An ingrown toenail happens when the nail curves and grows into the skin, usually at the sides of the nail. When the nail digs into the skin, it causes irritation and often leads to pain, redness, swelling, and warmth in the toe. If an ingrown nail causes a laceration, or cut, in the skin, it can become infected. Some signs of infection are drainage or pus, and a foul odor. Even if you don’t notice any pain, swelling, redness, or unusual warmth, an ingrown toenail can still become infected, and needs to be taken care of.
The most common cause of ingrown toenails is cutting your toenails too short, or cutting them incorrectly. Improper trimming can damage the nail. The skin will fold over the nail, making the nail grow into the skin, or become “ingrown.” Other causes come from pressure or trauma, and in some cases, there may be a hereditary predisposition for ingrown toenails. Excessive pressure on the toenail, from shoes, or repeated kicking or running, can also cause the nails to dig into the skin. Trauma, such as stubbing your toe, or having a heavy object fall on your toe, can sometimes cause an ingrown toenail.
Wearing socks or shoes that are too tight, or too short, can cause ingrown toenails because of the pressure on the toes. Ingrown toenails can also be caused by fungal infections, or by losing a nail. Bone deformities of the toes can change the shape of toenails, and also lead to them becoming ingrown.
- Home care: Home treatment for ingrown toenails is strongly discouraged if an infection is suspected, or for those who have medical conditions such as diabetes, nerve damage in the foot, or poor circulation that put feet at high risk. If you don’t have an infection or any medical conditions affecting your feet, you can soak your foot in room-temperature water (adding Epsom’s salt if recommended by your doctor), and gently massage the side of the nail to help reduce the swelling. DO NOT attempt “bathroom surgery,” or to cut the toenail out of the skin at all. Repeated cutting of the ingrown toenail can make condition worse over time. If your symptoms don’t improve with soaking or over time, see your podiatrist.
- Physician care: Oral antibiotics may be prescribed to help treat infection; however, antibiotics alone cannot cure an infected ingrown toenail. The infection will continue to return until the nail is fixed, and no longer digs into the skin. A minor surgical procedure can often be done in the office, to remove the nail and ease the pain. After applying a local anesthetic, the podiatrist removes the ingrown part of the nail. For nails that repeatedly become ingrown, there’s a more permanent option. The podiatrist can remove the nail matrix, the area responsible for nail production, and prevent further ingrown toenails. This procedure is still minor, and is often done in the office. The toe is wrapped in a light bandage after the procedure, and most people resume normal activity the next day, experiencing very little pain after surgery. If you’ve been prescribed an oral antibiotic, be sure to take all the medication even if your symptoms have improved.
Ingrown toenails can be prevented by properly trimming toenails, and by wearing appropriate footwear.
When trimming, cut toenails in a straight line, avoid rounding the nail, and don’t cut them too short. They should be long enough so that you can get your fingernail under the sides and end of the nail.
Wear shoes and socks that fit properly. Don’t wear shoes that are short or tight in the toe area. Also avoid shoes that are loose, because they can cause pressure on the toes, especially during running or brisk walking.