Journal of the American Academy of Dermatology

Effectiveness of standard lavage with supplemental chlorhexidine in patients undergoing chemical matricectomy for ingrown toenails: a clinical trial.

PMID 24680105


Phenolization is often used to treat ingrown toenails. Alcohol lavage with or without supplemental chlorhexidine may be used to remove residual phenol, which can contribute to side effects such as persistent oozing or drainage. We sought to compare the effectiveness in removing residual phenol of lavage with alcohol plus chlorhexidine versus alcohol alone. We studied 80 patients who underwent unilateral phenol matricectomy: 40 who received irrigation with alcohol alone and 40 who received irrigation with alcohol plus chlorhexidine. Phenol levels were measured after each of 5 rounds of 3-mL irrigations. After the first irrigation, an average of 44.92% and 38.35% of the phenol remained in the nailfold in the alcohol and the alcohol/chlorhexidine groups, respectively (P < .05). After all 5 irrigations, no difference in efficacy between the 2 solutions was found (P > .005). It was not possible to calculate the quantity of phenol initially introduced into the nail bed. The percentage remaining was calculated from the total amount of phenol recovered. When a single irrigation step is performed after phenolization, alcohol plus chlorhexidine is more effective than alcohol alone for removing residual phenol. When multiple irrigations are performed, the 2 solutions are equally effective.