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Ingrown Nails/Avulsions

Ingrown toenails are pesky and painful!

They occur when the outermost corner of the toenail cuts into the skin on the side of the toe. Luckily, the evaluation and treatment of an ingrown toenail is usually done during a single visit so we can quickly get you back on your feet.

In some cases, a full procedure to treat the nail is not necessary. Dr. Castelein can cut the nail on a slant to remove the painful portion of the nail.  This treatment involves no recovery time and provides immediate pain relief.  However, this treatment can be temporary as the nail may grow into the same painful position.

Schedule an appointment today with Dr. Bryant Castelein, DPM – Podiatry Specialist

Partial Nail Removal (Matrixectomy)

A permanent nail procedure known as a Matrixectomy may be decided upon. A matrixectomy is the removal of a desired ingrown nail portion on a permanent basis. This is typically done only to a small corner of the nail to remove the painful ingrown portion of the nail. A matrixectomy can also be done to the complete nail if needed.
Ingrown Nails-Avulsions Treatment and Surgery

Matrixectomy process involves a few steps:

  1. First, Dr. Castelein numbs the affected toe with local anesthetic to ensure the procedure is painless. 
  2. Next, a cut is made through the piece of the nail from the tip to the root to completely remove the painful portion of the nail. 
  3. After removal, Dr. Castelein treats the base of the nail under the cuticle (known as the nail matrix) with topical medications. These medications are used with the intent to permanently prevent the small corner of the nail from returning. This eliminates future concerns and pain while providing a great cosmetic appearance. 
  4. Finally, you are able to walk out of the office. Quick, painless care and epsom salt foot soaks are needed for a few days until the skin heals. Most patients return to full activity and shoes the day after the procedure.


An avulsion is another in-office procedure performed by Dr. Castelein that involves the complete removal of the toenail. Avulsions are typically recommended after a trauma to the nail or nail bed. They are also occasionally recommended when the toenail is thick, yellowed, and hardened from a nail fungus. 

Avulsion, broken down:

  1. The avulsion process begins by numbing the affected toe with a local anesthetic to ensure that no pain is felt during the procedure. 
  2. When numb, Dr. Castelein will detach and remove the nail. He will then clean and remove any overgrown tissue to the nail area. 
  3. After this procedure, the nail will begin to grow back naturally. A typical big toenail can take nine to twelve months to reach full length. Dr. Castelein can also combine techniques from the matrixectomy procedure to ensure the entire nail does not return if desired.

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Client Testimonials

I'm so happy to have found Brighton Foot And Ankle in Brighton. The office staff and assistant are very pleasant. Dr. Bryant Castelein is a great knowledgeable Dr. Who has eased my worry over my medical condition. Plus he's handsome. I would highly recommend this practice for anyone needing podiatry help.
What great people to help you! From receptionist to doctor, they are top notch! You would not regret going here for any of your foot/ankle problems, they will fix you up with the utmost care and compassion.
Yo K
Dr. Castelein and staff were friendly, knowledgeable , efficient and took the time to get to know me and understand my medical needs. I would not hesitate to go to Brighton Foot & Ankle. They go out of their way to treat their patients like family.
Dr. Castelein is great; he is very nice, patient, and professional. His staff is also excellent and friendly. It's only been about three hours since having my big toenail removed and, with acetaminophen and ibuprofen, there is very little pain(sometimes I completely forget about it); he did an excellent job. Overall, I am very impressed with Dr. Casteleins Practice and I would highly recommend his office.
Doctor & staff were so professional, friendly & efficient. I had a high risk condition that they expertly guided me through 5 months of healing. Thankfully a full recovery. I give them my best recommendation.
Very friendly and accommodating front desk staff. Dr. Castelein and Jennifer always take their time and do an amazing job! Great variety of quick pick up over the counter products that are always affordable too. Best experience I have had at an office.
Dr. Castelein is very friendly and extremely knowledgeable in his field. During my visit he did a great job explaining my situation and was very encouraging of any questions. I never felt rushed and I believe to have received the best care possible. Highly recommend this doctor and this facility.
Nicole C
Excellent staff and exceptional doctor. I went in with Bunion issues. Dr. Castelein listened to my concerns and addressed my options. 4 days post-op bunion surgery I can say he did an amazing job. Best experience I have ever had. I would definitely recommend; I promise you won't look further.
The staff and Dr. Castelein are all amazing. They are polite and very respectful. I came to see them in 2019 for bunion and hammer toe issues among some others. Dr. Castelein and his assistant listened to my concerns and gave me my options. He explained everything to me in detail and all my questions were answered.. I have seen other podiatrists and he is beyond the best. I would recommend him to anyone.
Friendly staff and intelligent doctor! I went in for some ankle X-rays and was given a great strategy on the different ways to heal my ankle, and how to progress forward if less invasive treatment doesn't help. I would highly recommend them to anyone with foot or ankle problems!