Ingrown Toenail

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What is an ingrown toenail?

An ingrown toenail is a common condition that usually affects the big toe. It happens when the skin on one or both sides or corners of the toe grows over the nail or the nail grows into the skin. This causes the skin to become red, swollen, hard or tender. Sometimes, ingrown toenails result in an infection. When this occurs, the skin becomes very sore and pus may be present.

The most common cause of ingrown toenails is trimming the nail improperly. This includes cutting it too short and rounding the corners or cutting the sides. Trimming the nail in this manner encourages it to curve and grow into the skin. Another common cause is wearing shoes that are too tight or too short. This puts pressure on the skin, causing it to overgrow. In some cases, people are born with curved nails, large nails, or nails that tend to grow into the skin.

Anyone can get an ingrown toenail. However, they are more common in teenagers, athletes, and people with toe deformities.

Healthy people without signs of infection or severe pain can usually treat an ingrown toenail at home. Ingrown toenails treatment involves soaking your feet, gently lifting the ingrown portion of the nail, and keeping pressure off the toe while it heals.

People with diabetes, circulation problems, or nerve problems need to see a doctor for treatment. You should also see a doctor if there are signs of infection around the nail. Treatment may require an oral antibiotic and ingrown toenails removal. Do not try to remove the ingrown portion of the nail yourself. This can make the condition worse.

Left untreated, an infected ingrown toenail can lead to serious complications, including a bone infection. People with health conditions that affect their feet can also end up with serious long-term effects. This includes infections and chronic sores, leading to tissue death and gangrene.

What are the symptoms of an ingrown toenail?

Any toe can develop an ingrown toenail, but the condition most often affects the big toe. It can involve the skin on one or both sides or corners of the toe. The nail either grows into the skin or the skin grows over part of the nail.

Common symptoms of an ingrown toenail

Common symptoms of an ingrown toenail include:

  • Hardness of the skin

  • Pain, soreness or tenderness

  • Redness

  • Swelling

If an infection develops in the skin, there may be additional symptoms of warmth, pus, drainage and odor.

The earlier you recognize and treat an ingrown toenail, the less likely it is to become infected. See your doctor promptly for an ingrown toenail if you have diabetes or circulation or nerve problems that affect your feet. You should also see your doctor if there are signs of infection.

What does an ingrown toenail look like?

inflamed big toe with an ingrown nail and pus
Getty

An ingrown toenail can cause swelling and pain in the affected area. In some cases, an ingrown toenail can become infected and produce pus or discharge.

What causes an ingrown toenail?

Improper nail trimming is the most common cause of ingrown toenails. This includes cutting toenails too short, cutting the sides of the nails, and tapering or rounding the corners. When you cut the nails in this manner, it encourages them to grow into the skin and the skin to grow over the nail.

Another common cause of ingrown toenails is wearing shoes that are too tight or too short. This puts constant pressure on the skin of the toe and squeezes the nail. The skin responds by swelling. Walking, playing sports, or being active in shoes with an improper fit can worsen the reaction.

Other causes of ingrown toenails can be hereditary. Trauma, such as stubbing your toe or dropping something on it, can cause ingrown toenails.

What are the risk factors for an ingrown toenail?

A number of factors increase the risk of developing an ingrown toenail. Not all people with risk factors will get an ingrown toenail. Risk factors include:

  • Being an athlete, especially with repetitive activities, such as kicking or running, that put pressure on the toes

  • Having barriers to proper nail trimming and foot care, such as poor eyesight or inability to easily reach the feet

  • Having foot, toe or toenail deformities, which can put pressure on the skin and nail

  • Having nail conditions, such as a fungal infection or thick nails, that make trimming difficult

  • Having toenails that naturally curve into the skin, toenails that are large compared to the toe, or nail borders that naturally grow over the nail

  • Picking at or tearing the toenails

How do you prevent an ingrown toenail?

You may be able to prevent or lower your risk of developing an ingrown toenail by:

  • Checking your feet on a daily basis if you have diabetes or another condition that affects your feet

  • Cutting your nails with a clean, sharp trimmer straight across without tapering or rounding the corners or sides

  • Keeping your feet clean and dry

  • Maintaining the length of your toenails even with the edge of the toe and not cutting them too short

  • Wearing protective boots or footwear if your toes are at risk of injury

  • Wearing shoes and socks with enough room for the toes to be free of pressure and do not pinch the toes

If you have diabetes or another condition that affects your feet, regular care from a foot doctor may help prevent problems like ingrown toenails.

How do doctors diagnose ingrown toenail?

To diagnose an ingrown toenail, your doctor will take a medical history and examine your foot. This is usually all that is necessary to make the diagnosis. Questions your doctor may ask include:

  • How long has your toe or toenail been painful or swollen?

  • Did you injure your toe?

  • What, if anything, seems to make your toe feel better or worse?

  • What treatments have you tried at home?

  • What other medical conditions do you have, such as diabetes or vascular disease?

  • What medications do you take?

What are the treatments for ingrown toenail?

People with diabetes, circulation problems, or nerve problems should see a doctor for treatment of an ingrown toenail. It is not safe for people with these conditions to treat the problem at home themselves. You should also see a doctor if there are signs of infection. Treatment of an infected ingrown toenail may require oral antibiotics. Doctors may also recommend surgery to remove part of the toenail when the ingrown toenail is severe. Otherwise, healthy people can usually manage an ingrown toenail at home.

Home remedies for an ingrown toenail

Ingrown toenails home remedy solutions include:

  • Soaking the foot in warm water 3 to 4 times a day. Dry the foot thoroughly and keep it dry for the rest of the time.

  • Gently lifting the edge of the embedded nail and placing a small piece of cotton or waxed dental floss underneath it to separate it from the skin. Change this daily and after soaking.

  • Taking acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain relief if necessary

  • Wearing comfortable shoes—sandals if possible—that do not squeeze the toes until the problem resolves

  • Avoiding running and other activities that put pressure on the toes until the ingrown toenail resolves

Starting this treatment as soon as you recognize an ingrown toenail may help prevent it from getting worse or becoming infected. See your doctor if the toenail does not show improvement after three days of home treatment or if it worsens.

What are the potential complications of ingrown toenail?

Left untreated, an ingrown toenail can become infected. The infection can spread and infect the bone in some cases. The complications can be severe for people with diabetes, blood flow problems, or nerve problems. Ingrown toenails may not heal the way they should and lead to chronic foot ulcers. This can eventually progress to tissue damage and death, or gangrene. See your doctor promptly for proper treatment of an ingrown toenail if you have these conditions.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Oct 6
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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