Ingrown Toenail Management

Abstract

Ingrown toenails are a common condition in general medicine and dermatology, and they occur when the nail curves inward and pierces the nail fold. Symptoms include pain in the affected toe, erythema and edema. The diagnosis is made clinically and, if left untreated, ingrown toenails can lead to infections and even cellulitis and osteomyelitis. Conservative treatments involve clipping on the spicule and topical antibiotics. However, the mainstay of treatment is matricectomy to reduce the recurrence rate. The risk of ingrown toenail development can be reduced by wearing proper footwear, keeping toenails cut straight and overall foot hygiene. Ingrown toenails can affect various patient populations but are more prevalent in males, young adolescents and pregnant patients. Risk factors include obesity, diabetes, improper toenail clipping and improper footwear. This review explores the clinical manifestations of ingrown toenails, along with their diagnosis and treatment, providing a concise review for physicians to accurately identify and effectively treat patients with ingrown toenails or their resultant complications.

Clinical Outcome of Wedge Resection Procedure for Ingrown Toe Nail

“…Radical procedure such as the Zadic procedure is associated with a high rate of bone infection and delayed wound healing 19,20 . Nasr and Colleagues studied ages under 18 only and 21% had complications after the wedge resection 18,21 . Recurrence occurred in only 1 patient while Sargin and colleague 22 performed toenail surgery in 143 patients and noted recurrence in 3 toenails.…”

“…There are ablative and non-ablative procedures; former techniques involve the destruction of the germinal matrix, whereas later modalities protect the germinal matrix. According to Asma and Colleagues 13 the recurrence risk can be reduced by keeping good foot hygiene and taking care of foot wear.…”

A novel cosmetic approach for partial matricectomy in treating ingrown toenails

“…Ideally, ingrown toenails should be treated by a facile, cost‐effective and efficient approach that will induce minimum discomfort after treatment and accelerate post‐treatment functional recovery. The treatment should also have low pain and relapse rates, with acceptable cosmetic outcomes 11,18,19 …”

Matricectomy with Electrocautery as Therapy for Recurrent Ingrown Toenail

“…There are several factors that can cause ingrown toenail such as hyperhidrosis, nail deformities such as pincer nails, mechanical trauma such as improper nail cutting, uncomfortable shoes, comorbidities, and use of drugs such as epidermal growth factor receptor inhibitors [4]. Ingrowing toenail occurs when the lateral periungual nail fold experiences penetration trauma by the surrounding nail plate, causing an inflammatory reaction that can even cause infection if bacterial colonization occurs, which in the process will also form granulation tissue [5]. Such penetration is often caused by nail spicules at the edge of the nail plate, which triggers an inflammatory response due to an imbalance between nail plate width, nail bed, and nail fold hypertrophy [6,7].…”