eMedicine Specialties > Emergency Medicine > Trauma & Orthopedics

Toenails, Ingrown: Follow-up

Author: Thomas E Benzoni, DO, Medical Director of Mercy Air Care, Consulting Staff, Department of Emergency Medicine, Mercy Medical Center
Contributor Information and Disclosures

Updated: Jul 24, 2008

Follow-up

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.

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 bulldog-type nail trimmers. Nails should not be cut shorter at the lateral edges.

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.

Prognosis

  • Generally, the prognosis is excellent.
  • Recurrence and/or regrowth of the treated side occurs in 10-30% of cases.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Good communication regarding the risks and purposes of the cauterizing procedure is the best protection.
 


More on Toenails, Ingrown

Overview: Toenails, Ingrown
Differential Diagnoses & Workup: Toenails, Ingrown
Treatment & Medication: Toenails, Ingrown
Follow-up: Toenails, Ingrown
Multimedia: Toenails, Ingrown
References
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References

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

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

  3. 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].

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

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

  6. 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].

  7. 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].

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

  10. 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].

  11. 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].

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Further Reading

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Keywords

ingrown toenail, sore toe, sore toenail, painful toe, swollen toe, unguis incarnatus, mycoses, chemical cautery, tender toe, diabetes, arterial insufficiency, lymphangitis

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Contributor Information and Disclosures

Author

Thomas E Benzoni, DO, Medical Director of Mercy Air Care, Consulting Staff, Department of Emergency Medicine, Mercy Medical Center
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.

Medical Editor

Theodore J Gaeta, DO, MPH, FACEP, Clinical Associate Professor, Department of Emergency Medicine, Joan and Sanford Weill Medical College at Cornell University; 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: American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, New York Academy of Medicine, New York Academy of Medicine, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Tom Scaletta, MD, Past-President, American Academy of Emergency Medicine; Chairperson, Department of Emergency Medicine, Edward Hospital; Assistant Professor of Emergency Medicine, Rush Medical College and Cook County Hospital
Tom Scaletta, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

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, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
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

 
 
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