Ingrown Toenail Recurrence Rates Between Two Treatment Options: Results of a Recent Review

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A recent abstract presented at the 2025 American Podiatric Medical Association National conference took a closer look at recurrence data for the use of nail braces versus traditional chemical matrixectomy when treating ingrown toenails.¹ Jessica Sima, BA, who authored the paper with Amanda L. Killeen, DPM, noted that while matrixectomy is a gold-standard surgical treatment in the United States, nail bracing is more common in Asia and Europe.  

“This question arose from personal and familial experiences—while my own ingrown toenail was treated surgically in the US, my mom received a nail brace in China, both with successful outcomes,” she shared. “Given the differences in regional practices, I wanted to evaluate the comparative efficacy of these approaches, particularly regarding recurrence rates and patient suitability.”

As a first-year podiatry student, Ms. Sima considered her limited access to clinical data, and said she chose to conduct a scoping review, she viewed it as an ideal method for synthesizing existing evidence. She systematically searched PubMed and Google Scholar, screening 344 publications to compare recurrence rates and other key considerations (eg, pain, complications, and study eligibilty) between matrixectomy and nail braces.¹ The primary focus, however, was on recurrence rates.

Her review revealed lower ingrown toenail recurrence rates with the matrixectomy (1.60–3.00%) compared to cases treated with nail braces (7.40–10.30%).¹ Reflecting on this data, Ms. Sima discussed some of the advantages of nail bracing being the lack of required anesthesia or incisions and immediate return to activity. She noted that this option could, as a result, prove appealing for higher-risk patient populations, such as those with diabetes, anesthesia allergies or intolerances, or bleeding disorders. Potential drawbacks of nail bracing, however, may include extended treatment duration, with possible months of brace adjustments, and the slightly higher recurrence rates found in this review.¹

Student Doctor Sima added that, while matrixectomy remains the most effective long-term solution, she feels this data on nail braces supports it as a valuable nonsurgical alternative for specific patient populations or case scenarios.

“I hope this research raises awareness among podiatrists about tailoring treatment plans based on patient needs and risk factors. Further clinical studies could help refine guidelines for when nail braces are most appropriate,” she said.

Reference

1.     Sima J, Killeen AL. Comparison of recurrence rates in chemical matricectomy with phenol and nail bracing: A scoping review. Abstract presented at the APMA National, July 24-27, 2025, Grapevine, TX.