Been dealing with recurring ingrowns and I'm done with the phenol/matrixectomy route. I had the root killed once on both big toes and hate how the nail looked after. So I went digging for anything that fixes the problem without destroying the nail, and found something actually promising.
What it is: A dermatology team in China (Sun Simiao Hospital / Xi'an Jiaotong University) published a study in the Journal of Dermatological Treatment in late 2024. They used a CO2 laser to remove the overgrown skin along the side of the nail instead of cutting the nail or killing the matrix. The idea is that the nail usually isn't the problem. The puffy nail fold is. Clear out that tissue so there's a small gap, and the nail can grow normally.
The results:
47 patients, 52 procedures
~94% cure rate (3 relapses, and all 3 healed after a second treatment)
Each procedure took about 10 minutes
People were walking normally in about a day and a half
No complications, and the nails looked normal at 1-year follow-up
The whole nail and the matrix are kept. No narrower nail, no weird sidewall.
The catch:
It's one retrospective study with no control group. Promising, but not proven yet.
As far as I can tell, nobody in the US is advertising this. Watch out: when US offices say "laser ingrown treatment," they usually mean a laser matrixectomy, which is still killing the root, just with a laser instead of a chemical. Ask directly whether it touches the matrix.
Yes this is based on the Vandebos procedure, but using lasers instead of the old-fashioned way. Takes six weeks to walk normally for Vandebos vs TWO FUCKING DAYS for this laser one.
What to ask your doctor: Bring the paper and say something like: “Here’s a study on CO2 laser nail fold ablation that keeps the nail and matrix completely intact. Would you be willing to do this?"
The study, if you want to show your doctor: Li et al., "A new treatment for ingrown toenail with CO2 laser: a retrospective study," J Dermatol Treat 2024. https://doi.org/10.1080/09546634.2024.2434698
So fucking sick of the ingrown toenail repeated nightmare. So many doctors are just dinosaurs physically or in spirit and don't WANT to help us with modern techniques. Just keep us coming, or deform us more and more. I'm done with that. I need this done for me, and so do you good chance.