Patient Journey: Resolving a Painful Ingrown Toenail
The Problem
An 18-year-old male patient presented with a painful and infected ingrown toenail affecting the outer edge of the right big toenail. The condition had become increasingly uncomfortable, with swelling, tenderness, and signs of infection affecting his day-to-day activities.
Assessment identified that both sides of the toenail were deeply curved (involuted), which was contributing to increased pressure on the surrounding skin and making him more prone to recurrent ingrown toenails.
Initial Treatment
To provide immediate relief, conservative treatment was carried out to carefully remove as much of the offending nail spicule as possible. The toe was cleaned and a sterile antiseptic dressing was applied.
The patient was advised to:
- Bathe the toe in warm saline to support healing.
- Complete the course of antibiotics prescribed by his GP to help clear the infection.
- Long-Term Solution
- Following assessment and review, it was discussed that the best long-term solution would be a partial nail avulsion (PNA) with phenolisation. This minor nail surgery procedure removes the problematic nail edges and prevents them from regrowing, helping to reduce the risk of future painful ingrown toenails.
As the patient was travelling abroad, he was referred to a trusted podiatry colleague overseas to continue his care and, if appropriate, proceed with nail surgery.
The Outcome
By addressing both the immediate infection and the underlying nail shape contributing to the problem, the patient was provided with a clear treatment pathway aimed at achieving long-term comfort and preventing recurrence.
Ingrown toenails can often be successfully managed with early intervention, expert advice, and—when required—minor nail surgery to provide lasting relief.