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Ingrown Toenail

William Andrew Pleasant, M.D., Daniel Scott Morrison, Doctor of Medicine and Chirag N. Shah, MD Reviewed 05/2023
 


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 mild cases (Stage 1) respond well to conservative therapy.

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

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
Mayeaux EJ Jr, Carter C, Murphy TE. Ingrown Toenail Management. Am Fam Physician. 2019;100(3):158-164
2
Thakur V, Vinay K, Haneke E. Onychocryptosis - decrypting the controversies. Int J Der...

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. &#...

SEE ALSO

For a video of this Nail Avulsion and Matrixectomy procedure, go to http://5minuteconsult.com/procedure/1508006

CODES

ICD10

L60.0 Ingrowing nail 

SNOMED

  • 400200009 ingrowing toenail (disorder)

  • 201108001 Ingrowing great toenail

  • 201109009 Ingrowing toenail (excluding great toe)

  • 25055007 Ingrowing nail with infection (di...

CLINICAL PEARLS

  • Nonsurgical interventions are appropriate for patients with Stage 1 and mild Stage 2 ingrown toenails.

  • The most common surgical intervention for treatment of an ingrown toenail is parti...

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