Medically Reviewed | Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle, Michigan
Quick Answer:
Quick Answer: Onychocryptosis is the medical term for an ingrown toenail — when the nail plate grows into the surrounding nail fold causing pain, inflammation, and often infection. Dr. Biernacki provides in-office treatment ranging from simple nail edge removal (partial nail avulsion) for mild cases to permanent nail matrix ablation (phenol matrixectomy) for recurring ingrown nails — eliminating the nail growth from that edge permanently.
Treatment at Balance Foot & Ankle: Professional Nail Care →
What Is Onychocryptosis?
Onychocryptosis — the clinical term for ingrown toenail — occurs when the lateral or medial edge of the toenail grows into or is embedded in the surrounding soft tissue (nail fold). The result is a predictable sequence: pressure and irritation → inflammation → pain → bacterial or fungal secondary infection. The great toe is affected in the overwhelming majority of cases, though any toe can develop an ingrown nail. Dr. Tom Biernacki performs in-office treatment for onychocryptosis at every stage — from mild discomfort to severe infection — with local anesthesia for a completely comfortable procedure.
Causes: Why Ingrown Nails Develop
Ingrown toenails develop from improper nail trimming (cutting corners too short or rounding the nail edges rather than cutting straight across), tight-fitting footwear that compresses the nail fold against the nail plate, trauma such as stubbing the toe or dropping something on it, nail curvature (involuted nail plate) that tends to grow into the surrounding tissue, and hyperhidrosis (excessive sweating) that softens the nail fold and makes it vulnerable to nail penetration. Identifying the contributing cause is part of Dr. Biernacki’s evaluation — so the nail doesn’t keep coming back.
In-Office Treatment: Partial Nail Avulsion vs. Permanent Matrixectomy
For a first-time ingrown nail without structural nail abnormality, partial nail avulsion — removing the ingrown edge under local anesthesia — provides immediate relief. The procedure takes 10–15 minutes, involves no significant pain, and allows return to normal footwear within days. For recurring ingrown nails, Dr. Biernacki recommends phenol matrixectomy: after nail edge removal, phenol (a chemical cauterant) is applied to the nail matrix cells at the base of that nail edge, permanently destroying the growth cells so the ingrown portion can never regrow. This procedure has a recurrence rate below 5% and is the definitive solution for chronic sufferers.
Managing Infection Before Treatment
Many patients arrive with established paronychia — bacterial infection of the nail fold — alongside the ingrown nail. Dr. Biernacki manages infection concurrent with nail treatment. Oral antibiotics are prescribed when cellulitis extends beyond the immediate nail fold. Incision and drainage is performed for abscess formation. Treatment is not delayed for infection — simultaneous management of the ingrown nail and infection produces faster resolution than sequential treatment.
Dr. Tom's Product Recommendations
Dr. Scholl’s Ingrown Toenail Pain Reliever
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OTC gel with a small tool to reduce pressure and pain from mild ingrown toenails while waiting for a professional appointment. Provides temporary relief — does not fix the underlying ingrown nail.
Dr. Tom says: “Used this the week before my appointment with Dr. Biernacki. Made the pain manageable until the actual procedure.”
Mild ingrown toenail pain relief while waiting for appointment
Infected ingrown nails or severe ingrown nails — see Dr. Biernacki immediately
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Hoka Clifton Wide-Width Running Shoe
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Maximum cushion, wide toe box shoe that reduces lateral toe box compression — one of the primary causes of recurring ingrown toenails. Dr. Biernacki frequently recommends wide toe box footwear post-treatment.
Dr. Tom says: “Dr. Biernacki told me my old narrow shoes were causing my ingrown nails to keep coming back. Switched to wide toe box and no more problems.”
Ingrown nail prevention, wide feet, hammer toes, toe discomfort
Patients whose toe box is already adequately wide in current footwear
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✅ Pros / Benefits
- Permanent phenol matrixectomy eliminates recurring ingrown nail edge — <5% recurrence rate
- Local anesthesia for a completely comfortable in-office procedure
- Infection managed concurrent with nail treatment — no waiting
- Same-week appointments for painful ingrown nails in most cases
❌ Cons / Risks
- Wound care required for 1–2 weeks post-matrixectomy before full healing
- Phenol matrixectomy permanently changes nail appearance (narrowed nail) — patients are counseled beforehand
Dr. Tom Biernacki’s Recommendation
Ingrown toenails are one of the most common — and most undertreated — foot problems I see. Patients suffer for months with something I can fix in 15 minutes with local anesthesia and no significant recovery. If you have an ingrown nail, just come in.
— Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle
Frequently Asked Questions
Does ingrown toenail removal hurt?
The injection of local anesthesia produces a brief sting — after that, the procedure is completely comfortable. Most patients are surprised by how painless it is once numb.
How long is recovery after permanent matrixectomy?
The treatment site takes 2–4 weeks to fully heal. Patients can walk and wear shoes immediately after, though the site requires daily wound care during healing.
Will my toenail look normal after permanent treatment?
The nail will be slightly narrower at the treated edge. Most patients find the cosmetic change far preferable to continued pain and infection.
Can I treat an ingrown toenail at home?
Mild cases can sometimes be managed temporarily with warm soaks and proper cutting technique. However, recurrent ingrown nails, any sign of infection (redness, pus, significant swelling), and ingrown nails in diabetic patients always require professional treatment.
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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.
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
- Hallux Valgus (Bunions): Evaluation and Management (PubMed)
- Bunions (Mayo Clinic)
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