An ingrown toenail occurs when the edge or corner of the nail plate grows into the soft skin adjacent to it, typically on the big toe. This condition causes inflammation and pain. This article addresses whether an ingrown toenail resolves spontaneously and details the appropriate steps for treatment.
Can an Ingrown Toenail Heal on Its Own?
The answer to whether an ingrown toenail can heal on its own is nuanced, depending entirely on the severity of the condition. A very mild, early-stage case characterized by slight tenderness and minimal redness, where the skin is not broken, may resolve if the pressure is immediately relieved.
However, most ingrown toenails are progressive, meaning they tend to worsen over time without intervention. Once the nail has cut into the skin, it creates an open wound, making spontaneous resolution unlikely because the area is then susceptible to bacterial infection. This progression leads to increased inflammation and the possible formation of hypertrophic granulation tissue, which is overgrown skin trying to heal the wound.
If the condition advances beyond simple irritation to involve significant inflammation or infection, intervention becomes necessary. The likelihood of the nail correcting its growth path independently is low, especially once the body has developed a more severe inflammatory reaction. Therefore, while minor cases might improve with focused home care, most painful ingrown toenails require either diligent self-treatment or professional medical attention.
Self-Care Techniques for Early Stage Ingrown Toenails
For a mild ingrown toenail, several self-care techniques can promote healing. The goal of these home treatments is to soften the skin and lift the nail edge away from the surrounding flesh to relieve the pressure.
Soaking the foot in warm water two to four times a day for about 10 to 20 minutes is helpful for softening the nail and skin. Adding Epsom salts to the water can aid in reducing swelling and soothing the affected area. After soaking, the foot should be thoroughly dried, and an over-the-counter antibiotic cream can be applied to the tender spot to discourage bacterial growth.
A crucial technique involves gently separating the nail from the skin using a small piece of cotton or waxed dental floss. This small piece of material is carefully wedged beneath the ingrown corner of the nail to slightly lift it and redirect its growth away from the skin. The material should be replaced daily, and this process must be continued until the nail has grown past the edge of the toe.
Wearing shoes that have a wide toe box or opting for open-toed footwear like sandals can significantly reduce external pressure on the toe. Avoid the temptation of attempting “bathroom surgery,” such as trying to cut out or dig under the nail edge deeply. Cutting the nail too short or rounding the corners can worsen the condition by encouraging the nail to grow further into the skin.
Red Flags Indicating Professional Medical Care
If the ingrown toenail has progressed beyond safe home treatment, professional care is required. Clear signs of an advancing bacterial infection, known as paronychia, include any pus or thick discharge draining from the site. Severe, throbbing, or persistent pain that makes walking difficult is also a strong indicator for professional care.
Spreading redness or red streaks that extend from the toe up toward the foot suggest the infection is spreading through the lymphatic system. If the toe feels noticeably warm to the touch, or if there is a foul odor, medical attention is needed. The development of chronic inflammation can lead to the formation of overgrown, bumpy skin tissue, known as hypertrophic granulation tissue, requiring clinical removal.
Individuals with underlying health conditions must seek immediate medical care at the first sign of an ingrown toenail, even if it seems minor. Conditions like diabetes, peripheral artery disease, or severe nerve damage (neuropathy) compromise blood circulation and sensation in the feet. This poor circulation increases the risk of the infection rapidly escalating to a serious complication like a deep tissue or bone infection. Professional interventions may involve lifting the nail with a splint or performing a minor procedure to remove the offending portion of the nail plate.