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Ingrown Toenail

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Definition

An ingrown toenail happens when a portion of the toenail curves into the flesh of the toe. It imbeds itself in the soft tissue. It can occur on any of the toes. However, it usually occurs on one of the big toes.
Ingrown Toenail
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Causes

The most common causes of an ingrown toenail are:
  • Improper cutting or trimming of the toenail
  • Wearing footwear that is too tight
  • Repeated trauma to the toes, often due to sports activities

Risk Factors

The main risk factor that increases your chances of having ingrown toenails is having family members with ingrown toenails.

Symptoms

Ingrown toenails often do not cause symptoms at first. Eventually, the following symptoms may develop:
  • Pain—sometimes severe
  • Redness
  • Swelling
  • Warmth
  • Pus draining from the area

Diagnosis

In almost all cases, you or your doctor can diagnose an ingrown toenail based on the location and the symptoms. In rare cases, you may need an x-ray. For example, if your doctor suspects an infection may have spread to the toe bone.

Treatment

You may be able to treat an ingrown toenail yourself if you catch it early. If the condition gets worse or does not improve, you will need to seek medical care. If you have diabetes, you must seek medical attention for any infection or wound involving your feet or toes.

Medical Care

Your doctor may recommend the following treatments:
  • Oral antibiotic medication
  • Removing the ingrown portion of the toenail
  • Draining the area that has become infected
  • Using a splint to lift the corner of the nail away from the soft tissue of the toe
If you repeatedly get ingrown toenails, or your ingrown toenail is severe, your doctor may:
  • Remove a portion of the toenail and apply medicine to the site to prevent that portion of the nail from growing back
  • Remove the entire toenail so that the nail will not grow back

Self-care

  • Wear open-toed shoes or sandals until the pain and swelling of the nail subsides. This will reduce any pressure on the toenail.
  • Soak your foot in warm water for 15 minutes, 3-4 times a day.
  • After soaking, dry your foot and toe thoroughly.
  • As the toenail grows out, cut it straight across.
  • Promptly seek medical care for an ingrown toenail if you have any of the following conditions:
    • Fever
    • An ingrown toenail that is severe, worsening, or not getting better
    • Diabetes
    • Age: over 50 years
    • Circulatory problems
    • A disorder of your immune system
    • Any other chronic health problem

Prevention

To help prevent ingrown toenails:
  • Cut your toenails straight across and avoid rounding the edges. The corner of the nail should be visible above the skin of your toe.
  • Wear shoes and socks that fit properly and are not too tight.
  • Keep your feet clean.
  • Keep your feet dry by wearing cotton socks and/or using foot powder.

RESOURCES

American Orthopaedic Foot and Ankle Society http://www.aofas.org

American Podiatric Medical Association http://www.apma.org

CANADIAN RESOURCES

Calgary Foot Clinic http://www.foottalk.com

Canadian Podiatric Medical Association http://www.podiatrycanada.org

References

Ingrown toenails. American Podiatric Medical Association website. Available at: http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=1522. Accessed May 2, 2013.

Matsumoto K, Hashimoto I, et al. Resin splint as a new conservative treatment for ingrown toenails. J Med Invest. 2010;57(3-4):321-325.

The Merck Manual of Medical Information—Home Edition. Simon and Schuster, Inc.; 2000.

Roberts JR, et al. Clinical Procedures in Emergency Medicine. 4th ed. Saunders; 2004.

Woo SH, Kim IH. Surgical pearl: nail edge separation with dental floss for ingrown toenails. J Am Acad Dermatol. 2004;50(6):939-940.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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