05/13/2014    Lawrence Sturm, DPM

Phenol Vs. NaOH (Dan Methuselah, DPM)

I have switched to using NaOH a few years ago. I
find there is a little more discomfort the night
after the procedure for the patient but they are
mostly resolved in 2 weeks. I have not had any
recurrences yet. The NaOH is applied for 60
seconds once only and then neutralized with acetic
acid. Here is an abstract comparing the two
agents:

Dermatol Surg. 2007 Jun;33(6):680-5.
Comparison of phenol and sodium hydroxide chemical
matricectomies for the treatment of ingrowing
toenails. Bostanci S, Kocyigit P, Gürgey E.
Department of Dermatology, Ankara University,
Medical School, Ankara, Turkey.

Abstract: Chemical matricectomy is performed
mainly by two agents: phenol and sodium hydroxide.
Both agents have excellent cure rates, but there
are no data about the comparison of
postoperative healing periods. This study was
designed to compare the postoperative morbidity
rates of sodium hydroxide and phenol
matricectomies.

Forty-six patients with 154 ingrowing nail sides
were treated with either sodium hydroxide or
phenol matricectomy. In the postoperative period,
the patients were evaluated for the duration and
severity of pain, drainage, and peripheral tissue
destruction; complete healing periods; and overall
success rates.

The incidence of pain was higher in the sodium
hydroxide group on the first visit, on the
second day, but all patients became pain-free
after that. The incidence and duration of drainage
and peripheral tissue destruction was
significantly higher in the phenol group. The mean
period for complete recovery was 10.8 days in the
sodium hydroxide group, whereas it was 18.02 days
in the phenol group. The overall success rates in
the sodium hydroxide and phenol groups were found
to be 95.1 and 95.8%, respectively.

Both sodium hydroxide and phenol are effective
agents giving high success rates, but sodium
hydroxide causes less post-operative morbidity and
provides faster recovery.

PMID: 17550444 [PubMed - indexed for MEDLINE]

Lawrence Sturm, DPM, Hallandale Beach,
FLlsturmdpm@gmail.com

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