1. Place the pad on the lateral nail bed with the Teflon-coated side facing up. Lift the electrode about 1 mm, creating a small gap.
2. Activate the electrode for 3-10 seconds. A short sizzling sound can be heard and a small puff of smoke can be seen.
3. Ensure that the lateral horn of the matrix is cauterized by moving the electrode laterally under the proximal nail fold. When properly treated, the nail bed appears white after thermal ablation.
4. Avoid prolonged electrode activation, which may damage deep tissue (eg, inserting the extensor tendon under the nail bed) and cause excessive time (months) for healing.
If necessary, the hypertrophied lateral tissue can be cut away or cauterized with an electrosurgical unit.