Comparison between conservative and surgical management of ingrown toenail in Bangladeshi patients
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20253391Keywords:
Ingrown toenail, Onychocryptosis, Surgical management, Conservative treatment, Recurrence, Patient satisfactionAbstract
Background: Ingrown toenail (onychocryptosis) is a common and painful condition that affects daily activities and quality of life. Treatment options include conservative and surgical interventions, with varying efficacy and patient outcomes. This study aimed to compare the effectiveness of conservative versus surgical management of ingrown toenails in Bangladeshi patients.
Methods: This prospective observational study was conducted at the Nail Unit, Aurora Skin and Aesthetic Center, Dhaka, over six months (10 January to 09 July 2024). A total of 100 patients with clinically diagnosed ingrown toenail were enrolled and equally divided into two groups: 50 patients received conservative treatment (topical antibiotics, proper nail trimming, and footwear advice) and 50 underwent surgical intervention (partial nail avulsion with/without matrixectomy). Outcomes measured included healing rate, healing time, pain reduction (VAS), recurrence, infection, patient satisfaction, and work/school absenteeism. Data were analyzed using statistical package for the social sciences (SPSS) version 25.
Results: The groups were comparable in terms of age, sex, affected toe, and disease severity. Surgical treatment showed significantly better outcomes: complete healing in 94% versus 78% (p=0.02), shorter mean healing time (10.1±2.7 versus 13.5±3.2 days; p<0.001), greater pain reduction (VAS: 5.1 versus 4.2; p=0.001), and lower recurrence (4% versus 18%; p=0.03). Patient satisfaction was higher in the surgical group (92% versus 68%; p=0.003), with fewer missed workdays and repeat visits.
Conclusion: Surgical management of ingrown toenails provides superior outcomes in terms of healing, pain relief, and recurrence compared to conservative treatment, and should be considered for definitive management.
Metrics
References
Exley V, Jones K, O'Carroll G, Watson J, Backhouse M. A systematic review and meta‐analysis of randomised controlled trials on surgical treatments for ingrown toenails part I: recurrence and relief of symptoms. J Foot Ankle Res. 2023;16(1):35. DOI: https://doi.org/10.1186/s13047-023-00631-1
Hassan RE, Khan L, Shah SH, Naeem H, Noor N, Iqbal M, Khan FD, Rehman Z, Ahmad W, Tanveer S, Khan AU. Surgical strategies for ingrown toenails: a comprehensive review of techniques, outcomes, and advancements. Cureus. 2024;16(1). DOI: https://doi.org/10.7759/cureus.52501
Huang S, Wang J, Chen Z, Kang Y. Surgical interventions for ingrown toenail. Foot Ankle Surg. 2024;30(3):181-90. DOI: https://doi.org/10.1016/j.fas.2023.12.003
Grover C, Khurana A, Bhattacharya SN, Sharma A. Controlled trial comparing the efficacy of 88% phenol versus 10% sodium hydroxide for chemical matricectomy in the management of ingrown toenail. Indian J Dermatol Venereol Leprol. 2015;81:472. DOI: https://doi.org/10.4103/0378-6323.163787
Di Chiacchio N, Di Chiacchio NG. Best way to treat an ingrown toenail. Dermatol Clin. 2015;33(2):277-82. DOI: https://doi.org/10.1016/j.det.2014.12.009
Khunger N, Kandhari R. Ingrown toenails. Indian J Dermatol Venereol Leprol. 2012;78:279. DOI: https://doi.org/10.4103/0378-6323.95442
Mayeaux Jr EJ, Carter C, Murphy TE. Ingrown toenail management. Am Fam Physician. 2019;100(3):158-64.
Yang G, Yanchar NL, Lo AY, Jones SA. Treatment of ingrown toenails in the pediatric population. J Pediatr Surg. 2008;43(5):931-5. DOI: https://doi.org/10.1016/j.jpedsurg.2007.12.042
Bano ZS, Rana FA, Irfan A, Tariq A, Iqbal MS, Bano Jr Z. Comparison of Partial Nail Avulsion With or Without Phenolization in the Management of Ingrown Toenails. Cureus. 2025;17(5).
Khan MA, Chowdhury MA, Khondker L, Siddiquie RU, Afroze D, Alauddin M. Outcome of partial nail avulsion followed by partial matricectomy with 88% phenol in management of ingrown toe nail. Int J Rese Med Sci. 2025;13(2):657. DOI: https://doi.org/10.18203/2320-6012.ijrms20250233
Ashraf J, Hussain SM, Gilani ST, Ahmed R, Zia SA, Minhas SA. Comparison of Outcome of Ingrowing Toenail Surgery-Simple Nail Removal V/S Wedge Resection. Pak Armed Forces Med J. 2025;75(2):312. DOI: https://doi.org/10.51253/pafmj.v75i2.10311
Exley V, Jones K, Watson J, Backhouse M. A survey of the treatment and management of ingrown toenails by UK podiatrists: A cross‐sectional survey. J Foot Ankle Res. 2024;17(2):e12017. DOI: https://doi.org/10.1002/jfa2.12017
Ergün T, Korkmaz M, Ergün D, Turan K, Muratoğlu OG, Cabuk H. Treatment of ingrown toenail with a minimally invasive nail fixator: comparative study with Winograd technique. J Am Podiatr Med Assoc. 2024;114(1). DOI: https://doi.org/10.7547/22-024
Guler O, Tuna H, Mahirogullari M, Erdil M, Mutlu S, Isyar M. Nail braces as an alternative treatment for ingrown toenails: results from a comparison with the Winograd technique. J Foot Ankle Res. 2015;54(4):620-4. DOI: https://doi.org/10.1053/j.jfas.2015.04.013
Watabe A, Yamasaki K, Hashimoto A, Aiba S. Retrospective evaluation of conservative treatment for 140 ingrown toenails with a novel taping procedure. Acta Dermato-venereologica. 2015;95(7):822-5. DOI: https://doi.org/10.2340/00015555-2065
Uygur E, Çarkçi E, Şenel A, Kemah B, Turhan Y. A new and simple suturing technique applied after surgery to correct ingrown toenails may improve clinical outcomes: A randomized controlled trial. Int J Surg. 2016;34:1-5. DOI: https://doi.org/10.1016/j.ijsu.2016.08.005
DeBrule MB. Operative treatment of ingrown toenail by nail fold resection without matricectomy. J Am Podiatr Med Assoc. 2015;105(4):295-301. DOI: https://doi.org/10.7547/13-121.1
Dressler C, Nast A, Heuer R, Löser CR. Ingrown toenails: a survey among dermatologists on current treatments. Dermatol Sur. 2024;50(3):260-6. DOI: https://doi.org/10.1097/DSS.0000000000004060
Peyvandi H, Robati RM, Yegane RA, Hajinasrollah E, Toossi P, Peyvandi AA, et al. Comparison of two surgical methods (Winograd and sleeve method) in the treatment of ingrown toenail. Dermatol Surg. 2011;37(3):331-5. DOI: https://doi.org/10.1111/j.1524-4725.2011.01880.x
Mitchell S, Jackson CR, Wilson-Storey D. Surgical treatment of ingrown toenails in children: what is best practice? Ann Royal Coll Surg Engl. 2011;93(2):99-102. DOI: https://doi.org/10.1308/003588411X12851639107674
Gera SK, Zaini DH, Wang S, Rahaman SH, Chia RF, Lim KB. Ingrowing toenails in children and adolescents: is nail avulsion superior to nonoperative treatment? Singapore Med J. 2019;60(2):94. DOI: https://doi.org/10.11622/smedj.2018106
Downloads
Published
How to Cite
Issue
Section
