Ingrown Toenail Treatment & Removal

Who This Is For

• Individuals experiencing pain, redness, or swelling around a toenail
• People whose toenail edge is growing into the surrounding skin
• Those who have trimmed their toenails too short or rounded the corners
• Adolescents and athletes who are at higher risk for ingrown toenails
• Anyone noticing drainage or pus coming from around a toenail
• People with diabetes who develop toenail problems
• Those whose ingrown toenail keeps coming back despite home treatment

What It Is

An ingrown toenail develops when the corner or side of your toenail grows into the soft flesh surrounding the nail. As the nail edge digs into the skin, it causes the skin along the edge of the nail to become inflamed, red, and painful. Any toe can develop an ingrown toenail, though the big toe is most commonly affected.

When an ingrown toenail is not properly treated, bacteria can enter the area where the nail has broken the skin, leading to infection. Signs of infection include increased redness, drainage of pus or other liquid, warmth in the area, and worsening pain and swelling. If left untreated, infections can become serious and spread.

The condition is quite common and can affect anyone, though it is particularly frequent among teenagers and athletes. People with curved nails, nails that are large for their toes, or certain toe shapes may be more prone to developing ingrown toenails.

Common Symptoms or When People Seek Care

• Pain along one or both sides of the toenail
• Redness and swelling around the nail
• The skin appearing to grow over the edge of the nail
• Tenderness when touching the area or when pressure is applied
• Hard, swollen skin around the nail
• Drainage of pus or clear fluid from the affected area
• Bleeding around the nail
• The nail visibly digging into the surrounding skin
• Difficulty wearing shoes due to pain
• Signs of infection including increased warmth, red streaks, or foul odor

Causes and Risk Factors

The most common cause of ingrown toenails is improper nail trimming. Cutting toenails too short or tapering the corners so that the nail curves with the shape of the toe allows the skin on the sides to cover the corners of the nail. As the nail grows, it can then grow back into the skin. Tearing or picking at nails instead of cutting them properly can also lead to ingrown toenails.

Wearing shoes that are too tight or too short places extra pressure on the toes, which can push the skin over the nail or cause the nail to grow incorrectly. High heels and narrow-toed shoes that compress the toes are particularly problematic.

Repeated activities that put pressure on the toes, such as kicking a soccer ball or other sports that involve running and quick stops, can contribute to developing ingrown toenails. Toe injuries, including stubbing your toe or having it stepped on, may also cause the condition.

Some people are born with nails that are naturally curved or too large for their toes, making them more susceptible to ingrown toenails. Other risk factors include having sweaty feet, certain foot deformities, and poor nail hygiene. People with diabetes, nerve damage in the legs or feet, or poor blood circulation face higher risks of complications from ingrown toenails.

How It Is Diagnosed

Your clinician can diagnose an ingrown toenail by examining your toe and asking about your symptoms. The diagnosis is typically straightforward based on the visible signs of the nail growing into the skin, along with redness and swelling in the area.

In most cases, no tests are needed to diagnose an ingrown toenail. However, if your clinician suspects a more serious infection or bone involvement, imaging studies such as X-rays may be discussed to evaluate the extent of the problem.

If you have diabetes, nerve problems, poor blood circulation to your feet, or signs of infection around the nail, your clinician will assess these factors carefully as they can increase the risk of complications.

Treatment Options

If caught early before infection sets in, you can often treat an ingrown toenail at home. Your clinician may recommend soaking your foot in warm, soapy water for 10 to 20 minutes three to four times a day until the toe improves. Some people add Epsom salt to the water for additional soothing effect.

After soaking, you can place a small piece of clean cotton or waxed dental floss under the ingrown nail edge to help lift the nail away from the skin. This should be replaced daily. Applying petroleum jelly to the tender area and covering with a bandage can protect the toe. Wearing open-toed shoes or sandals while the toe heals reduces pressure on the nail.

Over-the-counter pain relievers such as acetaminophen or ibuprofen can help ease discomfort. Your clinician will provide guidance on appropriate use of these medications.

If home treatments do not work or if infection develops, medical intervention becomes necessary. Your clinician may discuss several treatment approaches. For a slightly ingrown nail, the clinician may carefully lift the nail edge and place cotton or a splint underneath to separate the nail from the skin. This allows the nail to grow above the skin edge over the course of two to 12 weeks.

For more severe cases with significant pain, inflammation, or pus, your clinician may recommend a minor surgical procedure. The toe is numbed with local anesthesia, and the ingrown portion of the nail is trimmed or removed. This is called a partial nail avulsion. The nail typically regrows within two to four months.

If you experience repeated ingrown toenails on the same toe, your clinician may suggest removing a portion of the nail along with the underlying tissue to prevent that part of the nail from growing back. This can be done using a chemical treatment, laser, or other methods.

After any nail removal procedure, your clinician will provide specific care instructions to ensure proper healing and prevent complications.

Risks and Safety Notes

• Ingrown toenails can lead to serious infections, particularly in people with diabetes or poor circulation
• Attempting to cut out the ingrown portion of the nail yourself can worsen the problem and increase infection risk
• Contact your healthcare provider if you notice increased redness, drainage, red streaks from the toe, warmth, fever, or worsening pain
• People with diabetes should never attempt home treatment and should see a healthcare provider promptly for any toenail problems
• Even minor foot problems can become serious in people with diabetes due to poor healing and risk of infection
• After nail removal surgery, following post-procedure care instructions is essential to prevent the nail from growing back incorrectly
• Recurrence is possible even after treatment, especially if proper nail care habits are not maintained