Review Article

Controversies in the Treatment of Ingrown Nails

Table 1

Types of ingrowing nails.

Age of onset/growth directionCommon causeTreatment

NeonatalFree nail margin has not yet overgrown the tip of the toeConservative: massage
Infantile
ā€ƒ(1) Congenital malalignment of the big toenailMalformation, probably geneticSpontaneous healing in about 50%, if not by the age of 2 years: operation
ā€ƒ(2) Hypertrophic lateral lipHarmless malformationMassage usually sufficient
AdolescentDistal lateral ingrowing due to narrow nail bedConservative: packing, taping, gutter, acrylic nail; selective lateral matrix horn resection
AdultSharply bent lateral marginPacking, gutter; surgical narrowing of the nail
Distal embeddingBig toenail too shortTaping of the distal nail wall, surgery
RetronychiaChronic trauma with marked onycholysis leading to proximal ingrowing(Proximal) nail avulsion
Pincer nailWide base of the distal phalangeal bone with large medial and smaller lateral osteophytes. Some drugsOrthonyxia (braces)
Narrowing of the nail, in severe cases with nail bed plasty