Ingrown Toenails Follow-up

  • Author: Thomas E Benzoni, DO; Chief Editor: Rick Kulkarni, MD   more...
 
Updated: May 1, 2012
 

Further Outpatient Care

  • Follow-up for uncomplicated cases of ingrown toenails is needed only to reassure the patient.
  • A lot of drainage (but little bleeding) may occur in the 2-3 days following removal. The toe looks better, the patient has less pain, and the redness decreases.
  • Patients with risk factors require close follow-up, as noted in Consultations.
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Deterrence/Prevention

  • If inciting factors are present, counseling about prevention is indicated.
  • Preventive measures include the use of properly fitted footwear and correct trimming of nails.
    • Shoes should have a toe box large enough to fit the toes without pressure and to allow for normal spreading of the toes with walking.
    • Nails should be cut straight across with clean, sharp, preferably bullnose-type nail trimmers (curve is reverse of common fingernail clippers.) Nails should not be cut shorter at the lateral edges.
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Complications

  • Complications of ingrown toenails are very rare, except in those predisposed because of underlying pathologic conditions.
  • Complications include infection and loss of the nail.
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Prognosis

Generally, the prognosis is excellent.

Recurrence and/or regrowth of the treated side occurs in 10-30% of cases. According to an updated review by the Cochrane Database, surgical interventions are more effective than non-surgical interventions in preventing ingrown toenail recurrence. Postoperative treatments generally do not reduce the risk of infection, nor do they shorten healing time.[12]

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Patient Education

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Contributor Information and Disclosures
Author

Thomas E Benzoni, DO  Medical Director of Mercy Air Care; Attending Staff, Department of Emergency Medicine, Mercy Medical Center; Member, Board of Directors, Iowa Medical Society; Medical Director, DMAT-B; Medical Manager, IA TF-1 USAR.

Thomas E Benzoni, DO is a member of the following medical societies: American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, American Osteopathic Association, and Iowa Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Theodore J Gaeta, DO, MPH, FACEP  Clinical Associate Professor, Department of Emergency Medicine, Weill Cornell Medical College; Vice Chairman and Program Director of Emergency Medicine Residency Program, Department of Emergency Medicine, New York Methodist Hospital; Academic Chair, Adjunct Professor, Department of Emergency Medicine, St George's University School of Medicine

Theodore J Gaeta, DO, MPH, FACEP is a member of the following medical societies: Alliance for Clinical Education, American College of Emergency Physicians, Clerkship Directors in Emergency Medicine, Council of Emergency Medicine Residency Directors, New York Academy of Medicine, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Tom Scaletta, MD  Chair, Department of Emergency Medicine, Edward Hospital; Past-President, American Academy of Emergency Medicine

Tom Scaletta, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD  Attending Physician, Department of Emergency Medicine, Cambridge Health Alliance, Division of Emergency Medicine, Harvard Medical School

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

References

  1. Ingrown toenails. Last updated May 2007. Familydoctor.org. Available at http://familydoctor.org/online/famdocen/home/common/skin/disorders/208.html.

  2. Sauer GC. Manual of Skin Diseases. JB Lippincott; 1985.

  3. Barker LR, Burton JR, Zieve PD. Principles of Ambulatory Medicine. 3rd ed. Williams & Wilkins; 1991.

  4. Bossers AM, Jansen IM, Eggink WF. Rational therapy for ingrown toenails. A prospective study. Acta Orthop Belg. 1992;58(3):325-9. [Medline].

  5. Fulton GJ, O'Donohoe MK, Reynolds JV, Keane FB, Tanner WA. Wedge resection alone or combined with segmental phenolization for the treatment of ingrowing toenail. Br J Surg. Jul 1994;81(7):1074-5. [Medline].

  6. Wollina U. Modified Emmet's operation for ingrown nails using the Er:YAG laser. J Cosmet Laser Ther. May 2004;6(1):38-40. [Medline].

  7. Kimata Y, Uetake M, Tsukada S, Harii K. Follow-up study of patients treated for ingrown nails with the nail matrix phenolization method. Plast Reconstr Surg. Apr 1995;95(4):719-24. [Medline].

  8. Ozdemir E, Bostanci S, Ekmekci P, Gurgey E. Chemical matricectomy with 10% sodium hydroxide for the treatment of ingrowing toenails. Dermatol Surg. Jan 2004;30(1):26-31. [Medline].

  9. Zaborszky Z, Fekete L, Tauzin F, Orgovan G. Treatment of ingrowing toenail with segmental chemical ablation. Acta Chir Hung. 1997;36(1-4):398-400. [Medline].

  10. Mori H, Umeda T, Nishioka K, et al. Ingrown nails: a comparison of the nail matrix phenolization method with the elevation of the nail bed-periosteal flap procedure. J Dermatol. Jan 1998;25(1):1-4. [Medline].

  11. Giacalone VF. Phenol matricectomy in patients with diabetes. J Foot Ankle Surg. Jul-Aug 1997;36(4):264-7; discussion 328. [Medline].

  12. Eekhof JAH, Van Wijk B, Knuistingh Neven A, van der Wouden JC. Interventions for ingrowing toenails. Cochrane Database of Systematic Reviews. 2012.

 
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Appearance of typical ingrown toenail.
Cutting the nail.
Cauterizing the matrix.
Appearance of toenail at end of the cauterizing procedure.
 
 
 
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