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Twenty-five patients with ingrowing toenails were treated conservatively by inserting cotton wool under the ingrowing nail edge. Seventy-nine percent were relieved of their symptoms after follow up for a mean of 23.7 weeks. Thirty-six percent had a history of previous surgery to the nail, 75% of whom had a good or excellent result. Although conservative management was first described in the eighteenth century and has been reported sporadically since, only a few doctors treat their patients in this way. There is, however, a distinct place for this highly effective, low cost method as the initial treatment of these patients without the need for hospital referral.