Adult dose and durationApplied to the granulation tissue itself, and the label gives no schedule. What the label's APPLICATION section does say: the ARZOL applicator goes straight onto mucous membranes and other moist surfaces; on dry skin its tip is dipped in water immediately beforehand; and it is put carefully only on the area meant to be treated. It must NOT be used on the eyes. The applicator is silver nitrate 75% with potassium nitrate 25%. Neither the label nor the disease article states a number of applications or an interval, and none is invented here. - No duration is stated in either document. Apply once and review; the label's own warning about repeated use is in the cautions and is the limit that matters.
Paediatric doseNo strength, frequency, number of applications or maximum is stated for a child in either document, so no paediatric figure is printed. The label's neonatal warning is in the cautions and applies to thin skin generally. An ingrown toenail in a child is usually managed conservatively or surgically.
Dose sourceARZOL Silver Nitrate Applicators (silver nitrate 75% / potassium nitrate 25%) DailyMed label, Indications and Application (SetID 23b83457-8cbc-26f1-e054-00144ff8d46c)
WhyThe disease article names the drug and the tissue it is for: silver nitrate put on granulomatous tissue, to bring down hypergranulation and the heavy bleeding that comes with it. The product label's indications section names the same tissue - on skin it is put forward for cauterising wounds and indolent ulcers, and for taking off granulation tissue and warts. This is the same pairing already accepted on the umbilical-granuloma card and it is used here on the same basis. The card carried conservative nail care, an antibiotic and an analgesic, none of which touches the lump of granulation tissue that keeps the nail fold bleeding and weeping. Egypt registers no silver nitrate product at all, so no brand and no price can be shown - the applicators are clinic stock, not something the patient fills at a pharmacy.
Cautions- IT IS A CAUSTIC. Label verbatim: "Silver Nitrate is a caustic compound, the improper use of which may cause chemical burns. Silver Nitrate mixes with body fluids; this mixture is caustic and tissue damage may result if not removed quickly." Protect and dry the surrounding skin, and wipe away any run-off at once - the toe is wet with exudate, which is exactly how the burn spreads.
- REPEATED USE. Label verbatim: "Long continued applications to large areas may produce argyria, a slate-blue discoloration of the skin and mucous membranes." Granulation tissue that has not settled after two or three applications is a reason to refer for definitive nail surgery, not to cauterise again and again.
- It blackens what it touches. Label verbatim: "Silver nitrate blackens the tissues to which it is applied but this discoloration gradually disappears." Warn the patient, or they will think the toe has become gangrenous.
- NEVER USE IT ON THE EYES.
- It does not treat the ingrowing nail. The disease article's cautery sentence sits inside a list of non-surgical palliative measures; the definitive treatments on this card and in the article are nail care and surgery. Cautery removes the granulation tissue and leaves the cause.
- Infection is a separate question. The disease article gives antibiotics, by mouth or topically, where there is minor infection - cellulitis or an abscess alongside the nail - and where the patient carries a high-risk comorbidity such as diabetes or immunosuppression. A diabetic foot with a discharging nail fold is not a cautery problem.
- REGULATORY STATUS, STATED HONESTLY - this product is sold as an unapproved drug, and carries the FDA disclaimer that FDA has not established its safety or effectiveness. It is cited here only because it is the sole source found that describes how to apply the product; the indication itself comes from the disease article and the product's own indications section.
Egyptian brandsNo Egyptian brand matched — prescribe by generic name.