My toenail hurts when I press on it

Why ingrown toenails develop – and how to prevent them

Pain and tenderness in the big toenail is not an uncommon complaint but common or not, the discomfort can be so great it can stop you from doing the activities you normally do or wearing the shoes you want to wear. If your toenail is tender and sore it is most likely because the toenail is ingrown. An ingrown toenail (or onychocryptosis) is a toenail that has grown into the skin or occurs when a fold of skin on the side of the toenail has grown over the nail. The condition commonly occurs in big toenails but any of the other toenails can also be affected. Left untreated it can become swollen and red and infected, causing a great deal of pain.

Causes of ingrown toenails

A variety of factors and influences can result in ingrown toenails.

  • Some types of physical activity may cause repeated pressure on your toes and this may also result in an ingrown toenail developing.
  • Additionally an ingrown toenail can occur from a trauma to the toe, such as stubbing the toe or having the toe stepped on or dropping a heavy object on it.
  • The other major cause of ingrown toenails is the consistent wearing of shoes that are too tight. It is pertinent that in populations that do not wear shoes, there are no reports of ingrown toenail cases, which makes us assume a link between footwear and ingrown toenails. It is important to make sure that the shoes you wear on a regular basis do not constrict your toes, especially shoes in which you do physical activity. That means the shoes you wear all day at work, particularly if you are walking to and from transport, as well as sports or performance shoes.
  • And while we all need to regularly cut our toenails, we have to be careful to not cut our nails too short. Sometimes if you cut your toenails too short it can result in an ingrown toenail developing. Excessive trimming of your nails can encourage your nail to grow into the skin and a fold of skin to form over the nail bed. To reduce the risk of this occurring, you should regularly and properly trim your toenails.
  • And, unfortunately, some people are always going to develop ingrown toenails because their genetics result in their toenails growing too large for their toes.

Prevention of ingrown toenails

The best and most proven way to avoid ingrown toenails is to take good care of your feet. For example:

  • Have your toenails regularly and correctly trimmed by a trained podiatrist.
  • Wear properly assessed and fitted footwear, for your everyday as well as physical activities.
  • Wearing shoes when doing jobs around the house, like gardening or moving furniture, will help protect your toenails should you fall or drop a heavy object on them.
  • When kids are playing outside, riding bikes or skateboarding, for example, wearing proper shoes ensures their feet are adequately protected from childhood thumps and bumps.

Treatment

Ingrown toenails can be treated either with a simple procedure where the nail spike is removed from the affected toenail or, in more severe cases, surgery under local anaesthetic to remove part or all, of the nail.

However, treat your feet with the care they deserve and you can help avoid ingrown toenails altogether.

How Is a Toe Infection Treated?

If bacteria caused the infection, an antibiotic cream or pill can clear up the problem. Fungal infections are treated with antifungal pills or cream. You can buy antifungal medicines over the counter or with a prescription from your doctor.

To treat an ingrown toenail, your doctor might lift the nail and place a piece of cotton or a splint underneath it. This will help the nail grow away from your skin. If lifting doesn’t work, the doctor can remove part or all of the affected nail.

Sometimes the infection can cause a pus-filled blister to form. Your doctor might have to drain the blister.

You can also try these remedies at home:

  • Soak the toe for about 15 minutes in a bathtub or bucket filled with warm water and salt. Do this three to four times a day.
  • Rub a medicated ointment on the toe and wrap it in a clean bandage.
  • To treat an ingrown toenail, gently lift the corner of the nail. Place a small piece of cotton or waxed dental floss underneath to hold the nail away from your skin.

You’ll also want to protect your toe while it heals. To help it heal properly, wear loose, comfortable shoes that don’t rub. Keep your foot dry, and change your socks every day.

Home remedies for sore toe

A swollen foot or a toe injury due to unfortunate circumstances is a common phenomenon. The most common accidents such as hitting the toe against the bed post, shoe bites, blood coagulations under the nail, and cracked and bleeding heels can turn nightmare. Try the following home remedies for a long lasting relief.

Hot water treatment

To cure yourself of this perennial pain, hot water treatment (tolerable temperature) with a handful of salt is the handiest home remedy. Dip your feet till the water turns cold. Dry your feet with a clean towel and apply pain relieving ointment. Wear loose-fitted socks to keep your foot warm over night and support your foot with pillows.

Avoid tightfitted shoes

Avoid putting pressure on the injured foot and wear shoes accordingly. Tight-fitted shoes or high heeled shoes can often make it worse.

Turmeric

Stir a teaspoon of turmeric powder in a warm glass of milk and drink it up. This age-old concoction is the best healing medicine offered by the ayurveda.

Foods to avoid

Inflamed foot can be also due to high uric acid in the body that does not allow the inflammation to subside frequently. Till the foot is cured, it is usually suggested to abstain from food items such as red meats, beer, other alcoholic and fermented products, green peas, legumes and mushrooms. These foods increase the uric acid in the body and can prove detrimental to the health if avoided.

Bread and sugar

Another unique way is to take a slice of bread and break it into half. Sprinkle it with water stirred with sugar. See that the loaf is not too soft and not too hard. Next, sprinkle some sugar granules on the bread and wrap that side around the inflamed area with a bandage. This is the best remedy for a sore toe ridden with infection. This is known to cure infected toe nail corners and infections in the cuticles. Repeat it after every two to three hours with a different slice until no infection comes out.

Drink water

Drink plenty of water and abstain from unnecessary physical strain. A sore toe requires maximum rest. Towards the healing process, one can gently move the foot in circular motion and try calf muscle extensions sitting at home which helps ease the cramped muscles.

Image Source: Getty

Read more articles on Home Remedies

10 Ways to Treat Ingrown Toenails

  1. Try a foot soak. Allow your sore toe to soak in a warm salt water bath for 15 minutes a couple of times every day. This soak can help relieve pain and swelling in an ingrown toenail. Dry your foot completely after each soak.
  2. Keep your foot dry except when soaking.
  3. Take an over-the-counter pain-relieving medication, like acetaminophen or ibuprofen.
  4. Gently pull the skin away from the nail using a small nail file or other blunt device that won’t cut or hurt the toe.
  5. Stuff tiny pieces of clean, moist cotton between the ingrown toenail and the skin to help separate them and provide a little cushioning to the skin. You can soak the cotton in a bit of water or an antiseptic cleanser first.
  6. Rub your toe with antibiotic ointment to help reduce your chance of developing an infection.
  7. Cover the sore toe with a Band-Aid or other bandage to offer a little extra padding and protection.
  8. Choose shoes that are easy on your toes. Shoes made of soft fabrics with a wide toe are a good choice — try wearing sandals if you can. Avoid shoes that pinch the toes or place pressure on the ingrown toenail.
  9. Inspect your toe carefully for signs of infection. Check every day for signs and symptoms like redness, increased pain, swelling, and drainage of pus.
  10. See a podiatrist if you see signs of infection, or if your ingrown toenail keeps coming back.

Ingrown toenails are often a recurring problem. “If it’s a problem, if it’s recurrent, you should see a podiatrist who can fix the problem,” says Mauser. “It’s a small surgical procedure where you permanently remove the ingrown corner of the nail.

Prevention is often your best method for controlling the pain of ingrown toenails. There are numerous ways to prevent toenails from curving over and digging into the skin of your toe. Buying properly fitting footwear (it shouldn’t squeeze the toes) and cutting your toenails correctly (not too short and in a straight line across), are two easiest methods. “Once you start digging down the sides you’re probably going to get an infection,” says Mauser.

People with diabetes should carefully examine their feet regularly, and should always see a doctor about an ingrown toenail.

If you spot an ingrown toenail, act fast to prevent an infection. Use these tips to treat an ingrown toenail, and head to a podiatrist at the first sign of infection.

Surgical Treatment

If excessive inflammation, swelling, pain and discharge are present, the toenail is probably infected and should be treated by a physician (see left image below). You may need to take oral antibiotics and the nail may need to be partially or completely removed (see middle image below). The doctor can surgically remove a portion of the nail, a portion of the underlying nail bed, some of the adjacent soft tissues and even a part of the growth center (see right image below).

Possible treatment options for an ingrown toenail.

Surgery is effective in eliminating the nail edge from growing inward and cutting into the fleshy folds as the toenail grows forward. Permanent removal of the nail may be advised for children with chronic, recurrent infected ingrown toenails.

If you are in a lot of pain and/or the infection keeps coming back, your doctor may remove part of your ingrown toenail (partial nail avulsion). Your toe is injected with an anesthetic and your doctor uses scissors to cut away the ingrown part of the toenail, taking care not to disturb the nail bed. An exposed nail bed may be very painful. Removing your whole ingrown toenail (complete nail plate avulsion) increases the likelihood your toenail will come back deformed. It may take 3-4 months for your nail to regrow.

Ingrown Toenails

Mild ingrown toenails can be treated at home. Soak your foot in warm water for 15 to 20 minutes. Dry your foot, then place part of a cotton ball under the corner of your nail. You can wet the cotton with water or a disinfectant. This should be changed at least once a day. Try to wear shoes, such as sandals, that do not rub the toenail. This can delay healing or cause irritation.

Contact your doctor if your ingrown toenail does not improve or gets worse. Watch for signs, such as increased pain, swelling, and drainage. You may have an infection. The doctor may prescribe an antibiotic either in pill or cream form.

Severe cases of an ingrown toenail may require surgery. This is a minor procedure that involves removing the part of the nail that is ingrown. Before surgery, the doctor will numb your toe by injecting it with medicine. First, they cut your toenail along the edge that is growing into your skin. Then, they pull out the piece of nail. The doctor may apply a small electrical charge or liquid solution to the exposed part of your nail bed. This is called ablation. It should keep the toenail from growing into your skin again. Not all people need ablation.

Follow these instructions after surgery to care for your toe. Call your doctor if the toenail is not healing.

  • Soak your foot in warm water each day.
  • Apply antibiotic cream to the site at least twice a day.
  • Keep a bandage over the site until it heals.
  • Take acetaminophen (brand name: Tylenol) or ibuprofen (brand name: Motrin) as needed for pain.
  • Keep the wound clean and dry. It is okay to shower the day after surgery.
  • Wear loose fitting shoes for the first 2 weeks.
  • Avoid running or strenuous activity for the first 2 weeks.

What causes an infected toenail?

Your toenail can become infected in a number of ways, including fungal infections or even calluses caused by your shoes. One of the most common types of toenail infections is an ingrown toenail. If your toenail is ingrown, it means the edges of your toenail start to grow into the skin next to your toenail. Ingrown toenails can be red and inflamed, sore, and may even be filled with pus.

The most common causes of an ingrown toenails include:

  • Cutting your toenail too short or too long
  • Toenail injury
  • Curved toenails (genetic predisposition)
  • Improper footwear (too tight or narrow) that puts pressure on your big toes
  • Cutting your toenail improperly (you should cut it straight across without angling the sides of the nail)
  • Certain sports and activities like dance, soccer, and skiing
  • Poor foot hygiene (not keeping your feet clean and dry)

Infections on your toes may be common if you have diabetes or similar conditions that cause poor circulation or a weakened immune system. Diabetics should check their feet often and have regular appointments with a podiatrist because they may not feel the pain of a toe infection until the problem is severe.

Toenail infection symptoms

An infected toenail comes with pretty specific symptoms. They include:

  • Pain with pressure on your toe
  • The skin next to your nail being swollen, tender, or hard
  • Redness
  • Bleeding
  • Skin that grows over part of your toenail
  • A blister filled with pus (you may not notice a blister, but have large amounts of drainage coming from your toe)
  • Yellow toenails that are thick or cracked, suggesting a fungal infection in your toenails

At-home treatment options for ingrown toenails

You can do several things at home to treat an ingrown or infected toenail to help relieve pain and pressure:

  • Soak your toe in a warm foot bath with unscented Epsom salt. Mix 1-2 tablespoons of unscented Epsom salts into one quart of warm water and soak your foot for 15 minutes at a time. Do this several times a day for the first few days. Always dry your foot completely after soaking. Soaking your ingrown or infected toe will help relieve the pain and pressure of an infection. It can also help to draw out pus from your toe.
  • Keep your feet dry, unless you’re soaking them for treatment.
  • Carefully pull skin away from your ingrown toenail with a small nail file that’s blunt and won’t cut your toe. Place a small piece of cotton or dental floss between your nail and the lifted skin to lift the skin away from your nail.
  • Wear comfortable shoes.
  • Keep antibiotic ointment on your ingrown toenail to reduce infection.
  • Relieve pain with over-the-counter pain medications. Acetaminophen or ibuprofen can both help relieve the pain that comes from an infected toe.
  • Use an antifungal cream if you think you have a fungal infection. You can purchase an over-the-counter cream or get a prescription from your doctor.

When to see a doctor

Although you can do many things to treat an infected toe at home, it’s important to understand when you need to seek medical care. Call your doctor or a podiatrist if:

  • You are noticing redness, swelling, and/or drainage coming from your toe
  • You think you may have a fungal infection and over-the-counter creams haven’t worked
  • You have an infected or ingrown toenail and you’re diabetic
  • Your toenail infection symptoms don’t go away, they worsen, or they keep coming back

You should seek immediate medical attention if you have a fever and notice red streaks on your skin that lead away from the infected area on your toe, as these symptoms indicate a more severe infection.

An infected toenail can impact your daily life, but it doesn’t have to. Learning how to treat an infected toe and knowing when to call your doctor can get you back to doing all the activities you love. If you’re concerned about an infection in your toe, you should schedule an appointment with a podiatrist before attempting to treat painful symptoms at home.

Ingrown toenails: Lydia won’t let her toenail drag her down

  • ‘My experience’: Lydia won’t let her ingrown toenail drag her down
  • More information on nail anatomy

‘My experience’: Lydia won’t let her ingrown toenail drag her down

If your ingrown toenail or toenails are starting to drag you down, it’s time to show that nail who’s boss. And by the way, that’s you. Lydia was tired of feeling like a cassowary so she took her troubling nail to the GP and finally took care of it.

Big toe says no

“Your big toe will tell you when something is wrong with your nail,” Lydia says, when asked how people can know when you may be developing an ingrown toe nail.

“As far as I know, it really just affects big toes. For me, I started to notice a sharp pain in the side of my toe, where my nail meets the skin. I ignored it for ages because we don’t really pay attention to our feet … but we should!”

Lydia says she didn’t do anything about the pain for at least two months, until one day something changed.

The ‘uh-oh’ moment

“I was really busy and on my feet a lot, especially because I work at a bar. So I need my feet to do my job. Then one night after work, the pain seemed to be shooting up my ankle. I took my shoe off and copped a nasty surprise,” Lydia says.

Lydia’s toenail had irritated the skin so much that it started to become inflamed, red and infected. Lydia says she just looked at her toe and thought “uh-oh”.

“Pus was starting to seep out!” she says.

“It was just the thing I needed to send me straight to the doctor. I wish now I didn’t leave it for so long, especially because it becomes really tender and sore very quickly.”

Doctor Toe

“I went straight to my GP and as soon as he saw it he said, ‘You have an ingrown toenail,’” Lydia says.

“I was surprised because I’d never experienced one before, but I had been working quite a lot and it’s also possible that when I cut it, a small piece of sharp nail didn’t come away and started irritating the skin.”

Luckily, the doctor was able to apply a local anaesthetic to Lydia’s toe and, with special tools, was able to cut away the small part of the nail that was causing the trouble. He applied a dressing to keep it clean until the toe healed, and Lydia was back on her feet in a couple of days.

“My foot felt better immediately – I could feel it started to heal as soon as the irritant was removed. It healed quickly. I just have to watch out for it now because I’m probably more susceptible to getting another ingrown.”

Toe woes

Lydia says she wants to tell people that ingrown toenails are nothing to be embarrassed about. Everybody has something they need to watch, whether it be toenails or dandruff – it’s just the human body. She says her advice would be to go to the doctor sooner, rather than later.

“Don’t wait until you can’t walk!” she says.

After your doctor tends to your big red toe, they will be able to explain the best ways to keep it from being so severe again.

More information

For more information on the anatomy of nails, including how nails are produced and develop, nail injuries and interesting facts about nails, see Nails.

Have a health experience you want to share? Contact us

Toenail – Ingrown

Is this your child’s symptom?

  • The corner of the toenail grows into the skin around it
  • Almost always involves the big toe (great toe)

Symptoms of an Ingrown Toenail

  • Toe pain from sharp corner of toenail cutting into surrounding skin.
  • Redness and swelling around the corner of the toenail is usually present.
  • The area may drain pus or yellow fluid.
  • The red area is very tender to touch or pressure from a shoe.
  • Some teens with an ingrown toenail can barely walk.

Cause of an Ingrown Toenail

  • The toenail is usually pushed into the skin by wearing tight shoes.
  • The tiny cut made by the nail allows bacteria to enter the skin. The cut then becomes infected.
  • The sharp corner of buried nail keeps growing. The deeper it goes, the more painful it becomes.

When to Call for Toenail – Ingrown

Call 911 Now

  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Spreading red area or streak with fever
  • Spreading red area or streak that’s very large
  • Severe pain not improved 2 hours after pain medicine and antibiotic ointment
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Spreading red area or streak, but no fever
  • Entire toe is red and swollen
  • Pus pocket (yellow or green) seen in skin around toenail or under toenail. Reason: needs to be drained.
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Can’t locate and free up corner of toenail
  • After using Care Advice more than 2 days, pus discharge not gone
  • After using Care Advice more than 3 days, still hard to walk
  • After using Care Advice more than 7 days, not improved
  • After using Care Advice more than 14 days, not gone
  • Ingrown toenails are a frequent problem
  • You have other questions or concerns

Self Care at Home

  • Minor ingrown toenail

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Ingrown Toenail

  1. What You Should Know About Ingrown Toenails:
    • Ingrown toenails are always painful.
    • Pain is caused by the sharp toenail edge cutting into the skin around it.
    • The pain can be stopped. Find the toenail corner and lift it out of the raw tissue.
    • This will allow the area to heal.
    • Most ingrown toenails can be treated at home. Surgery or nail removal is rarely needed.
    • Here is some care advice that should help.
  2. Warm Soaks:
    • Soak the toe in warm water and soap for 20 minutes twice a day.
    • While soaking, massage the swollen part of the cuticle (skin next to the nail). Massage away from the nail.
    • While soaking, also try to bend the corners of the toenail upward.
    • Dry the toe and foot completely.
  3. Elevate Corner of Toenail with Dental Floss:
    • Goal: To help the toenail corner grow over the cuticle, rather than into it.
    • Take a short strip of dental floss or fishing line. Try to slip it under the corner of the nail. Then, lift the nail upward. Cut off any sharp edge.
    • Take a small wedge of cotton from a cotton ball. Try to place the wedge under the nail corner to keep it elevated. (Sometimes this step is impossible).
    • Elevate the corner away from the cuticle with every soak.
  4. Antibiotic Ointment:
    • After each soak, use an antibiotic ointment (such as Polysporin). Put it on the swollen part of the toe.
    • You can buy this ointment without a prescription.
  5. Taking Pressure Off Toenail With a Cotton Ball:
    • Until it heals, try to wear sandals or go barefoot.
    • When your child must wear closed shoes protect the ingrown toenail as follows:
    • Inner Edge of Toe. If the inner edge of the big toe is involved, try this technique. Tape a cotton ball or foam pad between the lower part of the first and second toes. This will keep the upper toes from touching.
    • Outer Edge of Toe. If the outer edge is involved, use a cotton ball. Tape it to the outside of the lower toe.
    • This will keep the toenail from touching the side of the shoe.
    • Never wear tight, narrow, or pointed shoes.
  6. Pain Medicine:
    • To help with the pain, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Use as needed.
  7. Prevention – Nail Trimming:
    • Cut your child’s toenails straight across so you can see the corners. Use a nail clipper.
    • Do not round off corners. Keep the corners visible.
    • Do not cut them too short.
    • After baths or showers, the nails are soft. Bend the corners of the toenails upward.
  8. Prevention – Wear Shoes That Fit:
    • Make sure that your child’s shoes are not too narrow. Give away any pointed or tight shoes.
    • Tight narrow shoes are the most common cause of ingrown toenails.
    • Shoes should have a wide toe box. The toes should not feel cramped.
  9. What to Expect:
    • With treatment, the pus should be gone in 48 hours.
    • Pain should be gone in 1 week.
    • Area should be healed up in 2 weeks.
  10. Call Your Doctor If:
    • Spreading redness or fever occur
    • Pus pocket occurs
    • Not improved after 7 days
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 02/01/2020

Last Revised: 03/14/2019

Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.

Summit Medical Group Web Site

What is an ingrown toenail?

An ingrown toenail is when the corner of a toenail grows into the skin around it. It causes tenderness, redness, and swelling of skin around the corner of the toenail on one of your big toes. Ingrown toenails are usually caused by tight shoes (for example, cowboy boots) or improper cutting of the toenails. They take several weeks to heal.

How can I take care of myself?

  • Soaking

    Soak your foot twice a day in warm water and antibacterial soap for 20 minutes. While the foot is soaking, massage the swollen part of the cuticle outward away from the nail.

  • Antibiotic ointment

    If your cuticle is just red and irritated, an antibiotic ointment is probably not needed. But if the cuticle becomes swollen or oozes secretions, apply an antibiotic ointment (no prescription needed) to the swollen part of the toe after soaking.

  • Cutting off the corner of the toenail

    The pain is usually caused by the corner of the toenail rubbing against the raw cuticle. Therefore, your healthcare provider will cut this corner off so that the irritated tissue can heal more easily. Your healthcare provider needs to do this only once. The main purpose of treatment is to help the nail grow over the nail cuticle rather than get stuck in it. Therefore, during soaks try to bend the corners of the nail upward. Try to slip a piece of dental floss under the corner of the nail and raise it upward. Then keep it elevated with a wedge of cotton.

  • Shoes

    Wear sandals or go barefoot as much as possible to prevent pressure on the toenail until it heals.

  • Use a cotton ball

    When you must wear closed shoes, protect the ingrown toenail as follows: If the inner edge is involved, tape a foam pad or cotton ball between the lower part of the first and second toes to keep the upper toes from touching. If the outer edge is involved, tape a foam pad or cotton ball to the outside of the ball of the lower toe to keep the toenail from touching the side of the shoe.

How can I prevent ingrown toenails?

Make sure that your shoes are not too narrow. Give away any pointed or tight shoes. After the cuticle is healed, cut the toenails straight across, leaving the corners visible. Don’t cut the nails too short. Cut the nail weekly to prevent pressure on the end of the nail, which can push the corners into the skin. Also, after every shower or bath, lift up the corners of the nail.

When should I call my healthcare provider?

Call IMMEDIATELY if:

  • You develop a fever.
  • A red streak spreads beyond the toe.

Call during office hours if:

  • Any pus or yellow drainage is not cleared up after 48 hours of treatment.
  • The cuticle has not totally healed in 2 weeks.
  • You have other concerns or questions.

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