From the Research
For an ingrown toenail, the most effective treatment approach is a combination of conservative measures and surgical interventions, with partial nail extraction from the ingrown nail edge in combination with destruction of the corresponding part of the matrix being the recommended operative treatment for stage II-III ingrown toenails and failing conservative treatment, as stated in the 2020 guideline 1. The treatment options for onychocryptosis (ingrown toenail) can be categorized into conservative and surgical approaches. Conservative treatments, such as soaking the foot in warm water with Epsom salt, gently lifting the edge of the nail using a clean cotton swab or dental floss, and applying an antibiotic ointment, can be effective for mild to moderate cases 2.
Conservative Treatment Options
- Soaking the foot in warm water with Epsom salt for 15-20 minutes, 3-4 times daily to reduce inflammation and soften the skin
- Gently lifting the edge of the nail using a clean cotton swab or dental floss, placing a small piece of cotton under the nail edge to help it grow above the skin
- Applying an antibiotic ointment like Neosporin and covering with a bandage
- Over-the-counter pain relievers such as ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) to manage pain However, for more severe cases or when conservative treatment fails, surgical interventions may be necessary.
Surgical Treatment Options
- Partial nail avulsion or complete nail excision with or without phenolization, as mentioned in the 2009 study 3
- Electrocautery, radiofrequency, and carbon dioxide laser ablation of the nail matrix, as discussed in the 2024 review 4
- Partial nail extraction from the ingrown nail edge in combination with destruction of the corresponding part of the matrix, as recommended in the 2020 guideline 1 It is essential to note that the choice of treatment approach depends on the severity and recurrence of the ingrown toenail, as well as the patient's overall health and expected wound healing problems.
Important Considerations
- Keeping the area clean and dry
- Wearing open-toed shoes or sandals if possible
- Trimming toenails straight across rather than curved
- Seeking medical attention promptly if severe pain, pus, spreading redness, or diabetes is present By following these treatment options and considering the individual patient's needs, healthcare providers can effectively manage ingrown toenails and improve patient outcomes, as supported by the highest quality study available, the 2020 guideline 1.