Nail Surgery
We have paricular expertise in nail surgery, which is a highly specialised area of dermatological surgery. The nail is an important part of the finger or toe, for both protection and cosmetic appearance. We take particlar care to provide you with the best outcome.
When is nail surgery required?
There are a variety of reasons patients may need a nail surgical procedure. You may be referred by another dermatologist, your GP or you may self refer. Common reasons for nail surgery include:
- Ingrowing nails
- Paranychia
- Fungal infection of the nails (onychomycosis)
- Pigmentation of the nail (melanonychia)
- Redness of the nail (erythronychia)
- Thickening of the nail after trauma
- Warts around the nails - periungual warts
- Laser treatment of warts
Some patients require skin cancer treatments around or involving the nail:
- Subungual melanoma
- Squamous cell carcinoma
- Bowen's disease
Also, we are able to remove benign lesions on or around the nail:
- Subungual hyperostosis
- Glomus tumour
- Myxoid Cyst/Ganglion
What does the procedure involve?
Nail surgery is performed under local anaesthetic, which means that you will be awake for the procedure. If you wish, for some procedures, such as laser treatment, you can be asleep under a general anaesthetic, but this is not usually necessary.
- A small injection (a digital ring block) is placed in the finger or toe to take away any feeling of pain
- A tourniquet is applied around the digit to reduce any bleeding during surgery
Nail removal vs Nail biopsy
Whether you simply need a biopsy of the nail or removal of the nail will be discussed with you in your pre operative consultation. It may be necessary to remove the entire nail plate, using a gentle surgical technique. In other cases, we may be able to preserve most of the nail plate by creating a small window to allow us to access the nail bed for biopsy. After this, the nail plate can be replaced, minimising the surgical wound.
What is the recovery time after nail removal or biopsy"
The length of the recovery time depends on whether you have a nail biopsy or a nail plate removal. If a nail biopsy is performed, you may have some minor pain, swelling and inconvenience for a few days after the procedure. However, if you have whole nail removed, the area may be raw for about two weeks after the surgery and it may take several weeks or months for the nail to regrow. It is important to think about:
- the impact of the procedure on your work
- the impact of the procedure on any caring roles you may have
- whether you are right or left handed
- whether you need special footwear after any toenail procedures
- whether the surgery impacts on your exercise routine or sport
Feel free to cover these issues during your consultation, as planning is an important part of a successful procedure.