Ingrown Toenails

What is an ingrown toenail?

An ingrown toenail occurs when the side or corner of the nail curls down and digs into the skin of your toe. It is most common for the big toenail to become ingrown, but it can happen to any toenail.

Symptoms of an ingrown toenail

Symptoms include redness, swelling, and pain on your toe around the nail.

What causes an ingrown toenail?

Many things can cause ingrown toenails. One main cause is wearing shoes that do not fit well. Shoes that are too tight or too small can press on your toenail in unnatural ways. Improperly trimmed toenails are another main cause. Toenails that are peeled off at the edge or trimmed down at the corners are more likely to become ingrown.

An injury to your toe also can cause an ingrown toenail. People who have deformed or misshaped toenails have a higher risk of ingrown toenails.

How is an ingrown toenail diagnosed?

Your doctor can examine your toe and toenail. If your doctor determines that you have an ingrown toenail, he or she may order treatment. Be sure to tell your doctor if you get ingrown toenails often. People who have diabetes are at risk of complications from an ingrown toenail.

Can an ingrown toenail be prevented or avoided?

To avoid ingrown toenails, you should cut your nails straight across. The top of your nail should make a straight line. Do not pick at your nails or tear them at the corners. Wear shoes that fit correctly. Avoid high heels and tight-fitting shoes.

Ingrown toenail treatment

Mild ingrown toenails can be treated at home. Soak your foot in warm water for 15 to 20 minutes. Dry your foot, then place part of a cotton ball under the corner of your nail. You can wet the cotton with water or a disinfectant. This should be changed at least once a day. Try to wear shoes, such as sandals, that do not rub the toenail. This can delay healing or cause irritation.

Contact your doctor if your ingrown toenail does not improve or gets worse. Watch for signs, such as increased pain, swelling, and drainage. You may have an infection. The doctor may prescribe an antibiotic either in pill or cream form.

Severe cases of an ingrown toenail may require surgery. This is a minor procedure that involves removing the part of the nail that is ingrown. Before surgery, the doctor will numb your toe by injecting it with medicine. First, they cut your toenail along the edge that is growing into your skin. Then, they pull out the piece of nail. The doctor may apply a small electrical charge or liquid solution to the exposed part of your nail bed. This is called ablation. It should keep the toenail from growing into your skin again. Not all people need ablation.

Follow these instructions after surgery to care for your toe. Call your doctor if the toenail is not healing.

  • Soak your foot in warm water each day.
  • Apply antibiotic cream to the site at least twice a day.
  • Keep a bandage over the site until it heals.
  • Take acetaminophen (brand name: Tylenol) or ibuprofen (brand name: Motrin) as needed for pain.
  • Keep the wound clean and dry. It is okay to shower the day after surgery.
  • Wear loose fitting shoes for the first 2 weeks.
  • Avoid running or strenuous activity for the first 2 weeks.

Living with an ingrown toenail

It is important to get treatment if you have an infection. If you don’t, the infection can spread to the rest of your toe or into your bone.

Treatment — at home or from your doctor — helps treat symptoms and heal the nail. Once the nail is healed, practice guidelines to prevent future problems. If you do not practice good foot care, the problem is more likely to reoccur. If you have surgery, it can take 2 to 4 months for your nail to grow back.

Questions to ask your doctor

  • What is the cause of my ingrown toenail?
  • What type of treatment will heal my toenail? Will I need surgery?
  • Do I need an antibiotic?
  • What kind of shoes should I wear?
  • Can you show me how to trim my nails?
  • What is my risk of the ingrown toenail coming back?