Ingrown toenails are a common condition in which the side or corner of a toenail grows into the soft flesh next to it. The result is pain, redness, swelling and sometimes an infection.
Ingrown toenails usually affect the big toe and can be both a debilitating and recurring problem.
People develop ingrown toenails for a variety of reasons, but the most common cause is cutting your toenails too short. Improper cutting allows the skin next to the toenail to fold over the nail and interrupt the normal growth path.
Other common causes include:
- Cutting nails too short and/or not straight across
- Wearing tight shoes that crowd the toes
- Wearing shoes with a pointy toe box (such as dress shoes)
- Picking at toenails and hangnails
- Having unusually curved toenails
- Experiencing an injury or trauma to the toe or toenail
The first sign of an ingrown toenail is generally redness and tenderness of the skin next to the toenail.
Additional symptoms include:
- Swelling to the side or corner of the nail
- Pain and tenderness to the corner of the nail
- Drainage/pus leaking from the skin next to the toenail
In most cases, you can take care of ingrown toenails on your own. We call these conservative treatment options.
If the conservative treatments don’t work, if the pain is severe or spreading, or you have a chronic illness that affects healing (mainly diabetes), it’s time to call the doctor. If an ingrown toenail is left untreated, an infection could develop and lead to other medical complications.
- Soaking the affected toe in warm water with Epson salts to soften the nail and make it easier to remove.
- Gently pulling back on the involved side to allow the skin to be pulled away from the nail.
- Simple removal of the affected portion of the nail from the corner.
If conservative treatment fails, your doctor may recommend surgical removal of the toenail. The American Academy of Family Physicians describes the process
“Surgical removal of an ingrown nail involves removing a small portion of the side of the nail and destroying the nail bed beneath. The toe is injected with a numbing medicine, and the toenail is cut to create a new, straight nail edge. The cells underneath the nail will try to grow a new nail, so they must be destroyed, thereby creating a permanently thinner nail. If there is heaped up (hypertrophied) tissue on the side of the toe, it must be removed. The toe is then bandaged until it completely heals (a few weeks).”
As with so many other medical conditions, the best treatment for ingrown toenails is to prevent them from happening in the first place. Here are the most effective ways to avoid ingrown toenails:
- Trim your toenails straight across. Don't curve your nails to match the shape of the front of your toe. If someone else trims your toenails, remind them to do so in this manner.
- Keep toenails even with the tips of your toes. If nails are too short, the pressure from shoes may cause an ingrown toenail to form.
- Wear shoes that fit properly and are not too tight. If your toes are smashed into a narrow, pointy shoe, you are more likely to develop ingrown toenails.
- Wear protective footwear. If your work or hobbies put you at risk of injuring your toes, wear protective footwear like steel-toed shoes/boots.
- Check your feet. If you have diabetes or another illness that makes healing difficult, check your feet daily for signs of ingrown toenails or other foot problems. Early detection is the key to avoiding infections and other complications.