Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

When Ingrown Toenails Need More Than Conservative Care

Ingrown toenails — onychocryptosis — occur when the nail edge grows into the adjacent nail fold, causing pain, inflammation, and often infection. Mild ingrown toenails can sometimes be managed conservatively with proper nail trimming, cotton wisp placement, and soaking. However, recurrent ingrown toenails, infected nail folds, chronic granulation tissue, and nails that have been previously treated without permanent resolution are appropriate candidates for surgical correction. At Balance Foot & Ankle, we perform nail procedures in our Michigan offices for patients throughout Southeast Michigan who are tired of recurring ingrown toenail pain.

Anatomy of the Toenail and Why Ingrown Nails Recur

The toenail grows from the nail matrix — the germinal tissue at the base and sides of the nail bed. The nail plate itself is simply keratinized cells that the matrix produces. When the nail edge is cut too short, torn, or curves excessively, it can penetrate the adjacent nail fold and soft tissue. Conservative treatment relieves the acute problem but does not change the nail matrix, so the same nail edge grows back and the problem recurs. Permanent correction requires ablation (destruction) of the portion of the nail matrix that produces the offending nail border.

The Partial Nail Avulsion and Matrixectomy Procedure

Partial nail avulsion with chemical or surgical matrixectomy is performed under digital block anesthesia — local anesthetic injected at the base of the toe to numb it completely. The procedure takes approximately 10 to 15 minutes. A tourniquet is applied to reduce bleeding. The offending nail border — typically the lateral 3 to 4 millimeters — is separated from the nail bed using a nail elevator and removed with nail splitters. The underlying nail matrix in the lateral horn of the nail fold is then ablated using phenol (an 89 percent chemical solution) applied to the matrix for 30 to 60 seconds. Phenol chemically destroys the matrix cells that would otherwise regenerate the nail edge, achieving permanent results. The area is thoroughly irrigated, dressed, and the patient walks out of the office.

Phenol vs Surgical Matrix Excision

Chemical matrixectomy with phenol is the most widely used technique because of its simplicity, high success rate (greater than 90 percent permanent resolution), and low complication rate. Surgical matrix excision — physically removing the matrix tissue — is an alternative with comparable results used by some surgeons who prefer it. Both techniques achieve equivalent long-term outcomes when performed correctly.

Recovery After Nail Matrixectomy

The treated toe has a small open wound in the lateral nail fold that requires daily wound care for 2 to 6 weeks as it heals by secondary intention. Daily soaking, antibiotic ointment application, and non-adherent dressing changes are the standard home care regimen. The toe is initially sore but most patients do not require prescription pain medication and return to work and light activity the same day or the next day. Healing typically completes within 4 to 6 weeks. The final cosmetic result leaves the nail slightly narrower on the treated side but otherwise normal in appearance.

Contact Balance Foot & Ankle if you have recurrent ingrown toenail pain or a current ingrown toenail that needs treatment. We offer same-day and same-week ingrown toenail procedures for patients throughout Southeast Michigan.

Frequently Asked Questions

How long does ingrown toenail surgery take to heal?

The procedure itself takes 15-20 minutes. Soaking and dressing changes continue for 2-3 weeks, with complete healing by 4-6 weeks. Most patients return to normal activity in 2-3 days.

Does matrixectomy hurt?

The procedure is performed under digital block anesthesia and is painless during surgery. Post-operative discomfort is typically mild and managed with over-the-counter pain medication.

How effective is phenol matrixectomy?

Phenol matrixectomy has a success rate of 95-98% in preventing recurrence. It is the most commonly performed and widely studied permanent ingrown toenail treatment.

Ingrown Toenail Surgery in Michigan

Chronic or infected ingrown toenails often require a simple in-office procedure for permanent relief. Our podiatrists perform partial nail avulsions at our Howell and Bloomfield Hills offices with minimal downtime.

Learn About Ingrown Toenail Treatment | Book Your Appointment | Call (810) 206-1402

Clinical References

1. Heidelbaugh JJ, Lee H. Management of the ingrown toenail. Am Fam Physician. 2009;79(4):303-308.
2. Eekhof JA, et al. Interventions for ingrowing toenails. Cochrane Database Syst Rev. 2012;(4):CD001541.
3. Bos AM, et al. Surgical treatment of ingrowing toenails: a systematic review and meta-analysis. J Foot Ankle Surg. 2007;46(2):64-72.

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.