Surgical treatment of an ingrown toenail, Category I complexity

How can you tell if an ingrown toenail may require surgical treatment?

An ingrown toenail does not always require surgery. The decision depends on how deeply the edge of the nail has grown into the surrounding tissue, whether it continues to cause repeated trauma to the nail fold, and whether there are signs of inflammation. It is also important to consider whether previous treatment has been effective.

Signs that the condition should be assessed by a surgeon may include:

• The edge of the nail continues to grow into the surrounding tissue, and the cause of the ingrowth cannot be resolved without repeated trauma.
• Pain persists or becomes more severe, particularly when walking or wearing shoes.
• Redness and swelling do not subside or return after periods of improvement.
• Pus or bloody discharge appears in the area of the ingrown nail.
• Granulation tissue develops around the nail, which may bleed easily when irritated.
• The problem keeps recurring after attempts to remove the ingrown edge yourself or after previous treatment.
• The shape of the nail or nail fold contributes to repeated ingrowth, causing the problem to return.

If you are unsure whether an ingrown toenail requires surgery, a consultation with a surgeon is the right place to start. During the examination, the surgeon will assess the condition of the nail and surrounding tissues, determine the necessary extent of treatment, and, if needed, identify the appropriate complexity category for the procedure. If a more extensive surgical intervention is required, the surgeon may determine whether surgical treatment of an ingrown toenail, Category II or Category III complexity, is indicated.

After the procedure, follow-up monitoring and wound dressing changes may be required to assess the healing process and adjust further treatment if necessary.