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Ingrown Toenail

Sally-Ann L. Pantin, MD, FAAFP and Thomas A. Waller, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • In an ingrown toenail, the distal margin of the nail plate grows into the lateral nail fold, causing irritation, inflammation, and sometimes bacterial or fungal infection:

    • Stage 1 (in...

DIAGNOSIS

HISTORY

  • Patients most often present with pain, redness, and swelling in the toe along one or both sides of the nail.

  • Drainage can occur as inflammation and/or infection develop.

PHYSICAL EXAM

  • Na...

TREATMENT

GENERAL MEASURES

  • Majority of cases respond to conservative therapy.

  • Warm, soapy water or Epsom salt soaks for 10 to 20 minutes 3 times per day until symptoms resolve (1)

  • Bluntly insert a cotton...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Dress with antibiotic ointment or sterile petroleum jelly; cover with sterile gauze and tube gauze.

  • Postop instructions should include the following:

    • Rest and eleva...

REFERENCES

1
Heidelbaugh J, Lee H. Management of the ingrown toenail. Am Fam Physician.  2009;79(4):303–308. [View Abstract on OvidMedline]
2
Eekhof JA, Van Wijk B, Knuistingh Neven A, et al. Interv...

ADDITIONAL READING

  • Bos AM, van Tilburg MW, van Sorge AA, et al. Randomized clinical trial of surgical technique and local antibiotics for ingrowing toenail. Br J Surg.  2007;94(3):292–296. [View ...

CODES

ICD10

L60.0 Ingrowing nail 

ICD9

703.0 Ingrowing nail 

SNOMED

  • 400200009 ingrowing toenail (disorder)

  • 201108001 Ingrowing great toenail

  • 201109009 Ingrowing toenail (excluding great toe)

  • 25055007 Ingrowin...

CLINICAL PEARLS

  • The best treatment for a stage 1 ingrown toenail is to insert a wisp of cotton or dental floss between the nail plate and lateral nail fold.

  • The best treatment for a stage 3 ingrown toe...

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