Assessment of Ingrown Toenails Treated with Nail Fold Cryotherapy in Adolescent Patients: An Observational Pilot Study.

Abstract

Background: Cryotherapy reduces pain by making some reversible functional changes in peripheral nerves. It has also been reported to have a positive effect on the regression of inflammation and granulation tissue. Few studies have evaluated the efficacy and safety of nail fold cryotherapy in ingrown toenails (IGTN) in adults, and there are no studies in the pediatric population. We aimed to evaluate the clinical efficacy of cryotherapy applied to the nail fold in juvenile IGTN.

Methods: This study was conducted in adolescent patients aged 12 to 16 years with unilateral juvenile IGTN. Liquid nitrogen was sprayed into the nail fold for 10 to 15 seconds with a double freeze-thaw cycle. The effectiveness of cryotherapy was interpreted by the clinician's decision, the improvement in visual analogue scale score, Children's Dermatology Life Quality Index score, and granulation tissue.

Results: According to the physician, good efficacy was achieved in 91.7% of patients (n = 22 of 24). We found that 54.5% of them (n = 12 of 22) were still in remission after 6 months. Rates of complete regression in granulation tissue were pronouncedly less in sizes larger than 5 mm (≤5 mm, 55.6%; >5 mm, 16.7%). However, adequate symptomatic relief was observed in 83.3% of stage 3 patients, even if complete granulation tissue response was not achieved yet. Significant improvements in visual analogue scale and the Children's Dermatology Life Quality Index scores were observed after cryotherapy (P < .05).

Conclusions: Nail fold cryotherapy is a useful alternative among conservative methods because of its rapid and high efficiency (91.7%), especially in mild to moderate cases, despite the high recurrence rates (45.5%) in juvenile IGTN.