Ingrown Toenail

Conditions Basics

What is an ingrown toenail?

An ingrown toenail is a toenail that has grown into the skin instead of over it. This usually happens to the big toe, but it can also happen to other toes. An ingrown toenail can get infected. It may be painful, red, and swollen, and it may drain pus.

Anyone can get an ingrown toenail, but they are more common in young adults.

What causes it?

An ingrown toenail can have a number of different causes. Cutting your toenail too short or rounding the edge of the nail can cause it to grow into the skin. Wearing shoes or socks that don't fit well can also cause an ingrown toenail. If your shoes are too tight, they might press the nail into the toe and cause it to grow into the skin.

You can get an ingrown toenail if you hurt your toe, such as stubbing it. This can cause the nail to grow inward. Repeating an activity that injures the nail, such as kicking a soccer ball, can also cause an ingrown nail.

What are the symptoms?

The main symptom of an ingrown toenail is the pain from the nail growing into the skin instead of over it. If the ingrown toenail gets infected, it might be swollen or red, and it might drain pus. The area around the ingrown toenail is often painful.

How is it diagnosed?

Your doctor will do a physical exam to diagnose an ingrown toenail. The doctor will look at your toe where the nail has grown into the skin.

How is an ingrown toenail treated?

Most ingrown toenails can be treated at home. But if home care doesn't work or your symptoms get worse, you may need to see your doctor. You may be prescribed antibiotics.

If your toenail is very ingrown, your doctor might suggest minor surgery to remove all or part of the ingrown nail. You may be referred to a foot specialist called a podiatrist.

During this surgery, the doctor will numb your toe. Then the doctor will cut the edge of the ingrown toenail and pull out the piece of nail. To prevent the nail from growing into the skin again, the doctor might destroy all or part of the nail root. This is called ablation. If your doctor removes all or part of your nail but does not destroy the root, it will start to grow back within a few months.

How can you care for yourself at home?

• Trim the nails straight across. Leave the corners a little longer so they do not cut into the skin. To do this when you have an ingrown nail:
  • Soak your foot in warm water for about 15 minutes to soften the nail.
  • Wedge a small piece of wet cotton under the corner of the nail to cushion the nail and lift it slightly. This keeps it from cutting the skin.
  • Repeat daily until the nail has grown out and can be trimmed.
• Do not trim your toenails too short.
• Wear comfortable shoes that are roomy in the toe area.
• Soak your foot in warm, soapy water for 10 to 20 minutes a few times each day.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Check with your doctor before trimming your own toenails if you have been diagnosed with diabetes or peripheral arterial disease. These conditions increase the risk of an infection because you may have decreased sensation in your toes and cut yourself without knowing it.

How can you prevent it?

You may be able to help prevent ingrown toenails by wearing roomy and comfortable shoes and socks that do not press on your toes. If you work in a place where your toe might get hurt, wear sturdy shoes such as steel-toed boots to protect your toes.

Be sure to trim your toenails properly. You can do this by cutting your toenail straight across, not curved. Make sure you do not cut your toenail too short. You can also leave your toenail a little longer at the corners to help it grow over the skin.

If you have diabetes or peripheral arterial disease, talk with your doctor before you trim your own toenails. People with diabetes have a hard time feeling their toes and might cut themselves without realizing it. Peripheral arterial disease can cause toes to be very painful.

If you have trouble caring for your feet for any reason, ask your doctor to recommend a foot care clinic close to your home.