Ingrown Toenails

Overview

Ingrown toenails are a common condition in which the corner or side of a toenail grows into the soft flesh. The result is pain, inflamed skin, swelling and, sometimes, an infection. Ingrown toenails usually affect the big toe.

Often you can take care of ingrown toenails on your own. If the pain is severe or spreading, your health care provider can take steps to relieve your discomfort and help you avoid complications of ingrown toenails.

If you have diabetes or another condition that causes poor blood flow to your feet, you're at greater risk of complications of ingrown toenails.

What are ingrown toenails?

Ingrown toenails occur when the edges or corners of your nails grow into the skin next to the nail. Your big toe is most likely to get an ingrown toenail.

You can treat ingrown toenails at home. However, they can cause complications that might require medical treatment. Your risk of complications is higher if you have diabetes or other conditions that cause poor circulation.

Symptoms

When one of your nails starts growing into the skin, you typically have symptoms in stages. First, you’ll have:

1.Pain and tenderness

2.Inflamed skin

3.Swelling

4.Infection

If your ingrown toe gets infected, you’ll move on to other symptoms including:

1.Redness

2.Pus coming out of your toe

3.Bleeding

4.Pain

5.Feeling hot or shivery

When to see a doctor

See your health care provider if you:

1.Experience severe discomfort in a toe, pus or inflamed skin that seems to be spreading

2.Have diabetes or another condition that causes poor blood flow to the feet and you have a foot sore or infection

Causes

Causes of ingrown toenails include:

1.Wearing shoes that crowd the toenails

2.Cutting toenails too short or not straight across

3.Injuring a toenail

4.Having very curved toenails

5.Nail infections

6.Certain medical conditions

Risk factors

Factors that increase your risk of ingrown toenails include:

1.Being an adolescent, when feet tend to perspire more, which softens the nail and skin

2.Having nail care habits that encourage the nail to grow into the skin, such as cutting the nails too short or rounding the corners

3.Having a reduced ability to care for your nails

4.Wearing shoes that constrict the toes

5.Participating in activities, such as running and kicking, that put your toes at risk of injury

6.Having a condition, such as diabetes, that causes poor blood flow

Complications

Complications can be especially severe if you have diabetes, which can cause poor blood flow and damaged nerves in the feet. So a minor foot injury — a cut, scrape, corn, callus or ingrown toenail — may not heal properly and become infected.

Prevention

To help prevent an ingrown toenail:

1.Trim your toenails straight across. Don't curve your nails to match the shape of the front of your toe. If you get a pedicure, ask the person doing it to trim your nails straight across. If you have a condition that causes poor blood flow to the feet and you can't trim your nails, see a podiatrist regularly to have your nails trimmed.

2.Keep toenails at a moderate length. Trim toenails so they're even with the tips of your toes. If you trim your toenails too short, the pressure from your shoes on your toes may direct a nail to grow into the tissue.

3.Wear shoes that fit properly. Shoes that place too much pressure on your toes or pinch them may cause a nail to grow into surrounding tissue. If you have nerve damage to the feet, you may not be able to sense if your shoes fit too tightly.

4.Wear protective footwear. If your activities put you at risk of injuring your toes, wear protective footwear, such as steel-toed shoes.

5.Check your feet. If you have diabetes, check your feet daily for signs of ingrown toenails or other foot problems.

What Are Some Ingrown Nail Treatments and Home Remedies?

If your ingrown nail isn’t infected, you should be able to treat it at home. To manage symptoms, you can:

1.Soak your feet. Reduce swelling and tenderness by putting your feet in warm water for 15-20 minutes three to four times a day.

2.Keep your feet dry. Let your feet breathe to avoid sweat or dampness.

3.Use a wedge to lift your nail. Put dental floss or a small piece of cotton under the edge of your nail to help lift it as it grows out. Change it out daily.

4.Apply antibiotic cream. Cover your toe with a bandage afterward to help protect it.

5.Pick helpful shoes. Choose open-toed shoes or shoes with plenty of room in the toe. Don’t wear heels.

6.Take pain relievers. Over-the-counter options like acetaminophen or  ibuprofen can help reduce tenderness and swelling.

If your symptoms don’t get better -- or get worse -- after you try home care, your doctor may need to treat the problem. They may try:

1.Prescription antibiotics. You may need oral or topical medication to help get rid of your infection.

2.Lifting the nail. If your problem is mild and doesn’t involve pus, your doctor can use a splint to lift your nail and set it in a new position to help it grow above the skin.

3.Removing some of your infected nail. Your doctor will numb your toe before surgically cutting away the part of the nail that’s growing into your skin.

4.Removing all of your infected nail. If you keep having ingrown nails on the same toe or finger, your doctor may take off your whole nail. it can take up to 4 months to grow all the way back in. And it’s more likely to be misshapen once it grows back.

What Are Some Ingrown Nail Complications?

If you have diabetes, vascular problems, or numbness in your toes, you need to take special care to treat and prevent ingrown toenails. And don’t put off getting treatment. Ingrown nails that go untreated for a long time can make the problem more severe.

Complications that can develop include:

1.Bone infection

2.Foot ulcers

3.Gangrene (decaying tissue). This is rare.

4.Losing a limb

Treating ingrown toenails at home

People can use the following strategies to help treat an ingrown toenail at home:

1.Take over-the-counter medications, such as acetaminophen or ibuprofen, to help with the pain.

2.Try a numbing cream or spray. This will not treat any underlying infection, but it can help with the pain if there is a wound.

3.Soak the foot in warm water several times per day. People can also add Epsom salt to help with the pain and swelling.

4.Gently massage the foot and the toenail. This improves blood flow to the area, which may help with pain while speeding the healing process.

5.Dry the foot after soaking it, and apply an antibacterial cream to reduce the risk of infection.

6.Wear loose fitting shoes with open toes until the ingrown toenail heals.

People should not cut a notch in the nail or repeatedly trim the borders of the nail. These strategies will not reduce the risk of ingrown toenails.

Can a doctor cut an ingrown toenail?

A doctor can help a person decide whether the toenail needs trimming or other treatment.

When an ingrown toenail is very painful, makes walking difficult, or shows signs of an infection, a doctor can treat the nail.

They may remove some or all of the toenail to help treat an ingrown toenail. They may also remove some of the underlying nail bed, and in some cases, part of the growth center. These minor surgeries are effective treatments for ingrown nails.

It is important for a healthcare professional to perform this procedure. They will use sterilized equipment to reduce the risk of infection. When they trim or remove part or all of the nail, they may inject the area with a numbing solution, so the patient will not feel any pain. Home removal, by contrast, can be extremely painful.

In some cases, a person may need antibiotics to treat an infection. Some symptoms that indicate a toenail infection include:

1.redness

2.intense pain

3.significant swelling

4.pus around the nail

5.a fever

How can I remove an ingrown toenail myself?

Use a pair of tweezers to gently push a tiny piece of cotton or gauze into the corner of your toenail where it's ingrown. This helps to make a space between the nail and the skin. Cut the visible nail corner or the ingrown spur away to help relieve the pressure and pain.

Does Vaseline help ingrown toenails?

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.