Ingrown toenails are removed through a quick in-office procedure called a partial nail avulsion, where a doctor numbs your toe and cuts away the strip of nail digging into your skin. The whole process takes about 20 to 30 minutes, and most people walk out of the office on their own feet. For nails that keep coming back, a chemical treatment can be applied during the same visit to permanently stop that portion of the nail from regrowing.
What Happens During the Procedure
The first step is numbing your toe. Your doctor injects a local anesthetic near the base of the toe to block the nerves on both sides. You’ll feel a brief sting from the needle, but within a few minutes the entire toe goes numb and stays that way for the rest of the procedure. Some providers add a small amount of epinephrine to the injection, which constricts blood vessels and keeps the area numb longer.
Once the toe is fully numb, the doctor slides a flat instrument underneath the nail to separate it from the nail bed. Then, using scissors or a specialized nail splitter, they cut straight back along the nail from the tip toward the cuticle, creating a clean, straight edge. Only the narrow strip of nail that’s pressing into your skin gets removed. The rest of the healthy nail stays intact. If irritated, puffy tissue (called granulation tissue) has built up along the nail edge, the doctor may remove that as well using a heated instrument to clear it away.
The entire cutting and removal portion is painless because of the anesthesia. What most people notice is pressure and tugging, not sharp pain. Afterward, the toe is cleaned, an antibiotic ointment is applied, and the toe is wrapped in a bandage.
Temporary vs. Permanent Removal
If this is your first ingrown toenail or a mild case, your doctor may simply remove the nail strip and let it grow back naturally. This is called a simple avulsion. The downside: the recurrence rate is high, up to 70% by some estimates. The nail often grows back into the same curved pattern that caused the problem in the first place.
For recurring ingrown toenails, most doctors recommend destroying the nail matrix, the small patch of tissue at the base of the nail responsible for growing that strip. This is done with a chemical matricectomy, performed immediately after the nail strip is removed. The doctor applies a chemical (typically 90% phenol or 10% sodium hydroxide) to the exposed nail matrix using a cotton-tipped applicator for about 30 seconds at a time, repeated two or three times. This kills the growth cells so that particular edge of the nail never regrows.
Chemical matricectomy drops the recurrence rate dramatically. Studies show reoperation rates of roughly 6 to 8% with either chemical, compared to that 70% figure for simple removal alone. The two chemicals perform similarly, so which one your doctor uses comes down to what they have available and their personal preference.
A Less Common Alternative: The Vandenbos Procedure
Most ingrown toenail surgeries involve removing part of the nail. The Vandenbos procedure takes the opposite approach: it leaves the nail completely intact and instead removes the overgrown skin fold pressing against the nail edge. The idea is that the nail itself isn’t the problem; the surrounding tissue is. This procedure preserves the natural width and appearance of the toenail, which appeals to some patients. It’s less widely practiced than standard nail avulsion, and healing takes longer since an open wound in the skin fold needs to close on its own, but it’s an option worth knowing about if cosmetic appearance matters to you or if you’ve had multiple failed procedures.
What Recovery Looks Like
The anesthesia wears off within a few hours, and that first evening is usually the most uncomfortable. Most people manage fine with over-the-counter pain relievers. You can expect some throbbing, mild swelling, and light bleeding or drainage for the first day or two.
Most people return to work or school the next day. You’ll want to wear loose, open-toed shoes or shoes with a roomy toe box for the first week or so, since pressure on the toe will be uncomfortable. Tight shoes should be avoided until the area has healed. Swimming and strenuous exercise are off the table until the wound closes.
Healing timelines depend on what was done. A partial nail removal typically takes six to eight weeks to fully heal. If the entire nail was removed, expect eight to ten weeks. During this time, the wound gradually closes and any redness fades. The toe will look a little raw at first, but that’s normal.
Caring for Your Toe Afterward
Change the dressing for the first time about 12 to 24 hours after surgery. After that, change it once or twice a day. Each time, soak your foot in warm water with Epsom salts two to three times daily to reduce swelling and keep the area clean. Pat the toe dry, apply antibiotic ointment if your provider recommended it, and re-bandage with a clean dressing. Keep an eye out for increasing redness that spreads beyond the toe, thick or foul-smelling discharge, or fever. These can signal an infection that needs attention.
Why DIY Removal Backfires
It’s tempting to dig out an ingrown nail yourself with clippers or a nail file, but “bathroom surgery” creates more problems than it solves. Home tools aren’t sterile, and you risk opening up surrounding skin and introducing bacteria directly into the wound. If any nail fragment remains embedded, the infection that’s already brewing won’t resolve and can worsen into a deeper soft-tissue infection.
Perhaps the bigger issue is technique. Without proper instruments, you’re likely to leave a jagged nail edge behind, which makes regrowth into the skin even more likely. You essentially trade a few days of relief for a worse ingrown nail a few weeks later. People with diabetes, peripheral artery disease, or any condition that reduces blood flow to the feet face especially high risks from self-treatment, since their healing is slower and infections can escalate quickly.
What It Costs
Without insurance, professional ingrown toenail removal typically runs $200 to $500, with a national average around $350. Costs can range from as low as $150 at a basic clinic to $850 or more at a surgical center, depending on the severity, whether chemical matricectomy is included, and the facility fees. Most health insurance plans cover the procedure when it’s medically necessary, which it usually is by the time you’re considering surgery. Check with your provider about your specific copay or deductible before scheduling.