# Nail matrixectomy > Nail matrixectomy is a procedure, done under local anaesthetic, that destroys the nail root so part or all of a toenail doesn't grow back. It's mainly used for ingrown toenails that are painful, keep coming back or haven't settled with simple care. Guide in [Treatments](https://footanklelowerlimb.com.au/learn/topics/treatments), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/surgical-nail-matrixectomy Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026. Next review by 27 October 2027. - **It stops all or part of a nail growing back.** The nail root (the matrix) is destroyed, so the problem edge, or the whole nail, doesn't regrow. - **It's mainly for ingrown toenails** that are painful, keep returning or haven't settled with simple care. - **It lowers the chance of the problem coming back, but can't promise it.** The nail can still regrow. - **Mild, early cases usually start without surgery,** and diabetes or poor circulation need extra care first. ## What is nail matrixectomy, and how does it work? Surgical nail matrixectomy (also called matricectomy) destroys or removes the nail matrix, the tissue at the base of the nail that makes it, so the treated part of the nail can't regrow [1]. A partial procedure treats only the part of the matrix causing the problem, so the rest of the nail keeps growing. A total procedure treats the whole matrix, so no nail grows back [1]. It's an add-on rather than a stand-alone operation. It's done together with removing the problem edge of the nail, or the whole nail [2]. The matrix is then destroyed by cutting it out, or by applying a chemical called phenol, which burns the matrix and stops the nail growing back [3]. ## What is it used for, and how well does it work? It's mainly used for ingrown toenails that are painful, keep coming back or haven't settled with simple care [4]. It's also described for thickened or damaged nails and long-term swelling of the skin beside the nail [5], but it isn't clear yet how well it works for those. For ingrown toenails, surgery prevents the problem returning better than a gutter or brace fitted to the nail [2]. Even so, the nail can still grow back. Reported rates vary widely between sources and methods, so no single figure can be promised [6][7]. Regrowth is more likely when the matrix isn't fully destroyed [5]. Most of the research comparing methods is of poor quality [8], and it isn't clear yet how much pain relief or what cosmetic result to expect. ## Is nail matrixectomy right for me? It tends to suit people whose ingrown toenail is painful, keeps coming back, is deformed, or hasn't settled with simple care [9]. Mild, early ingrown nails are usually managed without surgery first [1], and simple care can be given a steady go for 2–12 weeks [7]. It isn't needed for every nail: removing just the nail edge, without destroying the matrix, is suggested for a single ingrown nail with no underlying nail problem, or when healing is likely to be poor [9]. You have a higher risk of complications if you're older, have obesity, smoke, or have diabetes, heart disease or lung disease [10][11]. The phenol method is described as suitable for teenagers and for people whose diabetes is well controlled [5]. If you're pregnant, allergic to an anaesthetic, or take blood thinners, tell the clinic before surgery so they can seek advice. > [!see] If you have diabetes or poor circulation > Tell the clinic before you book, and see a podiatrist promptly if you have an ingrown toenail [12]. Your circulation should be checked before the matrix is destroyed [1]. ## What happens during and after the procedure? Before surgery, tell the clinic about all your medicines and health conditions. It's planned as one visit under local anaesthetic, an injection that numbs the toe [6]. The podiatrist or doctor removes the problem edge of the nail (or the whole nail), then destroys the matrix with phenol or by cutting it out [6][2]. Phenol is kept off the surrounding skin because it can damage healthy tissue [1]. Afterwards your toe is dressed and a review is arranged. Follow the clinic's written aftercare. Antibiotics and special dressings after surgery don't seem to reduce infection, pain or healing time [2]. Some oozing from the toe is common after phenol, and it can take a while to settle [5]. Healing time varies, so ask your podiatrist when you can return to usual shoes and activities. ## What are the risks and side effects? The main risks are: - **Infection** of the toe [10]. - **Regrowth** of the nail, or a sharp nail spike (a spicule) if some matrix is left behind [10][5]. - **Changes to the nail:** it can end up narrower and look different [7][10]. - **Slow healing** [10]. - **A rare, serious allergic reaction** to the local anaesthetic [10]. Phenol can also cause pain, oozing and damage to the tissue, and very rarely affects the whole body [5]. Don't assume ongoing drainage is harmless: see your GP or a podiatrist if it carries on, and the same day if redness or pain comes with it. ## How does it compare with other options? For a mild, early ingrown toenail, simple care without surgery usually comes first [1]. Removing the nail alone usually isn't enough, because the problem nearly always comes back [1]. Whether phenol or cutting out the matrix is better isn't clear yet: neither is clearly better for pain, healing, complications or satisfaction, and many trials are of low quality [8][9]. The choice often comes down to your nail, your health and what your podiatrist recommends, so ask about each option. ## When to see a podiatrist See a podiatrist if an ingrown toenail hasn't settled within 7–14 days or is getting worse [12], or if it keeps coming back and you'd like to ask whether nail surgery suits you. After surgery, see them if a nail edge regrows, you feel a sharp spike of nail, or pain carries on. See your GP or a podiatrist the same day if, after surgery, you have increasing redness, heat, swelling or pain, redness tracking up the toe, foot or leg, a bad-smelling discharge, flu-like symptoms, or heavy bleeding from your toe [13][3]. The same applies if you have diabetes and a wound, sore, blister or colour change on your foot, or if you notice unusual pain, heat or swelling in your feet or a sudden change in foot shape [14]. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic. See your GP soon if you notice a dark streak or a new dark patch under a nail, as it needs checking separately from an ingrown nail. ## Common questions ### Is nail surgery suitable for children? Phenol nail surgery is described as used in children and teenagers, who tend to heal well. A podiatrist or doctor will weigh up the nail, your child's age and their general health. If your child has a painful or repeatedly ingrown nail, ask a podiatrist what suits them. ### Do I need antibiotics after toenail surgery? Antibiotics and special dressings given routinely after nail surgery don't seem to reduce infection, pain or healing time. An infected ingrown nail is treated differently, and needs a prompt review. Whether you need an antibiotic is a decision for your podiatrist or GP, so ask them rather than deciding yourself. ### What happens to the shape of my nail after a partial matrixectomy? A partial procedure treats only the problem side of the nail root, so the rest of the nail keeps growing. The nail usually ends up narrower and can look a little different from before. If you're worried about appearance, talk it through with your podiatrist before the procedure. ## Further reading - [Nail matrixectomy on Clindice](https://clindice.com/surgical-nail-matrixectomy) - [Royal Orthopaedic Hospital - Nail Surgery](https://roh.nhs.uk/services-information/foot-and-ankle/nail-surgery), NHS - [Nail Surgery - PIL1199 Version 3 - North Tees and Hartlepool NHS Foundation Trust](https://www.nth.nhs.uk/resources/nail-surgery/), NHS - [Management of nail problems](https://www.chelwest.nhs.uk/your-visit/patient-leaflets/surgery-services/management-of-nail-problems), NHS - [Nail condition - Leeds Community Healthcare](https://leedscommunityhealthcare.nhs.uk/our-services-a-z/podiatry/nail-condition/), NHS - [Nail surgery pre-operative advice :: Dorset HealthCare University NHS Foundation Trust](https://www.dorsethealthcare.nhs.uk/our-services-and-sites/physical-health/podiatry-foot-care/nail-surgery-pre-operative-advice), NHS ## Sources 1. Nail Surgery: General Principles, Fundamental Techniques, and Practical Applications · Queirós C, Garrido PM, Fraga A et al. · Journal of Cutaneous and Aesthetic Surgery · 2022. https://doi.org/10.4103/jcas.jcas_81_21 2. Interventions for ingrowing toenails · Eekhof JAH, Van Wijk B, Knuistingh Neven A et al. · The Cochrane Database of Systematic Reviews · 2012. https://doi.org/10.1002/14651858.cd001541.pub3 3. Nail Surgery · NHS Lanarkshire · 2022. https://www.nhslanarkshire.scot.nhs.uk/services/podiatry/nail-surgery/ 4. Matricectomy · Ceilley RI, Collison DW · The Journal of Dermatologic Surgery and Oncology · 1992. https://doi.org/10.1111/j.1524-4725.1992.tb02007.x 5. Ingrown toenails · Khunger N, Kandhari R · Indian Journal of Dermatology, Venereology and Leprology · 2012. https://doi.org/10.4103/0378-6323.95442 6. Controversies in the treatment of ingrown nails · Haneke E · Dermatology Research and Practice · 2012. https://doi.org/10.1155/2012/783924 7. Unguis incarnatus-conservative or operative treatment? A practical treatment algorithm · Moellhoff N, Polzer H, Baumbach SF et al. · Der Unfallchirurg · 2021. https://doi.org/10.1007/s00113-020-00903-6 8. A systematic review and meta-analysis of randomised controlled trials of surgical treatments for ingrown toenails part II: healing time, post-operative complications, pain, and participant satisfaction · Exley V, Jones K, O'Carroll G et al. · Journal of Foot and Ankle Research · 2023. https://doi.org/10.1186/s13047-023-00655-7 9. A survey of the treatment and management of ingrown toenails by UK podiatrists: A cross-sectional survey · Exley V, Jones K, Watson J et al. · Journal of Foot and Ankle Research · 2024. https://doi.org/10.1002/jfa2.12017 10. Nail surgery pre-operative advice · Dorset HealthCare University NHS Foundation Trust. https://www.dorsethealthcare.nhs.uk/our-services-and-sites/physical-health/podiatry-foot-care/nail-surgery-pre-operative-advice 11. Surgery for ingrowing toenail (adult) · Healthdirect Australia · 2026. https://www.healthdirect.gov.au/surgery/surgery-for-ingrowing-toenail-adult 12. Nail disorders · NHS. https://www.rightdecisions.scot.nhs.uk/borders-ref-help-toolkit/podiatry/nail-disorders/ 13. Toenail surgery: after-care · Kingston and Richmond NHS Foundation Trust. https://www.kingstonandrichmond.nhs.uk/patients-and-families/patient-leaflets/toenail-surgery-after-care 14. Community Podiatry · Nottinghamshire Healthcare NHS Foundation Trust. https://www.nottinghamshirehealthcare.nhs.uk/community-podiatry-specialist-services/ --- This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.