An ingrown toenail, with the side edge of your nail growing into the skin, can make you painfully aware of a toe you don’t normally notice.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
As the nail continues to dig into the skin, it irritates it, causing pain.
“If an ingrown toenail causes a break in the skin, bacteria can enter and cause an infection, which will make it even more painful. A red, swollen, hot and very painful ingrown toenail is probably infected,” says podiatrist Georgeanne Botek, DPM.
- Ingrown toenail
- What causes ingrown toenails?
- Treating ingrown toenails
- Preventing ingrown toenails
- Ingrown Toenails: Why Do They Happen?
- What Causes Ingrown Toenails?
- Foot health: What to do about an ingrown toenail
- Ingrown Toenail
- Topic Overview
- What are the Misconceptions about Ingrown Toenails?
- Do Ingrown Toenails Consistently Leave on Their Own?
- Can Ingrown Toenail Treatment Be Performed at Home?
- Footwear Can’t Be the Cause of Ingrown Toenails, Right?
- Does Cutting an Indent or Bend in the Nail Cause it to Develop Correctly?
- Does Lifting an Ingrown Toenail with Dental Floss at Home Take Care of the Issue?
- Ingrown Toenails
- Ingrown toenail
- What is an ingrown toenail?
- What are the signs and symptoms of an ingrown toenail?
- Pseudo-ingrown toenail of the newborn
- What is the treatment for an ingrown toenail?
- Other treatment for an ingrown toenail
- Can ingrown toenails be prevented?
Causes of ingrown toenails
Dr. Botek shares the most common causes of painful ingrown toenails:
Heredity. Many people inherit the tendency to develop ingrown toenails from one or both parents.
Ill-fitting footwear. Crowding your feet into socks and shoes that are too short or tight can set up an environment for painful ingrown toenails to develop. This is why adolescents and teens often get ingrown toenails. “Due to sudden growth spurts and body changes, teens and adolescents may outgrow their footwear quickly and can end up wearing them a while before buying better-fitting shoes,” Dr. Botek says.
Trauma. Occasionally, stubbing or jamming your toe, dropping something on your toe or participating in activities that put repeated pressure on your toes (like running, soccer or ballet) can cause ingrown toenails to develop.
Improper trimming. One of the most common causes of ingrown toenails is cutting them too short. When nails are very short, it encourages the skin at the sides of the nail to fold over it. Don’t be overzealous with the clippers and be sure to cut straight across.
Pedicures. Many women (and increasing numbers of men) enjoy getting pedicures. Nothing wrong with that, but make sure to go to an experienced technician. “Pedicures can cause ingrown nails if the nail technician is overly aggressive in cutting back a toenail,” says podiatrist Dina Stock, DPM.
Poor Circulation. Adults with decreased arterial circulation are more susceptible to ingrowing toenails. If you have diabetes, heart disease, or a long history of tobacco abuse and suffer with repeated ingrown toenails, see your physician or foot and ankle doctor. Also, swelling in your feet and
How to treat ingrown toenails
Sometimes, you can treat your ingrown toenails at home. If your ingrown toenail doesn’t show any of the signs of infection — swelling, hot to the touch, oozing, foul odor — you might just try letting the nail grow out.
Soak it and wait. Dr. Stock suggests soaks in warm water with Epsom salt or a mild detergent, then applying an antibiotic ointment and bandage to the area.
Remove it yourself if there’s no infection. “First soak your feet in a very warm bath with Epsom salt. This softens the skin and reduces inflammation. Using clean nail-cutting tools, you can try to clip the affected area and apply antibiotic ointment afterward,” says Dr. Botek.
See a podiatrist. For an infected ingrown toenail, or if you aren’t sure you can deal with treating yours at home, a podiatrist can perform the procedure under a local anesthetic. “In the office, we can cut out the offending nail border after first numbing the area,” Dr. Stock says. This helps the pain and allows the infection to heal, but may not prevent recurring ingrown toenails.
Never ignore an infected ingrown nail. A prolonged infection can spread and lead to serious complications, especially if you suffer from poor blood flow, an impaired immune system or diabetic neuropathy.
Recurring ingrown toenails
For frequent ingrown nails, your doctor may suggest a common office procedure called the phenol and alcohol matrixectomy.
“During a matrixectomy, the doctor numbs the region and removes the problematic nail portion. The chemical phenol is then applied to burn and kill the cells that form the nail,” Dr. Botek says. This offers a more permanent solution to recurring ingrown nails.
Of course, it’s best to prevent getting ingrown nails in the first place. Experts Dr. Stock and Dr. Botek offer these suggestions:
- Avoid cutting nails too short and cutting unevenly at the corners. Cut straight across.
- Make sure your socks and shoes fit properly. You should be able to wiggle your toes easily in your shoes.
- Avoid trauma to the toe area. If you run, play soccer or participate in other sports where your toes get a lot of action, try to go barefoot for an hour or two afterward.
It’s also important to seek medical advice if you have diabetes and an ingrown toenail. Having diabetes could affect how your toenail heals.
What causes ingrown toenails?
A number of things can cause an ingrown toenail to develop, including:
- badly cut toenails – cutting your toenails too short, or cutting the edges, will encourage the skin to fold over your nail and the nail to grow into the skin
- wearing tight-fitting shoes, socks or tights – this places pressure on the skin around your toenail; the skin may be pierced if it’s pressed on to your toenail
- sweaty feet – if the skin around your toenails is soft, it’s easier for your nail to pierce it and embed itself within it
- injury – for example, stubbing your toe can sometimes cause an ingrown toenail to develop
- natural shape of the nail – the sides of curved or fan-shaped toenails are more likely to press into the skin surrounding the nail
A fungal nail infection can cause your toenail to thicken or widen.
Treating ingrown toenails
Left untreated, an ingrown toenail can become infected, so it’s important that you:
- keep your feet clean by washing them regularly with soap and water
- change your socks regularly
- cut your toenails straight across to stop them digging into the surrounding skin
- gently push the skin away from the nail using a cotton bud (this may be easier after using a small amount of olive oil to soften the skin)
- wear comfortable shoes that fit properly
Surgery may be recommended if your toenail doesn’t improve. Depending on the severity of your symptoms, this may involve removing part or all of your toenail.
Partial nail avulsion
Partial nail avulsion removes part of your toenail and is the most commonly used operation for treating ingrown toenails. It’s about 98% effective.
A local anaesthetic is used to numb your toe and the edges of your toenail are cut away. A chemical called phenol is applied to the affected area to prevent the nail growing back and becoming ingrown in the future.
A course of antibiotics may be prescribed if your nail is infected, and any pus will be drained away.
Total nail avulsion
Total nail avulsion completely removes your toenail. This may be necessary if your nail is thick and pressing into the skin surrounding your toe. After your toenail has been removed, you’ll have an indentation where your nail used to be. However, it’s perfectly safe for you not to have a toenail.
After toenail surgery, your toe will be wrapped in a sterile bandage. This will help stem any bleeding and prevent infection. Rest your foot and keep it raised for 1 to 2 days after the operation.
To help reduce the pain, you may need to take a painkiller, such as paracetamol, and wear soft or open-toed shoes for the first few days after surgery.
Preventing ingrown toenails
Taking care of your feet will help prevent foot problems such as ingrown toenails. It’s important to cut your toenails properly (straight across, not at an angle or down the edges).
Wash your feet every day, dry them thoroughly and use foot moisturiser. You can also use a foot file or pumice stone to remove hard or dead skin.
Wearing shoes that fit properly will help to ensure your feet remain healthy. You should also change your socks (or tights) every day.
Visit your GP or a podiatrist as soon as possible if you develop problems with your feet.
Ingrown Toenails: Why Do They Happen?
Ingrown toenails that aren’t infected can normally be treated at home. However, if your toenail has pierced the skin, or there is any sign of infection, seek medical treatment. Signs of infection include:
- redness and swelling
To treat your ingrown toenail at home, try:
- soaking your feet in warm water for about 15 to 20 minutes three to four times per day (At other times, your shoes and feet should be kept dry.)
- pushing skin away from the toenail edge with a cotton ball soaked in olive oil
- using over-the-counter medicines, like acetaminophen (Tylenol), for the pain
- applying a topical antibiotic, such as polymyxin and neomycin (both present in Neosporin) or a steroid cream, to prevent infection
Try home treatments for a few days to a few weeks. If the pain worsens or you find it difficult to walk or perform other activities because of the nail, see your doctor.
If the toenail does not respond to home treatments or an infection occurs, you may need surgery. In cases of infection, stop all home treatments and see your doctor.
There are different types of surgical treatments for ingrown toenails. Partial nail removal only involves removing the piece of nail that is digging into your skin. Your doctor numbs your toe and then narrows the toenail. According to the NHS, partial nail removal is 98 percent effective for preventing future ingrown toenails.
During a partial nail removal, the sides of the nail are cut away so that the edges are completely straight. A piece of cotton is placed under the remaining portion of the nail to keep the ingrown toenail from recurring. Your doctor may also treat your toe with a compound called phenol, which keeps the nail from growing back.
Total nail removal may be used if your ingrown nail is caused by thickening.Your doctor will give you a local pain injection and then remove the entire nail in a procedure called a matrixectomy.
After surgery, your doctor will send you home with your toe bandaged. You will probably need to keep your foot raised for the next one to two days and wear special footwear to allow your toe to heal properly.
Avoid movement as much as possible. Your bandage is usually removed two days after surgery. Your doctor will advise you to wear open-toe shoes and to do daily salt water soaks until your toe heals. You will also be prescribed pain relief medication and antibiotics to prevent infection.
Your toenail will likely grow back a few months after a partial nail removal surgery. If the entire nail is removed down to the base (the nail matrix under your skin), a toenail can take over a year to grow back.
What Causes Ingrown Toenails?
Toenails that curve over and dig into the skin of your toe are called ingrown toenails. They can cause significant pain, but are generally not serious if taken care of. If you don’t take good care of your feet though, an ingrown toenail can lead to a severe infection.
An ingrown toenail occurs when the toenail begins growing down into the skin of the toe instead of straight out and above the skin. Sometimes, the skin itself may cover the sides of the toenails, causing the nail to become embedded in the skin. An ingrown toenail can occur on any toe on the foot, but happens most frequently to the big toe.
You can easily spot an ingrown toenail — the skin actually covers the toenail. The toe may eventually become red, swollen, and quite painful. Sometimes, the skin may even feel hard or tight to the touch. If infection sets in, you may also notice a bit of drainage (pus) seeping from the skin where the nail meets it.
What Causes Ingrown Toenails?
Ingrown toenails happen for many different reasons. “The most common cause is improper cutting of the nails,” says Timothy C. Ford, DPM, director of the podiatric residency program at Jewish Hospital & St. Mary’s HealthCare in Louisville, Ky. “Other causes may be hereditary, trauma, or poor shoes.”
Some causes of ingrown toenails include:
- Small toes that are not large enough to accommodate the growth of the nail. Naturally curved or thick nails can also lead to ingrown toenails.
- Damage to the toe, following an injury like running into a piece of furniture.
- Toenails that are cut too short or in a curved line.
- Shoes that are too small and squeeze the toenails.
Risk Factors for Ingrown Toenails
If you have a congenital condition, meaning a problem present at birth, such as very large toenails, you’re at risk of developing ingrown toenails. This means that you should be extra careful to cut your toenails in a line straight across to discourage nail growth into the sides of your toes. You should also make sure that you don’t cut your toenails too short. Additionally, it’s very important to wear comfortable shoes that don’t cramp your toes, which can increase your chances of an ingrown toenail.
Diagnosing Ingrown Toenails
If you suspect you may have an ingrown toenail, it is best to see a podiatrist. He or she can help diagnose an ingrown toenail and figure out what’s causing it — if there’s an underlying problem that needs treatment, or if you’re just wearing the wrong shoes or not cutting your toenails correctly. A podiatrist can also treat the problem, and take care of any infection that may be present, says Dr. Ford. While there are things you can do yourself to ease the pain of an ingrown toenail, such as warm foot soaks, topical or oral antibiotics may also be needed.
Knowing what causes an ingrown toenail can help you prevent the painful condition. If you frequently experience ingrown toenails, see a podiatrist so that you can receive proper treatment.
Foot health: What to do about an ingrown toenail
If you have recurrent ingrown toenails, more extensive nail removal may be needed. In a commonly performed procedure called a partial nail avulsion, a narrow vertical strip of nail on the affected side (see illustration above) is cut, from the nail edge to the base of the nail, and removed. The clinician may also apply a chemical called phenol to the nail matrix (the area beneath the cuticle that produces nail-creating cells) to prevent nail regrowth. This can leave the toenail slightly narrower than it was previously. This procedure is usually performed in a clinician’s office after a local anesthetic is injected into the toe.
Ingrown toenail: Surgical treatment
An ingrown toenail occurs when the toenail digs into the skin, causing inflammation and sometimes infection. Treatment may require cutting away a narrow strip of nail from the nail edge to the base of the nail and treating the matrix to prevent nail regrowth.
After one of these procedures, the exposed nail bed is treated with an antibiotic ointment and covered with a nonadherent dressing. (Bring an open-toed shoe or slipper to wear home from your clinician’s office.) Most people return to normal activities (wearing an open-toed shoe) within a day or two. Consult your clinician about when you can return to vigorous exercise, such as jogging or aerobics.
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
What is an ingrown toenail?
An ingrown toenail is a toenail that has grown into the skin instead of over it. This usually happens to the big toe, but it can also happen to other toes. An ingrown toenail can get infected. It may be painful, red, and swollen, and it may drain pus. See a picture of an ingrown toenail.
Anyone can get an ingrown toenail, but adults get them more than children do. People who have curved or thick nails are more likely to get an ingrown toenail. This is more common in older adults.
What causes an ingrown toenail?
An ingrown toenail can have a number of different causes. Cutting your toenail too short or rounding the edge of the nail can cause it to grow into the skin. Wearing shoes or socks that don’t fit well can also cause an ingrown toenail. If your shoes are too tight, they might press the nail into the toe and cause it to grow into the skin.
You can get an ingrown toenail if you hurt your toe, such as stubbing it. This can cause the nail to grow inward. Repeating an activity that injuries the nail, such as kicking a soccer ball, can also cause an ingrown nail.
What are the symptoms?
The main symptom of an ingrown toenail is the pain from the nail growing into the skin instead of over it. If the ingrown toenail gets infected, it might be swollen or red, and it might drain pus. The area around the ingrown toenail is often painful.
How is an ingrown toenail diagnosed?
Your doctor will do a physical exam to diagnose an ingrown toenail. He or she will look at your toe where the nail has grown into the skin.
How is it treated?
You can try the following steps at home to relieve the pain caused by your ingrown toenail and help the nail to grow out naturally:
- Soak your sore toe in warm water for 15 minutes 2 to 3 times each day.
- Wedge a small piece of wet cotton, such as part of a cotton ball, under the corner of your ingrown nail. This will help lift the nail off of the skin.
- Soak your toe and change the piece of cotton each day until the nail grows out and can be trimmed.
- Do not use a sharp object like manicure scissors to dig under your nail, because the toe might get infected.
- Do not try to use a needle to drain the pus from your toe. This could make the infection worse.
- While your ingrown toenail is healing, wear comfortable shoes or sandals that do not press on your toe.
Use these home treatment steps for 3 days. If they do not help, you might need to see your doctor. Be sure to see a doctor if your toe gets infected. Your toe might be infected if it hurts more than it did before you tried the home treatment. Call your doctor if your toe is red, warm, swollen, or drains pus, or if there are red streaks leading from your toe.
Your doctor might give you antibiotics. If your toenail is very ingrown, your doctor might suggest minor surgery to remove all or part of the ingrown nail. He or she may refer you to a podiatrist.
During this surgery, the doctor will numb your toe. Then he or she will cut the edge of the ingrown toenail and pull out the piece of nail. To prevent the nail from growing into the skin again, your doctor might destroy all or part of the nail root. This is called ablation. If your doctor removes all or part of your nail but does not destroy the root, it will begin to grow back within a few months.
After the surgery it is important to take care of your toe so that it can heal. Your doctor will give you specific instructions to follow. He or she may tell you to:
- Soak your toe in warm water for 15 minutes 2 to 3 times each day.
- Apply a thin layer of petroleum jelly, such as Vaseline, 2 times each day on the toe where the nail was removed.
- Wear a bandage on your toe.
- Wear loose-fitting shoes that don’t press on the toe where the nail was removed.
- Take pain medicine if your toe hurts. Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin (such as Bayer), ibuprofen (such as Advil), or naproxen (such as Aleve), might help your toe feel better. Be safe with medicines. Read and follow all instructions on the label.
How can ingrown toenails be prevented?
You may be able to prevent ingrown toenails by wearing roomy and comfortable shoes and socks that do not press on your toes. If you work in a place where your toe might get hurt, wear sturdy shoes such as steel-toed boots to protect your toes.
Be sure to trim your toenails properly. You can do this by cutting your toenail straight across, not curved. Make sure you do not cut your toenail too short. You can also leave your toenail a little longer at the corners to help it grow over the skin.
If you have diabetes or peripheral arterial disease, talk with your doctor before you trim your own toenails. People with diabetes have a hard time feeling their toes and might cut themselves without realizing it. Peripheral arterial disease can cause toes to be very painful.
Many hospitals and health care centers have foot care clinics, where someone can help you trim your toenails. Ask your doctor to recommend a foot care clinic near your home.
What are the Misconceptions about Ingrown Toenails?
Normally, your toenails should continue to grow straight, but sometimes you can develop an issue like an ingrown toenail. This happens when your toenail grows into the side or corner of your nail bed. An ingrown toenail is a very common issue and often develops in one of your big toes or halluxes. The nail can dive deep into the side of your toenail bed and cause irritation like redness, swelling, and sometimes infection. Here are other causes and symptoms of ingrown toenails.
A lot of people know that the best way to deal with an ingrown toenail is to see your podiatrist. However, some individuals have fallen to believe in some misconceptions about ingrown toenails and are hesitant to go for surgery to remove ingrown toenail.
Do Ingrown Toenails Consistently Leave on Their Own?
No. Quite the opposite, if you leave the ingrown toenail alone and don’t deal with it properly, it can keep returning. Moreover, the cause of your foot pain could be more serious than you think, such as an infection that needs immediate attention. It’s always safer to check with your podiatrist for a proper diagnosis.
Can Ingrown Toenail Treatment Be Performed at Home?
No. While it is true that there are a few simple home remedies that can somewhat help your ingrown toenail, you should consult a podiatrist about ingrown nail surgery, especially if your ingrown toenail keeps coming back. Also, ingrown toenails are performed as an in-office surgery by the podiatrist instead of the hospital, which makes the experience much more tolerable.
Footwear Can’t Be the Cause of Ingrown Toenails, Right?
No. Tragically, a large number of individuals believe this misconception. Wearing appropriately fitting and supportive footwear has a HUGE impact on the health of your feet. If your shoes are too loose or too tight in the toe area, this can definitely irritate your toes and can lead to recurring ingrown toenails.
Does Cutting an Indent or Bend in the Nail Cause it to Develop Correctly?
No. This is just not the case. Whether you have an ingrown toenail or not, there is only one appropriate way to trim your nails. You should cut the white tips of your nails across the top so that there is only a thin strip of white remaining. You should never cut the side of your nail. Cutting an indent or bend in the side of your nail will not help since the cause of the problem is at the root of your nail. As long as that part of the nail root is still alive, it will continue to grow that part of the nail that is irritating the corner of your toe. When the podiatrist numbs your toe and performs the minor ingrown toenail surgery, he will split the nail at the correct distance from the edge of the toenail bed and then use a dab of medicine to kill that extra section of your nail bed, which is creating the problem.
Does Lifting an Ingrown Toenail with Dental Floss at Home Take Care of the Issue?
No. Some individuals think that they can fix their ingrown toenail by lifting it with some dental floss. Again, as discussed above, the issue is at the root of the nail. It’s not a matter of simply changing the direction that the nail is growing. The podiatrist most likely needs to eliminate a small section of your nail root so that your nail doesn’t keep growing into the edge of your toe and keep irritating it. Using dental floss to pull your nail could potentially cause more damage and pain to your ingrown toenail. Please call Podiatry Associates and schedule an appointment for your ingrown toenail.
If you’re wondering when you should go to the doctor for an ingrown toenail, remember that your health is very precious and worth the time and attention of a doctor. If you need ingrown toenail treatment in the Baltimore and the surrounding areas or have any questions about the treatments described above, check out our Podiatry Associates locations and find a podiatrist near you. Feel free to call our scheduling office to discuss your specific situation: (833) 500-FEET.
Ingrown toenails can form when the side of a toenail begins to grow into the flesh surrounding the nail. As a result, the affected toe—most commonly the big toe—may become red, swollen, painful, and—in severe cases—infected.
There are many reasons why an ingrown toenail may develop. Improperly cutting your toenails is a major cause of ingrown toenails. If toenails aren’t cut straight across or are cut too short, the likelihood of getting an ingrown toenail may increase. Other causes include having unusually curved toenails, wearing shoes that don’t give your toes an ample amount of space, and hereditary factors. Injuring the toe by stubbing it or having an object fall on it may also lead to ingrown toenails. If left untreated, an ingrown toenail can lead to further complications with the foot.
If you are someone who has diabetes, it’s extremely important to remain mindful of ingrown toenail prevention, as minor cuts or simple scrapes can lead to serious complications. You can prevent ingrown toenails by ensuring toenails are straight across and at a moderate length, wearing shoes that fit properly, and checking feet daily for signs of foot issues.
Treatment for an ingrown toenail will vary on a case by case basis. One form of treatment requires lifting the ingrown nail and placing a splint or piece of cotton underneath. Another method for a more severe case would involve partially removing the nail. For cases that need extreme care, the nail itself and tissue would have to be removed.
If you’d like more information about ingrown toenails, we recommend you consult with a podiatrist who can give you a proper diagnosis and go over your treatment options.
What is an ingrown toenail?
An ingrown toenail is a painful condition of the toe that occurs when the sides or corner of the toenail digs into the skin at the end or side of the toe. The disease mostly affects the outer edge of the big toe, although the nail on both sides of the toe, or nail on any toe can become ingrown.
An ingrown toenail is also known as onychocryptosis.
The causes for ingrown toenails are listed below, but the two most common reasons are ill-fitting shoes and improperly trimmed nails.
- Ill-fitting shoes such as tight shoes, high heels and pointed-toe shoes cause the toes to be compressed together so that the nail curls into the skin and cannot grow normally.
- Improper trimming of toenails can cause the nail edge or corner to dig into the skin. Toenails should be trimmed straight across so that the top of the nail should make a straight line.
- Injury near the nail such as a ripped nail or nail peeled off at the edge can cause an ingrown toenail.
- Fungal infections of the nail can cause a thickened or widened toenail to develop.
- Prescribed medications, particularly oral retinoids such as isotretinoin and acitretin.
- Abnormal nail shape, such as pincer or trumpet nails.
What are the signs and symptoms of an ingrown toenail?
Ingrown toenails can be classified into three stages according to severity.
- End of the toe becomes reddened with mild swelling
- May feel warm and be painful to touch
- No pus or drainage
- Toe becomes increasingly red, swollen and painful
- May be white or yellow coloured pus or drainage from the area
- Infection may have developed
- Symptoms of redness, swelling and pain are increased
- Granulation tissue forms and adds to the swelling and discharge of pus
- Lateral nail-fold hypertrophy (overgrowth of skin tissue around the affected toe)
- More severe infection with fever may follow
Pseudo-ingrown toenail of the newborn
About 2% of newborn babies are noted at birth to have ingrown toenails because the growing nail plate is very short. It is rarely painful. The appearance rights itself within a year or so.
What is the treatment for an ingrown toenail?
Treatment is dependent on the stage of the condition. However, at any stage of an ingrown toenail, the patient should avoid tight-fitting or high-heeled shoes. If possible, wear sandals until it has cleared up.
Stage 1 ingrown toenail should be managed conservatively using the following methods.
- Warm water soaks – soak the foot in warm water four times a day.
- Wash the foot including the affected area twice a day with soap and water.
- Cotton-wick insertion in the lateral groove corner – gently lift the edge of the nail that is digging into the skin and place a small piece of rolled cotton, gauze, dental tape or floss, between the nail and the skin to keep it elevated. This may be painful but should be done after every soaking.
Stage 2 ingrown toenail may require the administration of topical or oral antibiotics. Topical antibiotic ointments combined with local anaesthetic agents help to heal the toe faster and also provide pain relief by numbing the affected area. Surgical removal of the ingrown toenail may be required if the condition worsens.
Stage 3 ingrown toenail is often treated surgically. The surgical technique of lateral nail avulsion plus matricectomy is highly successful. A brief description of this procedure is given below.
- Local anaesthetic ring block to numb the affected toe.
- Any pus will be drained from the end of the toe.
- An ingrown toenail is cut out to create a new, straight nail edge.
- Electrocautery or phenol ablation is used to destroy any cells beneath the area where the nails plate has been cut out to prevent any regrowth of the unwanted nail.
- Any excessive granulation or hypertrophied tissue should also be removed.
- Antibiotic ointment may be applied, and the toe is bandaged up until it completely heals (usually within a few weeks).
The following post-surgery procedures should be followed:
- On the second day, remove the bandage and wash the area with soap and water.
- Gently dry the area and reapply antibiotic ointment if prescribed, and a new bandage once or twice daily for at least one week after surgery.
- Paracetamol or other analgesics as recommended or prescribed by your doctor may be taken to relieve pain.
- Try to keep the toe clean and dry. Do not go swimming, take baths or soak the toe for at least two weeks after surgery. Showering is allowed.
- Avoid running, jumping, or any strenuous activity for two weeks after surgery.
- Call your doctor if you develop increasing pain, swelling, redness or drainage from the toe.
Other treatment for an ingrown toenail
An ingrown toenail may also be treated by a gutter splinter using slit plastic tubing to keep the nail, and the lateral nail folds apart. These are held in place by using tape or acrylic adhesive. An artificial nail may be sculptured using formable acrylic solution.
Chemical or medical nail avulsion is a painless, slow way to remove damaged nails. As the process destroys the whole nail, it is rarely used for ingrown toenails.
Alternative surgical procedures are described, for example, removal of the surrounding soft tissue and shortening the bone of the distal phalanx.
Can ingrown toenails be prevented?
Adhering to the following simple rules can easily prevent ingrown toenails:
- Clip toenails straight across – do not cut them too short and do not round off the edges.
- Wear well-fitting shoes.
- Keep the feet clean and dry.