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)

Matrixectomy process involves a few steps:
- First, Dr. Castelein numbs the affected toe with local anesthetic to ensure the procedure is painless.
- 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.
- 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.
- 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.
Avulsion
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:
- The avulsion process begins by numbing the affected toe with a local anesthetic to ensure that no pain is felt during the procedure.
- When numb, Dr. Castelein will detach and remove the nail. He will then clean and remove any overgrown tissue to the nail area.
- 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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