Review Article
Controversies in the Treatment of Ingrown Nails
Table 1
Types of ingrowing nails.
| Age of onset/growth direction | Common cause | Treatment |
| Neonatal | Free nail margin has not yet overgrown the tip of the toe | Conservative: massage | Infantile | | | ā(1) Congenital malalignment of the big toenail | Malformation, probably genetic | Spontaneous healing in about 50%, if not by the age of 2 years: operation | ā(2) Hypertrophic lateral lip | Harmless malformation | Massage usually sufficient | Adolescent | Distal lateral ingrowing due to narrow nail bed | Conservative: packing, taping, gutter, acrylic nail; selective lateral matrix horn resection | Adult | Sharply bent lateral margin | Packing, gutter; surgical narrowing of the nail | Distal embedding | Big toenail too short | Taping of the distal nail wall, surgery | Retronychia | Chronic trauma with marked onycholysis leading to proximal ingrowing | (Proximal) nail avulsion | Pincer nail | Wide base of the distal phalangeal bone with large medial and smaller lateral osteophytes. Some drugs | Orthonyxia (braces) | Narrowing of the nail, in severe cases with nail bed plasty |
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