Ingrown toenail surgery: elevate, and wear sensible shoes
Two things decide how this goes, and neither of them is technique.
Written and clinically reviewed by Dr. G. Revanth, MBBS DDVL DNB · August 2026 · 2 min read
Ingrown toenail surgery is done under a digital ring block, takes twenty to forty-five minutes, and usually involves removing the offending nail edge and treating the matrix so it does not regrow. The two things that decide how comfortable the week is are genuine elevation for forty-eight hours and wide, open footwear for two weeks.
Elevation is not a suggestion
Above the level of the heart. For a toe that means lying down with the foot on pillows, not sitting with it on a stool. Blood pools in a dependent limb every minute it hangs down, and throbbing is almost always position rather than infection.
If it throbs, elevate higher. That is the diagnostic test as well as the treatment.
The wear-off is the worst moment
The ring block lasts several hours and then recedes. Start analgesia before it does, not after. Patients who wait until it hurts spend a considerably worse evening than those who take the first dose on schedule.
The discharge that is not infection
If a phenol matricectomy was performed — the chemical treatment of the nail matrix that stops the edge regrowing — the site produces a clear or straw-coloured sterile inflammatory discharge for two to six weeks. It is expected. Almost every patient who has not been warned assumes it is infected.
| Normal | Concerning |
|---|---|
| Clear or straw-coloured discharge | Thick, green or yellow discharge |
| Discharge for 2–6 weeks | Foul smell |
| Throbbing when the foot hangs down | Pain increasing after day three despite elevation |
| Mild redness at the nail fold | Redness spreading up the toe or foot |
The narrower nail is the result, not a complication
After a matrix procedure the nail regrows permanently narrower. That is intentional: it is what stops the edge digging in again. A fingernail replaces itself in about six months; a great toenail takes twelve to eighteen.
The thing that caused it
Cutting nails curved down at the corners, and narrow shoes. Cut straight across, permanently. Otherwise the procedure treats this episode and the habit produces the next one.
Any pigmented band running the length of a nail should be examined rather than watched, and a nail biopsy specimen always goes to histopathology.