Consultation on Do not keep enduring swelling, and repeated inflammation in Motomachi, Kobe
With an involuted or ingrown toenail, the nail edge may press into the skin and cause pain, redness, swelling, bleeding, or recurrent inflammation at the same site.
Involuted and ingrown toenails may look similar, but nail shape and skin inflammation must be assessed separately. Our plastic surgeons examine both and may perform an insurance-covered phenol matrixectomy when appropriate.
If you have the following symptoms, the edge of the nail may irritate the surrounding skin.
Pain where the nail edge presses into the skin
Redness and swelling around the nail
Bleeding or pus
Raised red granulation tissue
Pain worsens when wearing shoes
Recurrent inflammation at the same site
Please consider early check-up
Seek medical care rather than continuing self-treatment if swelling or pus is pronounced, pain makes walking difficult, or you have diabetes or impaired circulation.
UNDERSTANDING THE CONDITION
Involuted and ingrown toenails are different conditions
A curved nail and a nail edge that penetrates the skin and causes inflammation are not the same condition.
CURVED NAIL
Involuted toenail
Both sides of the nail curve strongly inward. Curvature alone may cause no pain or inflammation if the nail does not press into the skin.
INGROWN NAIL
Ingrown toenail
The nail edge grows into the surrounding skin, causing pain, redness, swelling, bleeding, or granulation tissue. It can occur without marked nail curvature.
Appearance alone may not distinguish the conditions. Examination checks nail curvature, overly short trimming, inflammation, granulation tissue, infection, footwear, and gait.
CAUSES & PREVENTION
Common causes and prevention
01
Cutting the nail too short or rounding the corners
Cutting the nail too short or deeply trimming only the painful corner makes the nail more likely to grow into the skin.
02
Poorly fitting footwear
Shoes with a tight toe box and high heels compress the nails. Shoes that are too large can also let the foot slide and increase pressure on the toes.
03
Uneven pressure on the toes
Bunions, gait, sports, and prolonged standing can concentrate pressure on particular toes and contribute to nail deformity or ingrowth.
DAILY CARE
Trim the nail straight across
Do not cut toenails too short. Cut the free edge almost straight across and soften only the corners. Deep diagonal trimming may provide temporary relief but encourages the regrowing nail to become ingrown again.
Leave the corner, not too short
PHENOL PROCEDURE
Treatment at our clinic
Insurance
Phenol matrixectomy
The nail edge pressing into the skin is removed as a narrow strip from the root, and the corresponding nail-producing tissue (nail matrix) is treated with phenol.
Because the treated side is less likely to regrow, the nail becomes correspondingly narrower. This may be considered for recurrent inflammation or when conservative care has not helped.
Removes only the nails on the side of the food and treats the roots.
01
Local anesthesia
Local anesthesia is administered at the base of the affected toe.
02
Remove the affected nail edge
Remove a narrow strip of the nail edge that presses into the skin, extending to the root.
03
Treat the nail matrix
Treat the corresponding nail matrix with phenol.
04
Hemostasis and dressing
Check the wound, then protect it with ointment and gauze.
Medical Treatment
Insurance
Anesthesia
Local anesthesia
Time required
Approx. 20 minutes
Walking is usually possible immediately after surgery.
Shower
From the following day, as a guide
Bathing
3 days later
Treatment at home
About 1 week, ointment and gauze replacement
Costs
Varies by insurance copayment, examinations, prescriptions, and procedures
Important surgical considerations
Possible risks include bleeding, infection, pain, swelling, delayed healing, recurrence, temporary shedding of the remaining nail, narrowing of the nail, and nail deformity. The duration of follow-up and wound care depends on healing.
TREATMENT FLOW
From consultation through aftercare
01
Initial consultation and assessment
We ask about the course of pain and inflammation, nail trimming, footwear, and previous treatment, then examine the nail and surrounding skin.
02
Explanation of treatment options
Based on the symptoms and recurrence history, we explain whether phenol matrixectomy is appropriate, what it may achieve, and the relevant precautions.
03
Outpatient procedure
Phenol matrixectomy is performed under local anesthesia. Because the toe will be bandaged, please wear shoes with ample room at the toes.
04
Treatment and care at home
Change the ointment and gauze as instructed. We check wound healing at follow-up and advise when exercise may be resumed.
FAQ
Frequently asked questions about ingrown and involuted toenails
What is the difference between an involuted and an ingrown toenail?
An involuted toenail curves strongly inward. An ingrown toenail penetrates the surrounding skin and causes pain, swelling, bleeding, or granulation tissue. Both can occur together.
Can I seek care even if the pain is mild?
Yes. Please seek care early if you have swelling, pus, bleeding, or difficulty walking.
Is phenol matrixectomy covered by Japanese health insurance?
The phenol matrixectomy we perform for ingrown toenails is covered by Japanese health insurance. Your out-of-pocket cost depends on the consultation, examinations, prescriptions, procedures, and your insurance copayment rate.
Can I walk after surgery?
Walking is usually possible immediately after surgery. Because the toe will be bandaged, please wear comfortable shoes with room at the toes. Resume long walks and vigorous exercise according to wound healing.
Can I take a shower or take a bath?
As a general guide, you may shower from the following day and take a bath after three days. Instructions may change with the condition of the wound, so follow the postoperative guidance you receive.
Can an ingrown toenail recur after phenol matrixectomy?
Recurrence is possible. Other risks include bleeding, infection, pain, delayed healing, and nail deformity. We explain the procedure and precautions before treatment.
Treatment planning considers not only nail shape but also skin inflammation and the previous course. Please consult plastic surgery if pain or swelling keeps recurring.
