Ingrown toenails: symptoms and self-care

An ingrown toenail is just what it sounds like. The nail (typically on the big toe) grows into the surrounding skin rather than growing above the skin. And as anyone who has experienced this can tell you: It’s no fun.

It can cause pain, redness, swelling and warmth, notes Kyle Lindow, DPM, a board-certified podiatrist who practices at Warner Orthopedics & Wellness in Baton Rouge, Louisiana. The good news? In many cases, ingrown toenails can be managed at home, Dr. Lindow explains. “If you don’t have a medical condition like diabetes, there are home remedies you can attempt,” he says.

One thing you shouldn’t do: Ignore it. “If an ingrown nail breaks the skin, it allows bacteria to enter and can cause an infection,” he says. “Early intervention is key to prevent that.”

Learn more about the most common causes of ingrown toenails, how they feel and what to do for relief support — as well as signs that it’s time for a doctor visit.

In this article:

What are ingrown toenails?

These foot injuries happen when the corner of a toenail curves in, putting pressure on the surrounding skin, explains Morris Morin, DPM, a board-certified podiatrist at Hackensack Center for Foot Surgery in New Jersey. “If it’s not taken care of right away, it can be painful,” Dr. Morin says.

Some people may think to cut the nail back, but that can sometimes make the problem worse. “As a person starts cutting the nail away, they may cut too deep, which allows the skinfold to come up. Then when the nail grows back, it grows in more deeply.” That extra pressure, he explains, can break the skin and lead to an infection. In extreme situations, the skin can start to grow over the toenail itself, leading to further pain and complications.

What causes ingrown toenails? 

Ingrown toenails can be hereditary or caused by lifestyle and medical factors:

• Diabetes. Medical conditions that cause poor blood flow, like diabetes or vascular disease, may impede healing and increase infection.
• Fungal infections. If the nail becomes thickened from the fungal infection, it can dig into the surrounding skin.
• Improper nail trimming. The most common cause of ingrown toenails is when nails are cut too short or rounded at the side.
• Natural nail shape. In some cases, the natural shape of the toenail makes it more likely to be ingrown. “It’s nothing you did,” Dr. Morin explains.
• Poorly fitting shoes. Shoes that are too tight, repeatedly rubbing or putting extra pressure on the toe can cause the toenail to dig into the skin.
• Sweaty feet. Skin that’s frequently damp from sweat becomes soft, making it more easily pierced by a toenail.
• Trauma. The toe and nail can be damaged during a one-time incident, like stubbing your toe or dropping something on it, or from participation in sports that involve a lot of running or kicking. “You can lose a nail due to trauma, and it can grow back embedded,” Dr. Morin says.

Help relieve ingrown toenail pain

Patients with ingrown toenails generally describe a throbbing type of pain in the toe that is sore to the touch. It can be especially painful when wearing closed-toed shoes, Dr. Lindow explains. If there’s pain from an ingrown toenail, there are treatments to do at home that may alleviate the discomfort.

• Over-the-counter pain medications, such as acetaminophen and ibuprofen can help manage the pain from an ingrown toenail.
• Soaking the foot in room-temperature water with Epsom salt, which can help alleviate the symptoms of an ingrown nail.
• Cold compresses on the nail and toe can also help quiet down the inflammation and pain, Dr. Morin explains.
• Wearing open-toed shoes may reduce pressure on the ingrown toenail and toe as it heals.

What to do for an ingrown toenail

Treating the symptoms and foot care are important first steps. These techniques can help relieve symptoms and help the problem go away, but it’s important to consult a health care provider with any concerns.

• Soak the foot in room-temperature water with Epsom salt and gently massage the toe to reduce inflammation.
• Apply a small amount of a topical antibiotic ointment to the inflamed skin to help reduce inflammation and soften the surrounding skin.
• Some over-the-counter treatments use sodium sulfide to soften the nail, to relieve pain and to pave the way for easier trimmings. Dr. Scholl’s ingrown toenail pain reliever is one such product.
• When it is time to trim, use a nail clipper to keep toenails cut straight across rather than curved. And don’t cut them so short that the edge of the nail is too close to the skin edge. Shorter isn’t always better. Dr. Lindow cautions against repeated and aggressive “bathroom surgery” — the persistent cutting of the nail can cause the condition to worsen.

Both doctors emphasize the importance of treating your ingrown toenail at the first sign of a problem. “Many people put up with it for 10 years or more, but it can usually be resolved very easily,” says Dr. Morin.

When to go to a doctor

If you catch it early, you may be able to successfully treat an ingrown toenail at home. But there are certain warning signs that should trigger an immediate trip to a health care professional.

Dr. Lindow advises calling a doctor if the home remedies are ineffective or if an infection (red, puffy skin is a clear visual sign) is suspected. It’s also a good idea to get help with a condition like diabetes, which can lead to poor circulation or reduced feeling in the feet.

A doctor will be able to assess the severity of an ingrown toenail and decide the best treatment. In some cases, that means partially removing the nail and infected tissue.

This content is for informational purposes only and is not medical advice. Consult your health care provider before taking any vitamins or supplements and prior to beginning or changing any health care practices.