Do they put you to sleep to remove ingrown toenails? Understanding the Anesthesia Process

October 13, 2025 •

4 min read

Ingrown toenail surgery is a quick and routine outpatient procedure, often taking less than 20 minutes. This leads many to wonder, do they put you to sleep to remove ingrown toenails? The answer, for the vast majority of cases, is no; a local anesthetic is all that is required to numb the area.

Quick Summary

Doctors use a local anesthetic to numb the toe for ingrown toenail removal, allowing the patient to stay awake. This is a safer option than general anesthesia, which is usually unnecessary for the minor, in-office procedure. Mild sedation may be considered for patients with extreme anxiety.

Key Points

Local Anesthesia is Standard: Ingrown toenail removal is typically performed using a local anesthetic injected into the toe, not general anesthesia.
The Procedure is Painless: A digital nerve block numbs the entire toe, so you will feel no pain during the surgery itself.
Sedation is an Option for Anxiety: For highly anxious patients, mild sedation can be used in conjunction with local anesthesia, but it is not putting you fully to sleep.
General Anesthesia is Unnecessary and Risky: Because the procedure is minor and quick, the risks associated with general anesthesia are not justified.
Recovery is Quick: Most patients can return to normal daily activities within a day or two, with full healing taking several weeks.
Pharmacology is Targeted: The choice of medication is specific and safe, ensuring pain relief only where it is needed.
Pain Management is Effective: Post-procedure discomfort is minimal and easily managed with over-the-counter pain medication.

Ingrown toenails are a common and painful condition, but the surgical procedure to correct them is often less intimidating than people assume. The fear of being "put to sleep" is a major concern for many, but modern pharmacology and surgical techniques have made this step almost entirely unnecessary for ingrown toenail correction.

Understanding Local vs. General Anesthesia

Before undergoing any procedure, it's helpful to understand the different types of anesthesia available and why a particular one is chosen. Anesthesia is the use of medicine to prevent or relieve pain. For ingrown toenail removal, the primary choice is local anesthesia, which targets only the affected area.

Local Anesthesia (Digital Block)

A local anesthetic, such as lidocaine, is injected at the base of the toe. This numbs the nerves that supply sensation to the entire toe, a technique known as a digital block. This makes the surgical area completely numb while the patient remains conscious and aware. While the initial injection can cause a brief stinging sensation, the procedure itself is painless. The benefits of local anesthesia for a minor procedure include:

Minimal risk: Local anesthesia is safer than general anesthesia, which carries more potential risks.
Speedy recovery: Patients can return home immediately after the procedure with minimal lingering effects from the anesthesia.
Efficiency: The procedure can be performed quickly in an outpatient setting, such as a podiatrist's office.

Sedation and General Anesthesia

For minor surgeries like ingrown toenail removal, general anesthesia is extremely rare. It involves more significant risks, requires more extensive monitoring, and is reserved for major operations. However, some patients experience extreme anxiety about the procedure or needles. In these cases, a doctor may discuss the option of oral or intravenous (IV) sedation. This puts the patient in a relaxed, drowsy state but does not put them fully to sleep. The benefits of sedation include:

Reduced anxiety: Helps patients who are nervous or phobic about the procedure.
Pain management support: Can help manage discomfort from the initial injection of the local anesthetic.

The Ingrown Toenail Removal Procedure

The surgical procedure for an ingrown toenail is typically called a partial nail avulsion with chemical matrixectomy. This is a definitive treatment that is effective at preventing recurrence. The steps are as follows:

Preparation: The podiatrist will clean and sterilize the affected toe and foot.
Anesthesia: A digital block is administered by injecting a local anesthetic into the base of the toe.
Tourniquet: A tight elastic band or tourniquet may be placed at the base of the toe to reduce bleeding during the procedure.
Nail Removal: The ingrown portion of the nail is carefully lifted and cut away using specialized tools.
Matrix Treatment: For permanent removal, a chemical (like phenol) is applied to the nail matrix (the tissue where the nail grows from) to prevent that part of the nail from growing back.
Dressing: A sterile dressing with antibiotic ointment is applied to the wound.

Anesthesia Options for Ingrown Toenail Removal


Feature	Local Anesthesia (Digital Block)	Sedation	General Anesthesia	Key Considerations
Patient Awareness	Awake, alert, and conscious.	Drowsy, relaxed, and minimally aware.	Unconscious and unaware.	Local is the standard; Sedation is for anxiety; General is typically not used.
Application	Injected directly into the base of the toe.	Oral medication or IV administered.	Inhaled gas or IV administered by an anesthesiologist.	Less invasive methods are preferred for minor procedures.
Duration	Numbness for several hours.	Wears off within hours.	Requires longer recovery from anesthesia.	Local anesthesia is sufficient for the length of the procedure.
Recovery Time	Rapid; often can walk out after the procedure (with caution).	Extended recovery period due to sedative effects.	Longest recovery; involves significant monitoring.	Quicker recovery allows a faster return to daily activities.
Risks	Minimal; primarily a brief sting or burning.	Some risks of complications; requires monitoring.	Higher risk of complications; requires specialized monitoring.	Risk is proportional to the depth of anesthesia.
Cost	Less expensive.	More expensive due to monitoring and medication.	Most expensive due to hospital setting and specialists.	Cost-effectiveness is a major factor for minor procedures.

Pain Management and Pharmacology during the Procedure

Anesthesia for ingrown toenail removal is a clear application of basic pharmacology to ensure patient comfort and safety. The active ingredient in the local anesthetic, often lidocaine, works by blocking sodium channels in nerve cells. This prevents the nerves from sending pain signals to the brain from the numbed area, even though the patient is fully conscious. This targeted approach is a cornerstone of modern pain management for minor procedures, highlighting why general anesthesia is unnecessary.

Recovery and Aftercare

Proper aftercare is essential for a smooth and quick recovery following ingrown toenail removal.

Elevate the foot: Keep your foot elevated for the first 24-48 hours to minimize swelling and throbbing.
Keep it clean: Follow your doctor's instructions for changing the dressing, which will typically involve soaking the foot and applying antibiotic ointment.
Wear appropriate footwear: For the first week or two, wear open-toed shoes or loose-fitting footwear to avoid pressure on the healing toe.
Manage pain: Over-the-counter pain relievers like ibuprofen can help with any mild discomfort as the anesthetic wears off.
Restrict activity: Avoid strenuous activities, including running and jumping, for about two weeks to allow for proper healing.

Conclusion

In summary, the fear of being put to sleep for ingrown toenail removal is largely unfounded. For almost all cases, a minor procedure performed under a simple and effective local anesthetic is all that is needed. This approach, known as a digital block, ensures a painless process with minimal risk and a rapid recovery. For patients with significant anxiety, safe sedation options are available. The pharmacological techniques used today make the experience of ingrown toenail removal a manageable and routine one, allowing patients to get back on their feet quickly and with lasting relief.

For more detailed information on ingrown toenail treatment and prevention, consult reliable medical resources such as the American Academy of Family Physicians.

Frequently Asked Questions

For ingrown toenail removal, a local anesthetic is used. A digital block, which involves injecting a numbing medication at the base of the toe, makes the entire area numb so you won't feel any pain during the procedure.

The injection itself may cause a brief, sharp stinging or burning sensation as the medication is administered. This discomfort is temporary and lasts for only a minute or so before the toe becomes completely numb.

While it is possible to discuss options like sedation with your doctor if you have extreme anxiety, general anesthesia is almost never used for ingrown toenail removal. It carries more risks and is unnecessary for such a minor, outpatient procedure.

The local anesthetic typically keeps the toe numb for several hours after the procedure is complete. As the medication wears off, you may experience some mild soreness, which can be managed with over-the-counter pain relievers.

The procedure is very quick, usually taking about 10 to 20 minutes from start to finish. This is another reason why general anesthesia is not used.

No, ingrown toenail removal is an outpatient procedure typically performed in a podiatrist's office. You will be able to go home shortly after the surgery is complete.

In the rare event of an allergy to standard local anesthetics, your doctor will discuss alternative options. In such cases, different numbing agents or other pain management strategies may be explored.