An ingrown nail (onychocryptosis) occurs when the edge of the nail plate grows sideways and cuts into the surrounding skin fold. Although most common on the big toes, the same home care principles apply to a fingernail. This causes local irritation, leading to swelling, pain, and sometimes infection. For mild cases, the goal of at-home treatment is to relieve pressure and guide the nail edge to grow above the skin, but it is important to know when to seek professional help.
Soothing the Area and Preparing for Home Care
The first step in addressing an ingrown fingernail is to reduce inflammation and soften the nail and skin tissue. This preparation makes subsequent treatment steps more manageable and less painful. Soaking the affected finger in warm water multiple times a day provides initial relief.
Adding Epsom salt (magnesium sulfate) to the warm water helps soothe the tissue and discourages bacterial growth. Soak the finger for 15 to 20 minutes, two to three times daily. After each soak, gently pat the area completely dry, as excessive moisture can worsen the condition. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can manage discomfort and reduce localized swelling.
Step-by-Step Guide to Treating the Nail Edge
Once the area is soothed and cleaned, you can gently lift the offending nail corner away from the skin. The goal is to separate the nail edge from the skin fold to allow the nail to grow out naturally without causing further irritation. Sterilize any tools used, such as fine-point tweezers or a dental pick, with rubbing alcohol beforehand to prevent introducing bacteria.
Use the sterilized tool to lift the embedded nail edge just enough to slide a small piece of material underneath it. This technique is known as “wicking” or “packing.” A tiny wisp of sterile cotton or a small piece of clean, waxed dental floss works well as a buffer material. This material acts as a wedge, physically separating the nail from the inflamed skin.
The packing material should be changed daily after a warm water soak to keep the area clean and dry. Repeat this lifting process consistently until the nail has grown past the point where it is digging into the skin. When trimming the nail, only cut the top edge straight across, avoiding the temptation to round the corners, which encourages the nail to grow inward again.
Recognizing Signs of Infection and Medical Intervention
Home care is appropriate only for mild cases where inflammation is minimal and there are no clear signs of infection. Discontinue home treatment and seek medical advice if the condition shows signs of worsening or infection. Signs requiring professional intervention include increased redness spreading beyond the nail fold, significant throbbing pain, or the presence of pus or foul-smelling discharge. A fever or red streaks extending up the finger are serious indicators of a spreading infection that requires immediate medical attention.
A physician, dermatologist, or podiatrist can safely remove the ingrown portion of the nail using sterile equipment and a local anesthetic. For severe or recurring ingrown nails, a partial nail plate avulsion may be performed. This procedure involves removing the side of the nail growing into the skin and applying a chemical to the nail matrix. This prevents that portion of the nail from growing back, providing a long-term solution by permanently narrowing the nail plate.
Long-Term Strategies for Prevention
Preventing recurrence centers on proper nail grooming and avoiding excessive pressure on the fingertips. The most effective technique is to cut nails straight across, ensuring the edge does not curve downward at the corners. The nail should be long enough so the white tip is visible and extends slightly past the end of the finger.
Avoid cutting nails too short, which leaves the surrounding skin vulnerable to pressure and allows the skin to fold over the nail edge. If you frequently wear gloves or work with your hands, ensure the gloves are not too tight, as constant pressure can force improper nail growth. Individuals with underlying medical conditions, such as diabetes or poor circulation, should consult a healthcare provider for routine nail care to prevent serious complications.