Study Shows Nail Braces To Be A Safe And Effective Treatment Of Ingrown Toenail In Diabetics

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Study Shows Nail Braces To Be A Safe And Effective Treatment Of Ingrown Toenail In Diabetics

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In most people with ingrown toenails, the condition may be quite painful and limit activity but isn’t generally dangerous. For those with diabetes, however, an ingrown toenail can be reason for serious concern and requires prompt and cautious treatment.

Diabetes creates several conditions which put patients at higher risk regardless of the condition in question. Most notably, this includes reduced sensation, slow healing of wounds, and lowered defense against infection.  With a loss of sensation, diabetics may not feel the pain of an ingrown toenail and thus let the condition progress until the area is infected.  Slow healing and lowered immune function makes this infection much more serious than it would be in patients without diabetes.  In addition, these factors make even minor surgery a major decision for diabetics.  As a result, non-surgical and long-lasting treatment of ingrown toenails becomes much more important.(1)

In the U.S. and many other countries, surgery is the default treatment for ingrown nails.  To address the needs of diabetics who are not good candidates for surgery, doctors at the Ankara University School of Medicine performed a multi-year study to assess the effectiveness and safeness of nail bracing as an ingrown toenail treatment option.

Illustration of Oniko ingrown toenail brace.

Illustration of Oniko ingrown toenail brace which works like the braces in the study.

Doctors applied nail braces to 21 non-insulin-dependent diabetics with severely painful, inflamed ingrown toenails.  The braces used in the study consisted of small hooks placed beneath either edge of the affected nail with a tensioning wire connecting the hooks.  The effect of the brace was to pull “up” on the two sides of the nail, relieving the pressure of the nail on the skin.  After application of the brace, the patients were immediately able to walk and stand on their tiptoes without any remaining discomfort.  This relief of pain was solely from the affects of the ingrown toenail brace as no type of anesthetic was used.  The braces were used until no signs or symptoms of ingrown toenail remained.(2)

Over the 2 years of observation following the removal of the nail braces, the participants reported very encouraging results.  Of the 21 patients, 15 (over 70%) experienced no further instances of ingrown toenail.  The 6 patients who did experience ingrown toenail again all chose to use the nail brace again rather than opt for surgery.(2)

Based on the relief of pain, prevention of infected ingrown toenails, and high success rate, doctors have concluded that nail bracing is a safe and effective treatment for ingrown toenails in diabetic patients*.  This evidence in favor of nail bracing as an alternative to surgical intervention is great news for both diabetics and non-diabetics alike.

While the braces used in the trial were hooked, there are also adhesive and combination style braces available.  Specific toenail characteristics and treatment needs will dictate which kind of brace is appropriate for each person. Additionally, geographic location may determine whether braces are available for home application or if a doctor visit is needed.  For more information on nail braces and availability see The Ingrown Toenail Treatment Guide – Nail Bracing.

*Please note that diabetic patients should consult with a physician regarding treatment of ingrown toenails or other conditions.

References:
1.  How Diabetes Affects Wound Healing. Wound Care Centers.
2.  Long-term Results of Nail Brace Application in Diabetic Patients With Ingrown Nails.  Erdogan FG.  Department of Dermatology, Ufuk University School of Medicine, Ankara, Turkey.