The Treatment of Ingrown Toenails: A Retrospective Study of Combined Wedge Resection with Phenol Versus Silver Nitrate Cauterization.
The treatment options for ingrown toenails ranges from simple
conservative approaches, limited surgical intervention to extensive surgical procedures.
Conservative treatment modalities are usually employed
for patients with stage 1 disease whereas patients stage 2 and 3 toenails usually require surgical intervention. Primary care physicians
frequently encounter young adults with ingrown toenails although
it can be seen at virtually any age. The condition primarily affects
the big toe with pain, swelling, redness, and discharge occasionally
and if left untreated granulomatous tissue and lateral wall hypertrophy ensues as a result of chronic inflammation. Inflicted individuals have difficulty in ambulation, decreased quality of life (QoL),
absenteeism from work and reduced social activities and increased
economic cost.1,2 Currently, various treatment options are available;
however, they are associated with high rates of recurrence, poor
cosmetic results, and low rates of patient satisfaction.
Conservative management is initially offered to patients
with mild cases of ingrown toenail including, the use of warm
baths, avoidance of tight-fitting footwear and soft compresses4
along with taping, packing,5
and nail braces and gutter treatment.
Refractory cases, on the other hand, are offered the option of surgical intervention. Many techniques have been illustrated, with majority targeting the nail as the responsible agent. Simple nail avulsion
is described in the literature but has high recurrence rate reaching
up to 70%,6
Partial nail avulsion along with chemical matricectomy
using silver nitrate or phenol have been described.1,4 One old study
reported a high overall recurrence rate of 34% when the procedure
was carried out by family physicians with an increase to 50% when
carried out by general surgeons.
Dermatol Open J. 2018; 3(1): 10-14. doi: 10.17140/DRMTOJ-3-130
