Preservative and surgical interventions to treat ingrown nail and pincer nail

Abstract

Ingrown nail and pincer nail are common diseases. Although they are sometimes indistinguishable and described together, they are different conditions. Pincer nail is a situation where nail plate is curved transversely. On the other hand, ingrown nail represents a condition, where lateral edge of nail cuts deep into the lateral nail fold causing severe inflammation and even pyogenic granuloma. Ingrown nail and pincer nail coexist in some patients. In certain occupational environments, these nail diseases frequently occur as well as irritant and allergic skin diseases. In addition, they may take place in patients receiving epidermal growth factor receptor inhibitors. Different approaches should be made for the treatment of these nail conditions. Historically, surgical interventions, as exemplified by partial avulsion of nail plate and matricectomy, were usually selected. Currently, a number of preservative methods have been emerging, including nail sculpture, Tsume Flat®, Pedigrass®, VHO®, and hyperelastic wire. However, there has been no golden standard. Each facility takes its own method for the treatment. In this review, we explain these preservative methods as well as surgical interventions.

Effects of two types of surface treatments on the structural elasticity of human fingernails

“…Nail diseases, such as pincer nails and thickened nails, are serious problems, especially for the elderly, as they are painful and interfere with daily life. 1 , 2 , 3 Pincer nails are corrected mechanically with wires and clips, 4 , 5 whereas thickened nails are removed using a file to reduce their thickness. Softening treatment 6 is effective for both diseases.…”

Improvements in pincer nail deformity occur earlier and last longer when acetylcysteine gel is added to an overcurvature‐correcting device: Results of a phase 3, multicenter, randomized, vehicle‐controlled, investigator‐blinded study

“…There is no standard treatment for pincer nails, although conservative and surgical procedures can be performed 1 . Conservative treatment involves attaching an overcurvature‐correcting device to relieve subjective symptoms and revert the transverse overcurvature to as near normal as possible 6 . Such procedures can take several months to correct the deformity, 2,7 and for particularly thick nails, simultaneous attachment of two wires, or repeat procedures, may be necessary 8 .…”