[Conservative treatment options for unguis incarnatus]

Area of Science:

• Podiatry
• Dermatology
• Surgical Procedures

Context:

• Ingrown toenails (unguis incarnatus) are a common condition.
• Current Dutch guidelines minimally address conservative and minimally-invasive alternatives.
• Surgical partial nail excision is often the default for advanced stages.

Purpose:

• To highlight conservative and minimally-invasive treatment options for ingrown toenails.
• To discuss the efficacy and safety of spiculectomy with nail bracing.
• To emphasize the need for improved guidance on nail growth and clipping post-procedure.

Summary:

• A prospective cohort study in 88 high-risk individuals demonstrated that spiculectomy followed by orthonyxia (nail brace) or tamponnade is a safe and effective treatment for ingrown toenails.
• This clinical lesson presents three cases, detailing their management with minimally-invasive approaches.
• The study underscores the importance of post-procedure nail guidance and clipping advice to prevent recurrence, aspects lacking in current guidelines.

Impact:

• Promotes the adoption of less invasive treatments for ingrown toenails.
• Offers evidence supporting podiatrist-led interventions for high-risk populations.
• Advocates for guideline updates to include comprehensive post-treatment care for ingrown toenails.