An ingrown toenail (onychocryptosis) occurs when the edge of the nail plate grows into the surrounding soft flesh of the toe, usually the big toe. This intrusion causes pain, redness, and swelling, often making walking uncomfortable. Minor cases without infection can resolve on their own, but only with consistent home care. Moderate or severe cases, or those showing signs of infection, require professional intervention to prevent complications.
Managing Mild Ingrown Toenails at Home
A non-infected ingrown toenail with slight tenderness and mild redness can often be managed at home. The primary goal of self-treatment is to reduce inflammation and gently guide the nail edge to grow above the skin fold. Warm water soaks are a first line of defense. Soaking the affected foot in warm, soapy water or water mixed with Epsom salts for 15 to 20 minutes, three to four times a day, helps soften the skin and reduce tenderness.
After soaking and thoroughly drying the foot, a gentle technique involves carefully lifting the ingrown corner of the nail. You can place a small, fresh piece of cotton or waxed dental floss beneath the raised edge of the nail. This acts as a wedge to separate the nail from the skin, encouraging the nail to grow out correctly over time. It is important to change this material daily and ensure the foot remains clean and dry between soaks.
Wearing open-toed shoes or sandals is recommended to relieve pressure on the affected toe while it heals. Over-the-counter pain relievers such as acetaminophen or ibuprofen can be taken to manage discomfort and reduce localized swelling. If the mild symptoms do not improve within a few days of consistent care, or if the pain increases, seek medical advice.
Warning Signs and When to See a Doctor
While mild ingrown toenails respond to home care, certain signs indicate the condition has progressed and requires professional medical attention. The most significant warning sign is infection, often visible as pus or watery discharge draining from the affected area. Other indicators include increasing pain, spreading redness, or the toe feeling warm to the touch.
If you notice a fever or if the pain makes it difficult to walk normally, consult a healthcare provider immediately. Individuals with underlying health conditions, such as diabetes, peripheral artery disease, or poor circulation, must seek professional help at the first sign of an ingrown toenail. In these patients, a minor foot issue can quickly lead to severe complications, including deep-tissue or bone infection, due to compromised immune response and blood flow.
Medical Interventions for Persistent Cases
When home remedies fail or the toe is infected, a podiatrist or physician provides clinical intervention. For slightly ingrown nails without significant infection, the doctor may perform a non-surgical nail lifting procedure. This involves carefully placing a cotton wick, dental floss, or a small gutter splint beneath the nail edge to separate it from the skin and promote proper growth.
For more severe or recurrent ingrown toenails, a minor surgical procedure is often necessary, performed under a local anesthetic to numb the toe. The most common approach is a partial nail avulsion, where the problematic edge of the nail plate is trimmed and removed. To prevent the ingrown section from regrowing, the procedure may be followed by a chemical matrixectomy. This typically uses a chemical agent like phenol to permanently destroy the nail matrix cells responsible for growth in that area.
Stopping Ingrown Toenails from Coming Back
Preventing the recurrence of ingrown toenails centers on addressing the mechanical causes. The most important preventative measure is adopting the correct nail trimming technique: always cut toenails straight across and avoid rounding the corners. Cutting the nails too short should also be avoided; the nail edge should be left slightly even with the tip of the toe.
Properly fitted footwear plays a significant role in prevention. Tight shoes or those with narrow toe boxes place excessive pressure on the toes, forcing the nail into the surrounding tissue. Choose shoes that have adequate room for the toes to move freely and avoid high heels or pointed-toe styles for daily wear. Avoiding trauma, such as repetitive pressure or stubbing, and ensuring feet are kept clean and dry minimize the risk of developing onychocryptosis.