How effective is cryotherapy applied to the nail fold in ingrown toenails?

Abstract

There are only two publications in Pubmed on the effectiveness of cryotherapy in ingrown toenails, and they present conflicting results. We aimed to clarify the clinical effectiveness of cryotherapy in onychocryptosis. This study retrospectively examined the visual analogue scale (VAS), dermatological life quality index (DLQI), other medical records, and photographs taken before each cryotherapy session and 6-month follow-up in 59 adult patients with ingrown toenails that underwent cryotherapy with a 3-week interval. Cryotherapy effectiveness was assessed by the clinicians' decisions, improvements in VAS and DLQI scores, and granulation tissue. Other factors related to effectiveness and recurrence were also investigated. After excluding approximately 20% of patients, for whom the treatment was not effective, this study revealed that recurrence rates in unilateral and bilateral onychocryptosis were 34.2% and 88.9%, respectively, 6 months after treatment. In patients that responded to the treatment, about 75 to 80% had excellent symptomatic responses. Excellent symptomatic responses were maintained in about 80% of patients in remission. We found that foot or toe deformity was associated with treatment ineffectiveness (p = 0.019). Age younger than 20 years and bilateral ingrown toenails were also related to recurrence (p = 0.042 and 0.003, respectively). Cryotherapy can be used to greatly and consistently improve the DLQI in suitable ingrown toenails.