Ingrown toenail treatment: home care and when to see a podiatrist

What is an ingrown toenail?

An ingrown toenail happens when the side edge of a toenail grows into the skin beside it, called the nail fold. The skin gets sore, red and swollen, and if bacteria get in, it can become infected. It’s most common on the big toe, but it can happen on any toe.

Ingrown toenails are very common, especially in teenagers and young adults. They’re usually easy to treat early, and they can get much more painful if they’re left.

What causes ingrown toenails?

• Cutting nails too short or rounding the corners. The skin at the side folds over the nail, and the nail grows into it.
• Tight or narrow shoes, high heels and pointed toes, which squeeze the toes against the nail.
• Injury, such as stubbing the toe, dropping something on it, or repeated pressure from running, soccer and other sports.
• The shape of your nails. Some people inherit nails that curve down at the sides, or wide nails, and are prone to ingrown nails however carefully they cut them.
• Sweaty feet, which soften the skin so the nail cuts in more easily. This is one reason teens get them so often.
• Thick or misshapen nails, for example from toenail fungus or an old injury.
• Picking or tearing at the nail instead of cutting it.

If your child keeps getting ingrown toenails, our guide to children’s foot health covers other common foot problems in children and how to choose shoes that fit.

Ingrown toenail symptoms and stages

An ingrown toenail usually gets worse in stages if it isn’t treated:

How to treat an ingrown toenail at home

If the toe is only a little red and sore, with no pus, and you don’t have diabetes or circulation problems, try this for 2 or 3 days:

1. Soak your foot in warm water for 10 to 15 minutes, two or three times a day. Plain water is fine, or add a little Epsom salt if you like.
2. Dry the toe well, then apply petroleum jelly or an antibiotic ointment and cover it with a clean bandage.
3. Lift the edge, if it’s comfortable. Some podiatrists suggest tucking a tiny wisp of clean cotton or waxed dental floss under the corner of the nail after a soak, to lift it off the skin while it grows. Only try this if the toe isn’t infected and it doesn’t hurt, and replace it every day.
4. Wear open-toe shoes, sandals or roomy shoes so nothing presses on the toe. Skip tight shoes and heels.
5. Take an over-the-counter pain reliever, such as ibuprofen or acetaminophen, if it’s safe for you.

If it’s getting better, keep going until the nail has grown out past the end of the toe, then cut it straight across.

What not to do

• Don’t dig out the corner or cut it at an angle. This usually leaves a sharp spike deeper in the skin, and the problem comes back worse.
• Don’t cut a V into the middle of the nail. It’s a myth and doesn’t help.
• Don’t use sharp tools or try to drain pus yourself.
• Don’t keep wearing tight shoes while it heals.

Who shouldn’t treat an ingrown toenail at home

See a podiatrist instead of trying home care if you have:

• diabetes
• neuropathy, or numb feet
• poor circulation
• a weakened immune system, for example from chemotherapy or medicines that suppress the immune system
• signs of infection, or severe pain

For people with these conditions, a small nail problem can become a serious infection or a wound that won’t heal. Don’t soak your feet if you have diabetes or numb feet, since you may not feel if the water is too hot.

Signs of an infected ingrown toenail

• pain, redness or swelling that’s getting worse or spreading beyond the nail edge
• warmth around the toe
• pus or cloudy drainage, or a bad smell
• red, raw tissue growing over the edge of the nail
• red streaks running up the foot, or a fever, which mean the infection is spreading

An infected ingrown toenail usually needs the nail edge removed. Left alone, the infection can spread into the toe, the foot or, rarely, the bone, especially in people with diabetes or poor circulation.

When to see a podiatrist for an ingrown toenail

Get seen the same day if:

• red streaks are spreading up your foot, or you have a fever or chills
• you have diabetes, neuropathy or poor circulation and any signs of an ingrown toenail
• the toe is turning dark, or the pain is severe

See a podiatrist within a few days if:

• there’s pus, drainage, or redness and swelling that are spreading
• the pain is getting worse
• it hasn’t improved after 2 or 3 days of home care
• red, raw tissue is growing over the nail

Book a visit if:

• ingrown toenails keep coming back on the same toe
• your nails are thick or curved and hard to cut safely

How a podiatrist treats an ingrown toenail

Treatment is done in the office, and most people walk out the same day. Depending on how bad it is, your podiatrist may:

• Lift or trim the corner of the nail for a mild ingrown edge, sometimes with a small splint or cotton packing to keep it off the skin while it grows.
• Remove the ingrown edge (partial nail avulsion). After a numbing injection at the base of the toe, a thin strip of nail along the ingrown side is cut from the cuticle to the tip and taken out. The rest of the nail stays. This is the most common procedure.
• Treat the nail root (matrixectomy) if ingrown nails keep coming back. A chemical, most often phenol, is applied to the root of that strip so it doesn’t grow back. It’s done at the same visit as the removal and makes a repeat less likely.
• Remove the whole nail, occasionally, if the nail is badly damaged or ingrown on both sides.

Antibiotics alone rarely fix an ingrown toenail, because the nail edge is still pressing into the skin. Once the edge is out, most mild infections settle. Your podiatrist will prescribe antibiotics if the infection has spread.

What the procedure is like

The numbing injection stings for a few seconds. After that, you shouldn’t feel the procedure itself, and the whole visit usually takes well under an hour. Your podiatrist puts on a dressing and explains how to look after it. Bring open-toe shoes or sandals to wear home.

Recovery after ingrown toenail removal

The toe usually aches for a day or two once the numbness wears off. Most people are back to most daily activities within a day or two, and most toes heal in 2 to 6 weeks. If the nail root was treated with phenol, the toe drains for longer and may take 6 to 8 weeks to heal fully.

For the first week or two you’ll change the dressing once or twice a day, wear roomy shoes and keep the toe out of pools and baths. Our guide to toenail removal aftercare has a day-by-day recovery timeline and the signs of infection to watch for.

How to prevent ingrown toenails

• Cut your toenails straight across, level with the tip of the toe. Don’t round the corners or cut them too short. Gently file any sharp edge.
• Use proper toenail clippers, and cut after a bath or shower when nails are softer.
• Give your toes room. Choose shoes with a roomy toe box, and replace shoes that have become misshapen.
• Protect your feet with safety footwear if your job puts your toes at risk.
• Keep your feet clean and dry, and change sweaty socks.
• Get help with thick or curved nails. If your nails are hard to cut, or you have diabetes, poor eyesight or trouble reaching your feet, a podiatrist can trim them safely. Thick, discolored nails may be fungal; see our guide to toenail fungus treatment.

If you have diabetes, check your feet every day and have your feet examined regularly. Our guide to diabetic foot check-ups explains what that involves, and you can read about diabetic foot care at Evolve Health.

Next step

A mild ingrown toenail is worth 2 or 3 days of careful home care. If it isn’t improving, it’s infected, or it keeps coming back, a quick visit usually ends the problem. Read about nail care at Evolve Health, or find a podiatrist near you and book online.