In-growing toenails can often be dealt with without having to have surgery by reducing the nail and stopping it from growing into the skin. When assessing in-growing toenails, this step will always be tried or considered before progressing to surgery. If non-surgical treatment fails, nail surgery will be suggested. This is a quick, day-case procedure, performed under local anaesthetic (so you will feel no pain), without the need to be admitted to hospital. The duration of the appointment is one hour and you can return home as soon as possible afterwards.
The procedure involves the removal of part of (partial nail avulsion) the nail from the side or sides that are in-growing or the whole of the nail (total nail avulsion) if the extent of the problem is too progressed to consider removing only part of the nail. Once the nail is removed, a chemical (phenol) is applied to the nail bed and this stops the nail from growing back permanently. Using phenol means that stitches don’t need to be used and therefore there is no need to have stitches removed afterwards. Most people heal within 6 weeks and in that time the discomfort is significantly less than the original problem and requires only simple dressing changes.
Verrucae can be extremely resistant to treatment in adults and, sometimes, in children, however, in children, there is an increased likelihood that they will resolve of their own accord. There are numerous treatments available such as cryotherapy (where the wart is frozen), caustic therapy (where salicylic acid is used to agitate the tissue where the virus is) and verrucae needling (or Faulkner’s technique) which is a minor surgical procedure.
Caustic therapy and cryotherapy will always be tried first to treat verrucae unless they have already been tried and failed or if they are unsuitable for some reason. If these options fail or are not suitable then verrucae needling may be offered. The procedure involves the use of a fine needle puncturing the verruca and agitating the area so that the immune system will respond to it more effectively. The success rate is thought to be around 70%. The procedure is carried out in a treatment room under local anaesthetic and you can return home as soon as possible afterwards. You will not have to be admitted to hospital and you will be able to remove your own dressings after a couple of days, returning to the clinic within 2 weeks for a check-up.