Ingrown Toenail FAQs

What Is an Ingrown Toenail?


An ingrown toenail is a painful condition of the toe. It occurs when a sharp corner or edge of the toenail digs into the skin at the end of or side of the toe.


Pain and inflammation at the spot where the nail curls into the skin occurs first.


Later, the inflamed area can begin to grow extra tissue or drain yellowish fluid.

  • If left untreated, an ingrown toenail can progress to an infection or even an abscess that could require surgical treatment.

  • Ingrown toenails are common in adults and adolescents but less common in children and infants. They are more common in men than in women. Young adults in their 20s or 30s are most at risk.

  • Any nail can become ingrown, but the condition is usually found in the big toe.


What Are Common Causes and Risk Factors of an Ingrown Toenail?


  • Tight-fitting shoes or high heels cause the toes to be compressed together and pressure the nail to grow abnormally.

  • Improper trimming of toenails can cause the corners of the nail to dig into the skin. Nails should be trimmed straight across, not rounded.

  • Either an acute injury near the nail or any trauma that causes the nail to be damaged repetitively (such as playing soccer) can also cause an ingrown nail.

  • If a member of your family has an ingrown toenail, then you are more likely to develop one, too. Some people's nails are normally more rounded than others or the underlying bone can be more "upturned," which increases the chance of developing ingrown nails.



What Are Ingrown Toenail Symptoms and Signs?


  • An ingrown toenail is a common disorder that most often affects the outer edges of the nail of the big toe (hallux). However, the nail on any toe can become ingrown.

  • The most common signs and symptoms are pain, redness, and swelling at the margins of a toenail.

  • Early in the course of an ingrown toenail, the end of the toe becomes reddened and painful with mild swelling. There is no pus or drainage. It may feel warm to the touch, but you will not have a fever.

  • Later, extra skin and tissue will grow around the sharp point of the nail. A yellowish drainage may begin. This is the body's response to the trauma of a nail irritating the skin and is not necessarily an infection.

  • Sometimes an infection develops. In this case, the swelling will become worse, and there may be white- or yellow-colored drainage (pus) from the area. A lighter-colored area of the skin may be surrounded by red skin. A fever may develop, although this is unusual.


When Should Someone Seek Medical Care for an Ingrown Toenail?


Anytime an ingrown toenail has developed into an infection it is wise to seek medical attention. Even if the ingrown toenail is only inflamed without infection, see a doctor if the following conditions also occur:

  • If it has been more than five years since the last tetanus booster shot

  • If there is no improvement after three days of home care

  • If someone has diabetes, poor circulation, AIDS, are on chemotherapy, or have another reason for poor wound healing or an increased risk of infection

Ingrown Toenail Treatments

A number of over-the-counter treatments for ingrown toenails are available. These topical nail products may contain botanical ingredients like menthol and tea tree oil to decrease inflammation. Other topical agents may contain salicylic acid, which relieves pain and softens nails. Over-the-counter remedies should not be used by those who have diabetes, poor circulation, or an infection of the foot.


What Are Ingrown Toenail Home Remedies?


If it is early in the course of the ingrown toenail, then home care may be successful in preventing the need for surgery.

  • Soak the foot in warm water four times a day. There is no need to add soap, Epsom salts, or antibacterial agents to the water.

  • Wash the foot, including the affected area, twice a day with soapy water. Keep the foot clean and dry during the rest of the day.

  • Do not wear high heels or tight-fitting shoes. Consider wearing sandals, if possible, until the condition clears up.

  • Try to lift up the corner of the nail that is digging into the skin. Take a small piece of cotton or gauze and roll it between the fingers to form a small roll or wick. Then place the roll between the nail and the skin to keep it elevated. This is painful but is the most important part of home treatment. After every soaking, try to push the roll a little farther in. Change the roll out every day. It may take from seven to 15 days for the nail to grow out so that it does not poke into the skin any longer.

  • It's OK to take a pain reliever such as paracetomol or ibuprofen.

  • If there is no improvement within three days, call a doctor.


What Are Ingrown Toenail Treatments?

  • Conservative measure will often be tried first.

  • If there is only a mild infection present treating this may help to settle the issue down.

Is Surgery Necessary for Ingrown Toenails?

If a more serious infection is present, then surgical removal of either part of the nail or the whole nail and drainage of the abscess will be needed. The extent of the procedure will depend on the severity of the infection, any other medical problems, and if this is a recurring problem.

How ingrown toenails are surgically removed

  • Sometimes a preoperative X-ray will be taken to make sure that the infection hasn't spread to the bone (osteomyelitis).

  • The doctor will inject a local anesthetic medicine.

  • The doctor will then drain the infection from the end of the toe or remove the extra tissue that has grown around the end of the nail.

  • At this point, the doctor will remove a portion of the nail (avulsion) so that the skin or infection can heal without the nail pushing on it.

  • The doctor may decide to destroy a portion of the nail matrix, the living tissue that produces the nail, by applying a chemical or by direct surgical destruction. This is performed so that the edge of the nail that caused the problem will not return, which is more likely with severe or recurring infections.

  • The toe will then be covered with ointment and a gauze bandage.

What Are Complications of Ingrown Toenails?


If the soft tissues of the toes become infected, then it is possible that cellulitis and perhaps even septicemia (bacterial infection in the bloodstream) could develop. This is especially true in those who have preexisting conditions like diabetes, AIDS, or any other condition that might compromise the immune response. In addition, constant pain produced by the ingrown nail could result in injury to other joints due to the need to change one's normal gait.



Is It Possible to Prevent Ingrown Toenails?


  • The best method of prevention is careful clipping of the toenails. Toenails should be clipped straight across -- taking care to keep the end longer than the skin edge. This prevents the corners from digging into the skin. They should not be rounded or cut too short.

  • Wear roomy, well-fitting shoes.

  • Keep the feet clean and dry.


What Is the Prognosis of Ingrown Toenails?

The toe usually heals well after this procedure. The primary concern is whether the nail will become ingrown again, which can occur even after destruction of the nail-growing cells.

The overall rate for recurrence of an ingrown toenail is 10%-34%.

If part of the toenail was removed, it will grow back within 12 months.

This information primarily sourced from: