An ingrown toenail occurs when the edge or corner tip of the nail pierces the skin, growing back into it. This potentially painful condition can happen to anyone and usually occurs in the big toe.
When left untreated, ingrown toenails can cause infections that may spread into the underlying bone structure of the foot.
Any condition that reduces blood flow to the feet, such as diabetes or peripheral arterial disease, may make ingrown toenails more likely. People with these types of conditions may also experience severe complications if infection does occur.
As with many potentially serious conditions, ingrown toenails start out with minor symptoms that can escalate. Pay attention to the early symptoms of this condition to prevent an infection or other complication. Symptoms of an infected ingrown toenail include:
- redness or hardening of the skin around the nail
- pain when touched
- pressure under the nail
- build-up or oozing of fluid
- foul smell
- warmth in the area around the nail
- pus-filled abscess where the nail punctured the skin
- overgrowth of new, inflamed tissue at the edges of the nail
- thick, cracked yellowing nails, specifically in fungal infections
You can get either a fungal or bacterial infection in an ingrown toenail. For example, MRSA, a drug-resistant staph infection, lives on skin and can cause infection to occur.
MRSA infections can spread into the bone, requiring weeks of intravenous antibiotics and sometimes surgery. It’s very important to treat infected ingrown toenails quickly in order to avoid this complication.
Any condition that reduces blood flow or causes nerve damage to the feet can also inhibit healing. This can make infections more likely and harder to treat.
Complications resulting from hard-to-treat infections can include gangrene. This complication typically requires surgery to remove dead or dying tissue.
Ingrown toenail infections can often be treated at home if you’re able to get under the part of the nail that’s digging into your skin.
Don’t yank or pull on your nail. You may be able to lift the skin gently with a piece of dental floss, but don’t force it, and make sure your hands are clean when you try.
- Soak your foot in warm water and Epsom salt or coarse salt to soften the area. This will help the pus to drain out and reduce pain.
- Apply antibiotic or antifungal lotion directly to the nail and to the skin under and around the nail.
- Take over-the-counter pain medication to help reduce symptoms, such as discomfort and swelling.
If your infection doesn’t begin to dissipate within a few days, see a doctor. They may be better able to lift and get under the nail, making treatment with topical antibiotics easier.
Treatments your doctor may try include:
- packing antibiotic-soaked gauze under the nail to eliminate the infection and help the nail to grow out regularly
- trimming or cutting off the part of your nail that’s ingrown
- surgery in the case of a serious or recurring problem
If a bone infection is suspected, your doctor may do a blood test to see how deep the infection goes. Other tests include:
- bone scan
- bone biopsy if your doctor suspects osteomyelitis, a rare complication
If you’re having trouble walking, or are in pain, see a doctor if your toenail has pierced the skin, and you can’t lift it or cut it away. Any infection that doesn’t get better with at-home treatment should also be seen by a doctor.
If you have diabetes, have a doctor check your feet regularly. Due to nerve damage, you may not feel the discomfort associated with an ingrown toenail, delaying treatment.