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.
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.
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. 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. [20]
Patient Education
For patient education resources, see the Foot Care Center, as well as Ingrown Toenails.
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Appearance of typical ingrown toenail.
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Cutting the nail.
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Cauterizing the matrix.
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Appearance of toenail at end of the cauterizing procedure.
