Ingrown Toenail

 

What Is It?

An ingrown toenail is a toenail with an edge that pushes into the skin and soft tissue at the side of the nail, piercing the skin. This causes redness, swelling and pain. Symptoms can be worse when you are wearing a shoe, which puts pressure on the nail. The area also can become infected. The nail on the big toe becomes ingrown more often than other toenails.

Ingrown toenails can be caused by cutting toenails improperly, by wearing shoes that fit poorly, or by injuring the nail bed. Ingrown toenails also can run in the family.

Symptoms

The most common symptom of an ingrown toenail is pain, especially if the area becomes infected. The surrounding skin might be deep pink and release a discharge or pus, or it might appear raw with a beef-red moist lump overlapping the nail edge.

Diagnosis

Your doctor can diagnose an ingrown toenail by examining the area.

Expected Duration

Ingrown toenails sometimes correct themselves as they grow out, but more advanced cases may need to be corrected with surgery.

Prevention

You can do several things to prevent ingrown toenails from forming:

  • Cut your toenails straight across so that the corner of the nail is visible above the skin. If your trimming removes nail all the way to the nail-fold corner, the skin might grow to encroach upon the space where the nail usually extends. This can get an ingrown nail started. Use clippers designed to cut toenails.
  • Wear shoes that are large enough that they don’t crowd or push your toes together.

If you are elderly, have diabetes or have other conditions that affect your circulation, be especially careful about how you cut your nails and manage your foot health.

Treatment

In the early stages of an ingrown toenail, soak your foot in warm water containing antibacterial soap or a few tablespoons of salt. Dry your foot and apply an over-the-counter antibiotic ointment and a clean dressing. Do not cut your nail. For the next few days, wear open-toed or loose-fitting shoes. When the nail grows out, cut it straight across.

More advanced ingrown toenails require the attention of a health care professional. If the nail is not deeply ingrown, the edge of the nail can be lifted from the skin edge that it is irritating. A small piece of clean cotton can then be used to prop the nail’s corner up and over the skin edge until the skin heals. Your doctor may cut open infected areas with a blade or a needle to allow the pus to drain.

For a more deeply ingrown nail, your doctor may numb your toe with local anesthetic and then remove a strip of nail, extending the full height of your nail into the cuticle, from the affected side of your toe. After this piece of nail is removed, the nail has a chance to regrow without an ingrown edge. If you continue to get an ingrown toenail, your doctor might treat the cuticle with a medicine called phenol, once a strip of nail has been removed. Phenol will prevent that area of your cuticle from producing new nail, so your toenail will be narrower than it was previously.

When To Call A Professional

Contact your doctor or foot care specialist if ingrown nail symptoms do not go away on their own in a reasonable period of time, if you are in pain, or if you notice an infection. If you have diabetes or another health problem that affects your circulation, contact your doctor for treatment of your ingrown nail even if your symptoms are mild.

Prognosis

Once you learn the proper technique for cutting your nails, you may never have another ingrown toenail. The results of surgery are usually excellent and result in a straight-growing nail.

Johns Hopkins patient information

Last revised:

Diseases and Conditions Center

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.