Ingrown Toenail

What is an ingrown nail?

An ingrown nail is when the nail grows into the skin causing irritation, which can lead to pain, swelling, redness, and infection. The toe can become infected if the nail causes a break in the skin and allows bacteria to enter.  

What are the causes of an ingrown toenail ?

An ingrown toenail can develop in people who are born with irregular shaped,curved toenails, improperly cut nails that create a spicule, or trauma. 

How to treat an ingrown toenail?

An ingrown toenail that is not infected can be treated with warm water soakss with epson salt to soften the nail. Often, part of the nail has to be removed whether it is a corner of the nail (slant back procedure), partial removal of the nail border with or without matrixectomy, or surgical matrixectomy. 

What is a matrixectomy?

A matrixectomy is removal of the nail matrix that is the origin for the growth of the nail. A matrixectomy is done for patient’s that have chronic ingrown toenails and had prior partial nail avulsions. A matrixectomy can be done chemically or surgically. Most commonly, a chemical matrixectomy is done using 89% phenol (carbolic acid) or 10% NaOH (sodium hydroxide). 

How does chemical matriexctomy work?

A chemical matrixectomy is done after the offending nail border is removed and cotton tip applicator is used to put either phenol or NaOH on the the nail matrix to kill it. Phenol is a protein denaturant which produces a cauterizing effect by producing a coagulation necrosis in the matrix and surrounding tissue. NaOH is a strong basic salt that causes basic tissue destruction via  liquefaction necrosis. Chemical matrixectomies have been shown to be 95-97% successful in preventing the regrowth of nail, which is why surgical matriextecomy is rarely done. 

Video of partial nail avulsion with chemical matrixectomy:

If you have a painful ingrown toenail and would like a consultation. Make an appointment at Orange County Podiatry with Dr. Andrew Yang or call (949) 651-1202