Ingrown Toenails

Written by Shannon Johnson | Published on 09 July 2012
Medically Reviewed by George Krucik, MD

What Are Ingrown Toenails?

Ingrown toenails occur when the edges or corners of the nail grow into the skin next to the nail. Your big toe is most likely to get an ingrown toenail.

For the most part, you can treat ingrown toenails at home. However, sometimes they cause complications that could make medical treatment necessary. You are at higher risk of such complications if you have diabetes or other conditions that cause poor circulation.

What Causes Ingrown Toenails?

Anyone can get an ingrown toenail. They occur in both men and women.

According to Britain’s National Health Service, ingrown toenails may be slightly more common in teenagers, who tend to have sweatier feet. Older people may also be at higher risk, because toenails thicken with age (NHS).

Many things can cause an ingrown toenail. Common causes include:

  • cutting toenails incorrectly: The toenail should be cut straight across. Angling the sides of the nail can encourage the nail to grow into the skin.
  • irregular, curved toenails
  • footwear that places a lot of pressure on the big toes: Pressure can be from shoes that are too tight, narrow, or flat for your feet. Socks and stockings that are too tight can also lead to ingrown toenails.
  • toenail injury
  • poor posture
  • improper foot hygiene, where feet aren’t kept dry and clean

What Are the Symptoms of Ingrown Toenails?

Ingrown toenails can be very painful. They usually get worse in stages. It is important to treat your ingrown toenail as soon as possible.

Early stage symptoms include:

  • skin next to the nail becomes tender, swollen, or hard
  • pressure on the toe is painful
  • fluid builds up around toe

If your toe becomes infected, symptoms may include:

  • red, swollen skin
  • pain
  • bleeding
  • oozing pus
  • overgrowth of skin around toe

How Are Ingrown Toenails Diagnosed?

Your doctor will most likely be able to diagnose your toe with a physical exam.

If your toe seems infected, you might need an X-ray. This can show how deep the nail is. An X-ray may also be taken if:

  • your ingrown nail was caused by injury
  • you have a history of chronic infections
  • your pain is severe

What Are the Treatment Options for Ingrown Toenails?

Ingrown toenails that are not infected can normally be treated at home. However, if the toenail has pierced the skin or there is any sign of infection, it is a good idea to seek medical treatment. Signs of infection include:

  • warmth
  • pus
  • redness and swelling

Home Treatment

To treat an ingrown toenail at home, try:

  • soaking feet in warm water three to four times a day
  • pushing skin away from the toenail edge with a cotton ball soaked in olive oil
  • using over-the-counter medicines, like Tylenol, for the pain
  • applying a topical antibiotic to prevent infection

If the toenail does not respond to home treatments, you may need surgery.

Surgical Treatment

There are several ways that surgery can be used to treat an ingrown toenail.

Partial nail removal removes only the piece of nail that is digging into your skin. Your toe will be numbed. Then your doctor will narrow the toenail. The sides will be cut away so the edges are completely straight. A piece of cotton will be placed under the remaining portion of the nail to keep the ingrown toenail from reoccurring. Your doctor may also treat your toe with a compound called phenol. This keeps the nail from growing back.

Total nail removal may be used if your ingrown nail is caused by thickening. The doctor will give you a local pain injection and then remove the entire nail.

After Surgery

Your doctor will send you home with your toe bandaged. You will probably need to keep your foot raised for the next one to two days. Try to avoid as much movement as possible. Your bandage is usually removed on day two. Your doctor will advise you to wear open-toe shoes and to do daily saltwater soaks until your toe heals.

Your doctor will also prescribe pain relief medication and antibiotics to prevent infection.

Preventing Ingrown Toenails

Ingrown toenails can be prevented. Here are some tips to help you avoid ingrown toenails:

  • Trim your toenails straight across and make sure that edges do not curve in.
  • Avoid cutting toenails too short.
  • Wear proper-fitting shoes, socks, and tights.
  • Wear steel-toe boots if you work in hazardous conditions

If your toenails are abnormally curved or thick, surgery may be necessary to prevent ingrown nails. According to the National Health Service, partial nail removal is 98 percent effective for preventing ingrown toenails (NHS).

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