Guideline sources The following summarized guidelines for the management of ingrown toenails are prepared by our editorial team based on guidelines from the American Association of Family Physicians (AAFP 2019). 1 Guidelines 1. Medical management Oral antibiotics: do not use oral antibiotics before or after phenolization for the sole purpose of decreasing healing rates or post-procedure morbidity of patients with ingrown toenails. D 2. Nonpharmacologic interventions Conservative management: offer conservative approaches for the treatment of patients with ingrown toenails without infection, including placing a cotton wisp, dental floss, or gutter splint (with or without acrylic nail) under the ingrown nail edge. B 3. Surgical interventions Partial nail avulsion: https://web.pathway.md/diseases/recFhdOS64XqY9KoA 1/2 6/24/23, 2:34 PM Ingrown toenails Pathway Offer partial nail avulsion followed by phenolization or direct surgical excision of the nail matrix as they are equally effective in the treatment of patients with ingrown toenails. B Offer partial nail avulsion combined with phenolization rather than surgical excision of the nail without phenolization considering its effectiveness at preventing symptomatic recurrence of ingrown toenails, but recognizing that it has a slightly increased risk of postoperative infection. B References 1. E J Mayeaux Jr, Charles Carter, Tenley E Murphy. Management of the Ingrown Toenail. Am Fam Physician. 2019 Aug 1;100 3 158 164. Open https://web.pathway.md/diseases/recFhdOS64XqY9KoA 2/2