In such cases, surgery is required to remove the offending part of the nail to stop it from growing into the skin. A sliver of the nail is removed, running from the tip to the base. This immediately eases the pressure on the skin, and will stop pain and swelling. However in order to ensure that the condition does not return, part of the nailbed itself is destroyed. The destruction is usually achieved by chemical means, with phenol one of the most common agents used. With the nailbed partially destroyed, the ingrown toenail is unlikely to return.
However even this treatment may not be sufficient, with repeat procedures required periodically for some people. In such cases many seek more drastic surgical intervention. A technique dating back to 1959 targets the toe itself, rather than the toenail. The Vandenbos procedure is not commonly performed, with only a few United States surgeons conducting the highly invasive and destructive procedure. The nail is left totally untouched, however part of the toe is removed on each side of the nail. Whilst the toenail will appear intact and perfect, the procedure removes a considerable amount of tissue, which can take some weeks to heal and can be highly uncomfortable.
The technique has been shown to be highly effective; however the invasive nature has come under considerable criticism for leaving the toe open to serious infection. Over 600 patients have benefitted from the treatment without any recurrence; however the procedure appears a little barbaric, and will take considerably longer for a full recovery than a simple chemical cauterization of the nail matrix. However such is the discomfort suffered, that it leads people to take all manner of drastic measures to ease the pain and suffering. However before such a course of action is taken, it is a wise move to opt for the chemical treatment in the first instance, and only if that fails, undertake more drastic measures.
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