You've been soaking your toe for days, wrapping it carefully, and hoping the pain will just go away, but it hasn't. Now you're wondering if surgery is the only way out—or if there's something less drastic that might actually work.
Ingrown toenails happen when the edge of the nail pierces the surrounding skin instead of growing straight out. However, most ingrown toenails don't require surgery, but some do. The difference comes down to the severity of the problem, its duration, and whether an infection has set in. The board-certified foot doctors at Indy Podiatry help people throughout Central Indiana understand whether conservative treatments or surgery are the best solution. Here’s what you need to know.
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What Makes a Toenail Grow Inward in the First Place?
If your toenails are thick or naturally curved, you may be more prone to this condition. Some individuals are also more susceptible due to genetics or ongoing health conditions, such as diabetes, that limit proper blood circulation. Other reasons for ingrown toenails include:
- Certain medical conditions, such as psoriasis
- Footwear that presses or crowds the toenail
- Trauma to the toe
- Trimming toenails too short or rounding the corners
- Fungal or bacterial nail infections
- Poor foot hygiene, including keeping feet damp or sweaty
During a comprehensive exam with one of our Indianapolis foot doctors, we assess all the factors contributing to the condition before recommending a treatment protocol.
Why Can’t I Treat Ingrown Toenails at Home?
Well, if you have a mild problem that you spot right away, you might be able to. Warm water foot soaks sometimes help lift the nail edge off the skin, making it a little easier to trim the curved portion into a straight line.
However, once the nail embeds into the skin, self-treatment rarely helps. Cutting the nail often makes things worse, as it’s hard to see the full extent of the problem, and improper trimming leaves a sharp edge that digs in even deeper. Additionally, the risk of infection increases when non-sterile tools are used. So, what starts as an attempt to avoid the doctor can end up requiring more intensive care than the original problem would have required.
What Conservative Treatments Help Ingrown Toenails?
If your condition hasn’t yet caused infection or severe pain, conservative treatment often works. One of our Indianapolis foot doctors carefully lifts the nail edge away from the skin and places a small barrier underneath to guide the nail as it grows. This allows the skin time to heal without the need for surgical intervention. Oral or topical antibiotics may be prescribed if early signs of infection are present. We also might examine your shoes and make recommendations to reduce pressure on the affected toe and provide space for the nail to grow normally.
Many of our patients usually see improvement within a few weeks when these methods are applied correctly and consistently, especially when:
- The ingrown toenail is caught early. Mild redness and discomfort typically respond well to gently lifting the nail and adjusting the footwear.
- There's no infection present. Once pus or significant swelling develops, conservative methods struggle to eliminate the underlying problem.
- You follow aftercare instructions to the letter. Success depends on keeping the area clean, wearing appropriate shoes, and avoiding activities that reinjure the toe.
When Is Ingrown Toenail Surgery the Right Choice?
This might be our recommendation when the condition is recurrent, severely infected, or causing chronic pain that non-invasive treatments haven’t resolved. The most common procedure is a partial nail avulsion, when one of our podiatrists removes the section of nail that's digging into the skin. A chemical is often applied to the nail matrix—the tissue where the nail grows—to prevent that portion from regrowing.
This procedure is performed under local anesthesia in our Indianapolis office and takes about 20 minutes. Recovery is straightforward for most patients, with significant pain relief occurring almost immediately and minimal downtime. Full healing typically occurs within 2 to 4 weeks.
In cases where the entire nail is problematic, a total avulsion may be recommended. This is less common but appropriate when the nail is severely damaged, misshapen, or prone to repeated ingrowth on multiple sides.
What Happens If You Wait Too Long for Ingrown Toenail Treatment?
Ignoring the problem doesn't make it go away. All too often, this causes:
- Abscesses beneath the skin. Pockets of pus form around the nail, requiring drainage and stronger antibiotics than a simple course of oral medication.
- Infection spreads to the bone. When bacteria reach the underlying bone, osteomyelitis develops—a painful condition that often requires hospitalization, intravenous antibiotics, and months of recovery.
- More complications for people with diabetes. Reduced blood flow means wounds heal slowly, and nerve damage may mask the pain until the infection has already progressed dangerously far.
- Minor injuries evolve into medical emergencies. What starts as redness and swelling can quickly evolve into tissue death or systemic infection for patients with compromised immune systems or vascular disease.
Regular podiatric care prevents these outcomes. At Indy Podiatry, our goal is always to resolve the pain, prevent recurrence, and help you return to normal activity after an ingrown toenail as quickly as possible. Whether that requires a simple in-office procedure or a surgical solution, our dedicated team provides care tailored to your specific situation—not a one-size-fits-all approach.