What are the possible complications of ingrown nails?

Updated: Nov 06, 2020
  • Author: Amira M Elbendary, MBBCh, MSc; Chief Editor: William D James, MD  more...
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Development of paronychia is the most common complication. If paronychia is not treated, the condition may progress to cellulitis, osteomyelitis, or systemic infection.

If neglected, abscess formation (paronychia) can spread and lead to osteomyelitis, systemic infection, and sepsis; amputation of the digit may even be required for definitive treatment.

An ingrown nail causes varying degrees of inflammation in the surrounding tissue, and this may predispose to infection if not well treated.

Hypertrophy of the medial and lateral skin folds may occur, as shown in the image below, and bilateral sidewall hypertrophy that covers the entire nail has been reported. [21]

Hypertrophy of the lateral nail fold that partiall Hypertrophy of the lateral nail fold that partially cover the nail. Courtesy of Dermatology Research and Practice (Haneke, E. "Controversies in the Treatment of Ingrown Nails." Dermatology Research and Practice. 2012; 2012:783924).

Pyogenic granuloma may develop on longstanding infected ingrown nails.

If left untreated, chronic inflammation may cause skin bridging secondary to epithelialization of the adjacent inflamed hypertrophied soft tissue. [22]

Keloid formation may result from chronic inflammation, especially in cases of recurrent ingrown nails. [23]

Recurrence is defined as the occurrence of pain, discomfort, erythema, and/or drainage at the site of the treated nail edge.

Although infrequent, postsurgical infection may occur in a small percentage of patients. Appropriate precautions should be given to return for any signs of infection or fever.

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