A lot of people suffer the pain and frustration of ingrown toenails. Unfortunately, some cases are much worse than others and refuse to clear up on their own. Those cases, although not common, lead to surgery to remove part or all of the nail. But how do you determine if surgery might be necessary for this condition? Following the outlined steps should help you determine if surgery is necessary for an ingrown toenail.

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How to Determine if Surgery is Necessary for an Ingrown Toenail

Using a well-lit magnifying mirror or a lighted mirror and magnifying glass, examine the toe. Check to see if the nail is irregularly or improperly curved. This information could indicate the reason for the ingrown nail. Take note if it is red and/or hot to the touch as these symptoms could indicate that the skin and/or surrounding tissue of the toe might be inflamed. Look to see if the toe is swollen, which could indicate possible infection. Finally, try to determine exactly where the nail might be ingrown into the skin of the toe. This information may be helpful in trying to get an appointment with a physician or podiatrist. It may also give an indication as to the severity of the problem as well as the danger of infection.

Determine the pain level of the toe as well the surrounding nail area. Rate it on a scale of one to 10 with one being mild and 10 being the worst pain you’ve ever felt. This pain level information will be key when you meet with or speak to your physician.

Try to determine what might have caused the situation. Typical causes are wearing shoes or socks that were improperly made or too tight; incorrect grooming methods and/or cutting of the nails; or injury to the toe like “jamming” or “stubbing” it. These are factors that the doctor will take into consideration when deciding whether surgery may be necessary. For example, you can easily make corrections with regard to the shoes you wear by choosing better made and properly fitting shoes. However, if your job involves the use of your toes in a manner that could cause additional injury in the future, that may be a factor that you cannot control.

If possible causes of the ingrown toenail are situations that you can change, make those changes to see if they help to improve the overall situation.

Try the standard self-treatment. Soak the toe in clean, warm water. Carefully towel dry. Using rubbing alcohol or hydrogen peroxide and Q-Tips, carefully clean around the ingrown area. Using a nail file or similar tool, carefully separate the nail from the inflamed area. If possible, put a small amount of antiseptic soaked gauze in between the nail and the tissue. If that isn’t possible, then use a Q-Tip to put antibiotic ointment or cream into the area.

Continue the treatment outlined in Step 5 for 10 to 14 days to see if it will help the nail grow apart from the skin. If it appears to be working, then continue the treatment until the toe feels better. If not, make an appointment to see a doctor or podiatrist.

If and when you go to the doctor, go armed with as much information as you can. Take a list of your symptoms as well as any possible causes for the problem and any at home treatments that you have tried. Also be sure to prepare a list of any questions you may have so that you can ask them at the time of your visit.

Try any additional treatments that your physician or podiatrist might prescribe. This could include a round of antibiotics if she feels that the toe might be infected. Be sure to follow her instructions to the letter so that a determination can be made if more drastic actions are required.

Attend any follow-up appointments and continue treatment regimens until such time as the doctor determines they are not working. At that point, he will likely recommend surgery. This possibility becomes a probability in the event that the toe is infected or becomes infected during other treatments. Chronic infection, unfortunately, may make surgery the only viability.


  • Unusually or improper curved nails may be a symptom of a long-term problem that could cause more ingrown toenails.

  • Be sure to thoroughly clean and take proper care of feet.

  • Apply antiseptic or antibiotic ointment or cream at the first sign of any kind of nail infection.

  • Take proper precautions to protect your toes in sports and your job, using reinforced toe shoes or boots.