Ingrown Toenails: Signs, Causes, Treatment & Prevention

A note from Cleveland Clinic: An ingrown toenail is annoying and painful but very treatable. Often, soaking your nail will improve symptoms within a few days.

What Is an Ingrown Toenail?

An ingrown toenail occurs when the corner or edge of your toenail grows into the skin beside it. This common condition typically affects the big toe and happens frequently when you cut your toenails by tapering around the corners instead of cutting straight across. While ingrown toenails usually aren’t serious, they can become uncomfortable and may require professional treatment if left untreated.

The condition develops when the nail edge pierces the surrounding skin, creating a pathway for bacteria to enter and cause infection. In most cases, you can treat ingrown toenails at home with conservative measures, though some situations require professional intervention.

Causes and Risk Factors

Understanding what causes ingrown toenails can help you prevent them from developing in the first place. Several factors contribute to this condition:

• Improper toenail trimming, particularly cutting nails too short or at angles
• Genetic predisposition to curved or irregular nails
• Tight, narrow, or ill-fitting shoes that place pressure on the toes
• Injury from pedicures, nail picking, or stubbing your toe
• Abnormal gait or walking pattern
• Poor foot hygiene practices

Certain individuals face higher risks for developing ingrown toenails. If you are obese, have diabetes, arthritis, fungal nail infections, or foot deformities, you’re more susceptible to this condition. Additionally, people with poor circulation or compromised immune systems should pay special attention to foot care.

Symptoms to Watch For

Recognizing the early signs of an ingrown toenail allows for prompt treatment and prevents complications. Common symptoms include:

• Redness and inflammation around the nail edge
• Swelling of the affected toe
• Pain or tenderness in the area
• Discomfort when wearing shoes or walking
• In rare cases, yellowish or pus-like drainage from the nail

If you notice any of these symptoms, especially if you have diabetes or poor circulation, consult a healthcare provider promptly. Ignoring an ingrown toenail can lead to serious complications, including infections that progress from the nail border to deeper soft tissues and potentially to bone infections.

Home Treatment Options

For mild to moderate ingrown toenails, several home remedies can effectively relieve symptoms and promote healing. These approaches are convenient and often work without professional intervention.

Soaking and Warm Water Treatment

One of the most effective home remedies is soaking your foot in warm water several times daily. This simple approach softens the skin and nail, reducing pain and inflammation. Many people experience symptom improvement within a few days of regular soaking. You can add Epsom salts or mild soap to the water for enhanced benefits.

Over-the-Counter Pain Relief

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help manage pain and reduce inflammation. Following the package directions ensures safe and effective use of these medications.

Moisture and Protection

Applying petrolatum jelly or antibiotic ointment to the affected area helps keep the skin moisturized and protected from bacteria. Cover the area with a clean bandage to prevent dirt and debris from entering the wound.

Alternative Remedies

Some people find relief using apple cider vinegar, though scientific evidence for this approach is limited. Others use ingrown toenail correctors or taping methods that attempt to pull the skin back and allow the nail to grow properly. However, the American College of Foot and Ankle Surgeons warns that certain practices may not relieve pain and can actually create environments where harmful bacteria grow, potentially leading to infection.

When to Seek Professional Care

While home remedies help many people, certain situations require professional medical attention. You should consult a healthcare provider if:

• Your ingrown toenail hasn’t improved after a few days of home treatment
• Signs of infection are present, including increased redness, swelling, or pus drainage
• You have diabetes or poor circulation
• The ingrown toenail keeps recurring
• Pain is severe or interfering with daily activities

A podiatrist can provide more sophisticated tools and techniques than available at home, and all instruments are properly sterilized to prevent infection. Professional care ensures proper diagnosis and appropriate treatment selection based on your specific situation.

Professional Treatment Options

When home treatments fail or complications develop, healthcare providers offer several professional treatment approaches, ranging from simple office procedures to surgical interventions.

In-Office Nail Trimming

During an office visit, a podiatrist can numb the area with local anesthetic and carefully cut away the offending nail border. This procedure helps relieve pain immediately and allows any infection to heal. However, simple nail trimming may not prevent future occurrences, particularly in cases of recurring ingrown toenails.

Nail Lifting and Taping

For some cases, a healthcare provider may manually push the skin away from the ingrown portion or apply special tape that gently pulls the skin back. This approach allows the nail to grow properly and can be repeated as needed.

Surgical Treatment: Nail Avulsion

For more persistent or severe ingrown toenails, surgical intervention becomes necessary. The primary surgical procedure is called nail avulsion, which involves removing part or all of the affected toenail.

Partial Nail Avulsion

In this procedure, your healthcare provider injects numbing medicine into your toe, then carefully cuts away the portion of the nail growing into your skin. The surrounding nail remains intact. According to the NHS, partial nail removal is approximately 98 percent effective at preventing future ingrown toenails. The procedure is straightforward and typically performed in an office setting.

After partial nail removal, your provider may apply cotton under the remaining nail portion to keep the ingrown toenail from recurring. Some doctors also treat the area with phenol, a chemical compound that prevents the nail from growing back in that location.

Complete Nail Avulsion and Matrixectomy

For recurring ingrown toenails or cases involving nail thickening, your provider may recommend complete toenail removal through a procedure called matrixectomy. During this procedure, the doctor numbs the region, removes the entire toenail, and applies phenol to burn and kill the cells that form the nail. This approach offers a more permanent solution to the problem and prevents the nail from regrowing in its original form.

It can take a few months for your nail to fully regrow after removal. If the condition continues occurring after nail avulsion, your provider can perform permanent ingrown toenail removal with phenol application to kill the nail root completely.

Recovery and Aftercare

Following any professional treatment, proper aftercare promotes healing and prevents complications. Your healthcare provider will give you specific instructions based on your treatment type. Generally, keep the area clean and dry, change bandages as directed, and avoid activities that put pressure on the toe during healing.

Watch for signs of infection such as increased redness, swelling, warmth, or drainage. Contact your healthcare provider if you notice these symptoms, as infection requires prompt antibiotic treatment.

Prevention Strategies

Preventing ingrown toenails is easier than treating them. Implement these strategies to reduce your risk:

• Cut toenails straight across rather than at angles, and avoid leaving sharp edges
• Don’t cut nails too short, as this increases ingrown toenail risk
• Wear properly fitting shoes that don’t pinch or crowd your toes
• Choose socks and stockings that aren’t too tight
• Practice good foot hygiene and keep nails clean and dry
• Avoid picking at nails or skin around the nail
• Be careful during pedicures to ensure nails aren’t cut too short or at problematic angles

Special Considerations for Diabetes and Other Conditions

If you have diabetes or poor circulation, ingrown toenails require particular attention. These conditions increase infection risk significantly, as they may impair your body’s ability to fight bacteria and heal wounds. People with these conditions should avoid attempting to treat ingrown toenails at home and instead seek professional medical care at the first sign of problems.

Frequently Asked Questions

Q: Are ingrown toenails serious?

A: Ingrown toenails are usually not serious and can often heal on their own. However, they can become serious if infection develops, particularly for people with diabetes or poor circulation. If an ingrown toenail causes a break in the skin, bacteria can enter and cause infection, making it much more painful and requiring professional treatment.

Q: How long does it take for an ingrown toenail to heal?

A: Home treatment typically improves symptoms within a few days of soaking. After surgical nail removal, it can take a few months for your nail to regrow. The timeline depends on the severity of your condition and the treatment approach used.

Q: Can ingrown toenails come back after surgery?

A: Partial nail removal may prevent recurrence in most cases, though some people experience repeat problems. Complete nail removal with phenol application offers a more permanent solution to recurring ingrown toenails. If you have a genetic predisposition to ingrown toenails, they may continue to recur on other toes.

Q: Is ingrown toenail surgery painful?

A: No, ingrown toenail surgery is not painful during the procedure because your healthcare provider injects numbing medicine before beginning treatment. You may feel pressure or hear sounds during the procedure, but you shouldn’t feel pain. Some mild discomfort may occur during recovery, which is manageable with over-the-counter pain relievers.

Q: Can I prevent ingrown toenails?

A: Yes, you can reduce your risk by cutting toenails straight across, wearing properly fitting shoes, maintaining good foot hygiene, and avoiding activities that injure your toenails. However, people with genetic predispositions may still develop ingrown toenails despite preventive efforts.

Q: When should I see a doctor about an ingrown toenail?

A: You should see a healthcare provider if your ingrown toenail hasn’t improved after a few days, shows signs of infection, keeps recurring, or if you have diabetes or poor circulation. Don’t wait to seek professional care if you’re concerned about complications.