Ingrown Toenail (IGTN)
The nail edge grows into the surrounding skin, causing pain, swelling and infection. Repeated home-cutting only makes it worse.
See us if you have
- Pain at the nail corner, especially inside shoes
- Redness, swelling or pus around the nail
- The same toenail keeps getting re-infected
- You're diabetic and have a toe infection
- The nail has come back after a previous ingrown-toenail surgery
How we treat it
Matched to how often it recurs: a first episode is treated by nail-edge removal under local anaesthesia. If it recurs, we add a partial matrixectomy (Winograd or phenol) so that edge does not regrow. For nails recurring on both sides, deformed or thickened nails, or failed previous surgery, Dr. Kharde performs Zadik's procedure — total nail-bed ablation. All are day-care; you walk out the same day, and we use a diabetic-foot–safe technique.
Which ingrown toenail procedure do you need?
| Situation | Procedure | What is done | Nail afterwards |
|---|---|---|---|
| First episode, one side | Partial nail avulsion (wedge excision) | Nail edge removed under local anaesthesia; nail root left intact | Grows back normally |
| Recurred once, one side | Partial avulsion + matrixectomy (Winograd / phenol) | Nail edge removed and that part of the nail root treated so the edge does not regrow | Slightly narrower nail |
| Recurrent on both sides, deformed / thickened nail, or failed previous surgery | Zadik's procedure (total nail-bed ablation) | Whole nail removed and the entire germinal matrix (nail root) excised through a small skin flap, so no nail can regrow | No nail; smooth skin-covered nail bed |
All three are day-care under local anaesthesia (a digital block at the base of the toe), 20–40 minutes, walk in / walk out. Dr. Kundan Kharde chooses the option after examining the toe — a first-time ingrown nail does not need Zadik's procedure.
Zadik's procedure — what to expect
- Who it is for: ingrown toenail recurring on both edges, chronic infected or deformed (onychogryphosis) nail, or recurrence after a partial matrixectomy.
- Procedure: local anaesthetic block → full nail removed → small skin flap raised at the nail base → germinal matrix excised completely → flap stitched back. About 30–40 minutes. Home the same day.
- Recovery: dressing for 48 hours, foot elevated for 2 days, open-toe footwear for about a week, stitches out at 10–14 days, wound healed in 3–4 weeks. Most desk work resumes in 2–3 days.
- Result: the nail does not grow back. A small spicule of nail can occasionally regrow at the edge (a minority of cases) and is treated in the clinic.
- Risks: wound infection, delayed healing, temporary numbness at the toe tip, and the permanent cosmetic change of having no nail. Results vary.
- Diabetes or poor circulation: assessed first — foot pulses and sugar control are checked before any nail-root surgery.
- Want to keep the nail? Partial matrixectomy (Winograd or phenol) on the affected edges is the alternative — less cosmetic change, higher recurrence than Zadik's.
Treating the nail root (matrixectomy) after nail-edge removal reduces recurrence compared with nail-edge removal alone — Cochrane review of surgical treatments for ingrowing toenails.
