A comparison between CO₂ laser surgery with and without lateral fold vaporization for ingrowing toenails

Abstract

Background: An ingrowing toenail is an excessive lateral nail growth into the nail fold. It acts as a foreign body and exerts a local pressure sore‐like effect, which may result in inflammation and granulation. Several treatment modalities exist, including chemical ablation and different surgical procedures. Here we describe and compare a simple and effective method of partial matricectomy using the CO₂ laser (group A) versus a similar method with the addition of lateral nail fold vaporization (group B). Objective: Outcome evaluation of a modified laser treatment modality for ingrowing toenails and determination of the role of lateral fold vaporization in reducing the recurrence of symptoms. Methods: Forty patients (mean age 32.45 years) were treated with CO₂ laser ablation of toenails between 1999 and 2005 by four physicians. One physician implemented a method that includes lateral nail fold vaporization and resection of the nail segment with its nail bed from 1999 to 2005. Three physicians implemented a similar technique but without lateral fold vaporization between 1999 and 2003, and added lateral fold vaporization to the performed procedure starting in 2004. Results: The recurrence rate was 37.5% in group A and 6.2% in group B. The overall average disease‐free follow‐up period was 42.2 months. Conclusion: The use of CO₂ laser in the treatment of ingrowing toenails offers an effective modality. We demonstrate the importance of lateral fold vaporization with the CO₂ laser both in improving efficacy and in decreasing recurrence rates over a long follow‐up period.

• CO₂ laser
• ingrowing toenail
• lateral fold vaporization
• partial matricectomy