Ingrown Toe Nails Medical Treatment

Treatment options be determined by the stage of ingrown toenails, medically referred to as onychocryptosis.

Stage 1 could be managed by recommending shoes with a cushty wide toe box or open-toed shoes. Instruct the patient's parents to slice the nail straight across and steer clear of reducing the lateral margins. The nail edge should extend at night tissue.

Stage 2 could be treated by stretching the soft tissue from the medial side of the nail, elevating the offending edge of nail from the soft tissue, and placing a little pledget of cotton beneath the nail edge to lift it back to the nail grove. Instruct patients with stage 2 ingrown nails on how best to perform this treatment. Parents also needs to be instructed to really have the child rest, keep carefully the foot elevated, and use warm soaks.

Stage 3 ought to be treated by detatching the nail margin as described in "Surgical Care." Chronic ingrown toenails may necessitate matrix ablation.

Surgical Care:

Stage 3 ingrown nails require avulsion of the lateral border of the nail plate with sharp excision of the hypertrophic granulation tissue. If avulsion has been unsuccessful during the past, partial or total ablation of the nail plate chemically, surgically, or via laser could be indicated.

Prepare the digit with Betadine or alcohol if the individual is iodine allergic. Perform digital block with 2% lidocaine without epinephrine.

Lift the nail from the nail matrix bluntly completely back again to approximately one eighth of an inch beneath the proximal nail fold.

Insert a scissors blade and slice the nail back again to the proximal nail fold.

Remove the free part of the nail.

Protuberant granulation tissue could be removed sharply or treated with silver nitrate.

Bleeding, if any, is controlled with pressure.

Antibiotic ointment and clean dressing ought to be applied.

Consultations:

Consult a podiatrist for routine follow-up care or for patients in whom primary avulsion therapy has been unsuccessful.

Close follow-up care having an orthopedist is necessary if inflammatory osteophytic changes are found or if proof osteomyelitis exists.

Follow-up with a primary care physician is indicated for just about any kind of immunosuppression, including diabetes mellitus.