The Biggest Fear Most Patients Have

For many patients, the greatest fear is not the procedure itself.

It is the fear of pain.

This is particularly true if they have had a previous painful experience or have heard frightening stories from friends or family.

Fortunately, modern techniques are designed to make the procedure as comfortable as possible.

The Local Anaesthetic

The procedure is performed after the toe has been completely numbed with local anaesthetic.

The purpose of the injection is to temporarily block the nerves supplying the toe so that you should not feel pain during the procedure.

You may still notice:

  • Pressure.
  • Gentle movement.
  • Touch.

However, sharp pain should not be present once adequate anaesthesia has been achieved.

If discomfort is experienced, additional local anaesthetic can usually be administered before continuing.

What About the Injection?

Most patients say the injection was much easier than they expected.

The injection itself generally lasts only a short time.

A careful technique, taking time and explaining each step, often makes a significant difference to the overall experience.

Patients Who Are Particularly Anxious

Some patients arrive after previous traumatic procedures.

Others have:

  • Needle phobia.
  • Significant anxiety.
  • Autism spectrum disorder.
  • Previous painful medical experiences.
  • Children who are especially nervous.

These patients often benefit from having a tailored treatment plan rather than simply rushing into the procedure.

Nitrous Oxide (Laughing Gas)

For suitable patients, I also offer nitrous oxide (commonly known as laughing gas) in my Sydney clinic.

This is particularly helpful for anxious patients or those who have previously had a difficult experience.

The nitrous oxide is administered by one of my medical colleagues while I perform the local anaesthetic.

It is not a general anaesthetic.

Patients continue breathing for themselves, remain responsive throughout the procedure and recover quickly afterwards.

Because this is performed in the clinic, it is usually much simpler and considerably less expensive than arranging treatment in hospital.

Hospital Surgery

Occasionally, treatment in hospital under the care of an anaesthetist may be appropriate.

This is generally reserved for patients with exceptional anxiety, complex medical needs or situations where clinic treatment is not suitable.

Most patients do not require this level of anaesthesia.

Previous Bad Experiences

One of the saddest things I hear is:

"I'll never have another toenail done."

Often these patients experienced treatment many years ago using techniques that differ from modern practice.

A previous bad experience does not necessarily predict what your next experience will be.

Evidence Update

Local anaesthetic remains the standard of care for most ingrown toenail procedures. For selected anxious patients, inhaled nitrous oxide provides an evidence-supported option for reducing anxiety while maintaining consciousness and rapid recovery.

Patient Tip

Tell your clinician if you have had a previous painful procedure or suffer from needle anxiety. A personalised anaesthetic plan can often make the experience much more comfortable.