Surgical management of ingrown toenails – an update overdue


  • Bertrand Richert

    Corresponding author
    • Dermatology Department, Université Libre de Bruxelles, University Hospital Brugmann – Saint Pierre – Children Hospital Queen Fabiola, Brussels, Belgium
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Address correspondence and reprint requests to: Bertrand Richert, MD, PhD, Dermatology Department, CHU Brugmann, Place Van Gehuchten 4, 1020 Brussels, Belgium, or email:


For decades, every year sees a wide number of articles about treatment of ingrown toenails. There is still a debate about the cause of this painful condition. Surgical treatments rely on two main approaches: either narrowing the nail plate or debulking the soft tissues. It is up to the surgeon to select the most appropriate approach in each case. All procedures cited in this article have high cure rates as long as they are properly performed. As with all surgical procedures, they are operator dependent. Chemical cautery is the easiest and most versatile technique that may help in almost all instances for lateral ingrowing. For distal embedding and very hypertrophic and exuberant lateral folds, debulking with secondary intention healing is the most effective and easy to perform, with great results.