsible portion of the matrix and breaks the cycle.

Can children get ingrown toenails?

Yes. It is relatively common in children aged 8–10 and older, especially among those who play soccer or wear tight athletic shoes. In children, the initial approach is usually conservative. If the condition recurs, a partial matricectomy can be performed under local anesthesia, just as in adults, with excellent results.

🏥 About the surgery

Does surgery for an ingrown toenail hurt?

The procedure is performed under digital local anesthesia, so you will not feel any pain during the procedure. The injection of the anesthetic may cause brief discomfort (2–3 seconds). After surgery, any discomfort is mild and can be managed with oral pain medication (acetaminophen or ibuprofen). Most patients describe the postoperative period as “much less painful than they expected.”

How long does it take to heal?

Complete healing usually occurs within 2 to 4 weeks. During this time, patients perform simple home care using an antiseptic (Betadine). Most patients return to work within 2 to 3 days and can wear closed-toe shoes starting in the second week.

Can it reincarnate after the surgery?

According to the medical literature, the recurrence rate for partial phenol matricectomy is less than 5%. Without matricectomy (spiculectomy alone), the recurrence rate can exceed 70%. At Clínica San Román, we perform selective matricectomy to achieve a definitive result.

Will the nail look bad after the procedure?

No. Since this is a partial matricectomy, only the lateral portion of the matrix responsible for the recurrence (2–3 mm) is removed. The nail grows back looking virtually normal, though slightly narrower. The vast majority of patients are satisfied with the cosmetic result.

❌ Myths

Do I have to remove the entire nail?

False. Total avulsion (removing the entire nail) is an outdated procedure for ingrown toenails. It has a 30% recurrence rate, and the nail may grow back deformed. Partial matricectomy is much more effective, less invasive, and preserves most of the nail.

Does cutting your nails into a V-shape prevent ingrown toenails?

False. This is one of the most widespread myths. Cutting a V-shape in the center of the nail does not change the direction of growth or relieve pressure on the sides. In fact, it weakens the nail and can create sharp edges that are more likely to dig into the skin.

Does putting cotton under the nail solve the problem?

It may temporarily relieve pressure, but it is not a solution. The cotton can become damp and turn into a source of bacterial or fungal infection. In mild Stage I cases, it can be used as a temporary measure alongside other treatments, but if the problem recurs, a partial matricectomy is the definitive solution.

📚 Scientific bibliography and references

Surgery and matrixectomy for ingrown toenails :
– Espensen EH, Nixon BP, Armstrong DG. Chemical matrixectomy for ingrown toenails: is there an evidence-based choice? J Am Podiatr Med Assoc. 2020;110(2):Article_1. [PubMed]
– Alcelik I, Sukeik M, Pollock R, et al. Surgical Strategies for Ingrown Toenails: A Comprehensive Review of Techniques, Outcomes, and Advancements. Cureus. 2024;16(2):e53620. [PubMed — Review 2024]
– Acar E. New, Effective and Minimally Invasive Technique for the Treatment of Ingrown Toenails. Indian J Surg. 2024;86:399-403. [PubMed — 2023]
– Romero-Pérez D, Betlloch-Mas I, Encabo-Durán B. Onychocryptosis: a long-term retrospective and comparative follow-up study of surgical and chemical matrixectomy in 553 procedures. Dermatol Surg. 2017;43(11):1437-1441. [PubMed]

Epidemiology and classification:
– Haneke E. Controversies in the Treatment of Ingrown Nails. Dermatol Res Pract. 2012;2012:783924. [PubMed]
– Heifetz CJ. Ingrown toenail. A clinical study. Am J Surg. 1937;38:298-315.
– DeLauro NM, DeLauro TM. Onychocryptosis. Clin Podiatr Med Surg. 2004;21(4):617-630. [PubMed]

Clinical guidelines:
– Ingrown Toenails. StatPearls. 2024. [NCBI StatPearls — 2024]

Request your free consultation at Clínica San Román Alicante

Stop suffering from an ingrown toenail. Fix it today.

Over 45 years of solving foot problems. The initial consultation is free and requires no obligation. In just one visit, we’ll confirm the diagnosis and recommend the most appropriate treatment for your condition.

📞 +34 965 921 156
✉️ info@clinicasanroman.com
📍 Av. del Dr. Ramón y Cajal 1, 03001 Alicante