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Ingrown Toenail

Definition

An ingrown toenail is when the edge of a toenail grows into the skin of the toe. This can happen with any of the toes. However, it is most common in one of the big toes.

Ingrown Toenail
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Causes

Common causes are improper nail care and pressure or injury to the toes. This can make the nail curve and grow into the skin.

Risk Factors

Ingrown toenails are more common in people with family members who have them. Other things that may raise the chance of an ingrown toenail are:

  • Improper cutting or trimming of the toenail
  • Footwear that is too tight
  • Repeated pressure or injury to the toes, often during sports
  • Diabetes
  • Toenail fungus infections
  • Turner syndrome
  • Arthritis
  • Gout

Symptoms

Ingrown toenails may not cause symptoms at first. When symptoms occur, they may include:

  • Pain—sometimes severe
  • Redness
  • Swelling
  • Warmth

Diagnosis

The doctor will ask about symptoms and past health. A physical exam may be done. The doctor will know it is an ingrown toenail when they see it.

Treatment

Treatment depends on how severe the ingrown toenail is. It also depends on if the person has other health problems. Medical care is needed for those who have:

  • Fever
  • An ingrown toenail that is severe, worsening, or not getting better
  • Diabetes
  • Circulation problems
  • Problems with the immune system
  • Other chronic health problems

People over 50 years of age should also talk to their doctor. General treatment options include:

Self-care

It may help to:

  • Wear open-toed shoes or sandals. This reduces pressure on the toenail.
  • Soak the foot in warm water. Dry it thoroughly.

Medical Care

Medical care may include:

  • Antibiotic cream or ointment
  • A splint to lift the corner of the nail from the skin
  • Surgery to remove the ingrown part of the toenail

If ingrown toenails happen often, or the ingrown toenail is severe, the doctor may:

  • Remove part of the toenail and apply medicine. This will stop that part of the nail from growing back.
  • Remove the entire toenail. This will stop the entire nail from growing back.

Prevention

To help reduce the chances of an ingrown toenail:

  • Cut toenails straight across. Do not round the edges. The corner of the nail should be above the skin of the toe.
  • Wear shoes and socks that fit well. They should not be too tight.
  • Keep the feet clean and dry.
RESOURCES:

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

Foot Health Facts—American College of Foot and Ankle Surgeons
https://www.foothealthfacts.org

CANADIAN RESOURCES:

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

Wounds Canada
https://www.woundscanada.ca

REFERENCES:

Ingrown toenails. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/ingrown-toenails. Accessed December 18, 2020.

Ingrown toenail. Foot Health Facts—American College of Foot and Ankle Surgeons website. Available at: https://www.foothealthfacts.org/conditions/ingrown-toenail. Accessed December 18, 2020.

Paronychia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/paronychia. Accessed December 18, 2020.

Tian,J, et al., A new perspective on the nail plate for treatment of ingrown toenail. Dermatol Pract Concept. 2018 Jan; 8(1): 22–27.

Last reviewed February 2021 by EBSCO Medical Review Board Mary-Beth Seymour, RN  Last Updated: 12/18/2020