How to Remove an Ingrown Toenail at Home or With a Pro

Mild ingrown toenails can often be managed at home with simple techniques like warm soaks and careful lifting of the nail edge, but anything beyond the earliest stage typically needs professional treatment. The dividing line is straightforward: if the toe is draining pus, growing extra tissue around the nail, or increasingly painful despite a few days of home care, you’re past the point of self-treatment. Understanding where your ingrown nail falls on the severity spectrum is the single most useful thing you can learn before deciding what to do about it.

How to Tell How Serious It Is

Ingrown toenails are commonly graded into three stages based on visible signs and symptoms. In stage 1, the end of the toe is red with mild swelling, may feel warm, and hurts when you press on it, but there’s no pus or drainage. Stage 2 brings increasing redness, swelling, and pain, along with white or yellow discharge, which signals that infection may be setting in. Stage 3 is the most advanced: the swelling and pain are worse, extra granulation tissue forms along the nail fold, the skin around the nail may start to overgrow, and in severe cases fever can develop.¹ Home care is reasonable for stage 1. Anything at stage 2 or 3 warrants a visit to a podiatrist, dermatologist, or family doctor.

Why Toenails Grow In

The biggest controllable risk factor is how you trim your nails. A case-control study found that improper nail trimming raised the odds of an ingrown toenail roughly sevenfold compared to people who trimmed correctly.² “Improper” usually means rounding the corners or cutting too short, which encourages the nail edge to dig into the surrounding skin as it grows back. Other factors that significantly increased risk in the same study included poor foot hygiene, excessive sweating of the feet, naturally curved nails, toe deformities, fungal nail infections, and higher body mass index.²

Tight shoes compound the problem by pressing the skin against the nail edge for hours at a time. Repeated trauma to the toe, whether from running, kicking a ball, or stubbing it, can also push things in the wrong direction. Some people are simply dealt a genetic hand that includes very curved nail plates, which makes recurrence more likely no matter how carefully they trim.

What You Can Safely Do at Home

For a stage-1 ingrown toenail, the goal is to separate the nail edge from the irritated skin and let inflammation settle. Here’s what that looks like in practice:

Warm soaks: Soak the foot in warm (not hot) water for 15 to 20 minutes, two or three times a day. Adding Epsom salt is a common recommendation; it won’t cure anything, but it can soften the skin and reduce tenderness.
Lifting the nail edge: After soaking, gently lift the corner of the nail away from the skin and tuck a small wisp of clean cotton or dental floss underneath. This keeps the nail from re-embedding as it grows out. A dermatologist described a version of this technique using a cotton wick and reported that it resolved the problem in more than 80 percent of the ingrown toenails he treated in practice.³
Keeping it clean and dry: After soaking, dry the toe thoroughly and apply a thin layer of antibiotic ointment. Wear open-toed shoes or shoes with a wide toe box whenever possible.
Pain relief: Over-the-counter ibuprofen or acetaminophen can take the edge off. Avoid repeatedly digging at the nail with tools you haven’t sterilized.

Replace the cotton daily. If the toe isn’t improving after three to five days of consistent home care, or if redness and swelling are spreading, stop trying to fix it yourself. Pushing cotton under a nail that’s deeply embedded or infected can make things worse.

What You Should Not Do at Home

The temptation to cut out the offending nail corner with bathroom scissors or clippers is strong and understandable. Resist it. Cutting a V-shaped notch in the center of the nail (a folk remedy you’ll find all over the internet) does nothing useful; the nail grows from the root, not the tip, so a notch at the free edge won’t change the direction of growth at the sides. Digging under the nail with unsterilized tools is a fast route to a worse infection. And pulling the entire nail off at home is genuinely dangerous, particularly if you have any circulation problems or diabetes.

When You Need Professional Help

You should see a clinician if any of the following apply:

Pus or spreading redness: Yellow or green drainage, red streaks moving up the toe, or increasing warmth all point to infection.
Granulation tissue: Beefy red, moist tissue growing over the nail fold is a stage-3 sign that won’t resolve with soaking.
Recurring ingrown nails: If the same toe keeps acting up every few months, conservative measures aren’t addressing the underlying anatomy.
Diabetes or poor circulation: In people with diabetes, an ingrown toenail isn’t just painful; it can trigger ulceration, deep infection, and in severe cases even lead to amputation.⁴ The threshold for professional care in this group should be very low.
Immunosuppression: If you’re on medications that dampen your immune system, or if you have peripheral vascular disease, even a mild ingrown nail deserves professional attention sooner rather than later.

Non-Surgical Professional Treatments

Not every visit to a podiatrist ends with a procedure. For early-to-moderate ingrown nails, clinicians have several tools that sit between what you’d do at home and full-on surgery.

One approach is nail splinting, where a small flexible tube is slipped along the nail edge to act as a barrier between the nail and the skin. A study of 32 patients using this technique found a recurrence rate of only about 6 percent at six months, with the splints worn for one to two weeks.⁵ It’s painless and requires no anesthesia.

Nail bracing is a related technique in which a thin wire or composite strip is bonded across the top of the nail to gradually flatten its curvature over weeks or months, somewhat like an orthodontic brace for a tooth. It requires no anesthetic, allows you to keep wearing your normal shoes, and typically gives immediate pain relief.⁶ The broader category of these corrective devices is sometimes called orthonyxia, and a retrospective study in children found it effective enough to avoid surgery while letting kids get right back to their daily activities.⁷ For patients whose main problem is excessively curved nails rather than severe tissue overgrowth, bracing is worth asking about before jumping to surgery.

Surgical Options and How They Compare

When conservative and non-surgical approaches have failed, or when the nail is deeply embedded with significant infection and tissue changes, surgery becomes the standard recommendation. The most common procedure is partial nail avulsion: the offending strip of nail along one or both edges is removed under local anesthesia. The question is what happens next, because just pulling the nail strip leaves the growth cells (the matrix) intact, which means the problematic edge will often grow right back.

To prevent that regrowth, clinicians typically destroy the exposed matrix. The most widely used method is chemical matricectomy with phenol, where a concentrated phenol solution is applied to the nail matrix for a timed period to kill the growth cells. One study evaluating a 45-second application of 88% phenol reported a recurrence rate of under 2 percent at six months.⁸ Another comparative study found zero recurrence in the phenol group versus 20 percent recurrence in the group that had partial nail avulsion alone.⁹ A Cochrane review of the broader evidence similarly concluded that surgical interventions are more effective than non-surgical ones at preventing recurrence, and that adding phenol to partial nail avulsion significantly reduces the chance the nail comes back compared to avulsion without it.¹⁰

Surgical (non-chemical) matricectomy is the other main approach. Here, the matrix is physically cut out rather than chemically destroyed. A long-term study of 520 procedures found that surgical matricectomy had a lower recurrence rate (about 8 percent) than chemical matricectomy with phenol (roughly 18 percent), but it came with more pain (averaging 5.7 out of 10 versus 3.6), a higher infection risk (about 15 percent versus 3 percent), and somewhat lower cosmetic satisfaction.¹¹ So the trade-off is real: the surgical cut may give a slightly better recurrence rate in some settings, but phenol is less painful, less likely to get infected, and leaves a more cosmetically acceptable result. Most dermatologists and podiatrists lean toward phenol for routine cases, reserving surgical excision for more complex situations or phenol failures.

A network meta-analysis comparing multiple treatment approaches found that chemical matricectomy and minor surgery produced comparable outcomes for recurrence, pain, and recovery time overall, although chemical matricectomy was associated with longer healing times than surgical excision.¹² This is a point worth discussing with your provider. If you need to get back into closed-toe work shoes quickly, the choice of technique can matter.

Recovery After a Procedure

If you have a partial nail avulsion with phenol, expect the toe to drain a clear to yellowish fluid for a couple of weeks. This is normal and not the same as infection. The area is typically tender for the first few days, manageable with over-the-counter pain medication. Keep the toe clean, change the dressing daily, and avoid submerging it in pools or baths for at least two weeks. Most people can walk normally within a day or two, though vigorous exercise and tight shoes should wait.

Healing time varies with technique. Research suggests that shorter phenol application times lead to faster healing, and that adding curettage (scraping the matrix bed after phenol) may also speed things up, though it can increase post-operative bleeding and pain.¹³ Some practitioners use sodium hydroxide (NaOH) instead of phenol to cauterize the matrix. One study comparing NaOH to conventional wedge resection found lower recurrence and infection rates with NaOH, plus a shorter time to being discharged from care, though those patients did have more follow-up visits.¹⁴

Full healing after chemical matricectomy generally takes four to six weeks. After surgical matricectomy, the timeline can be similar or slightly shorter in terms of wound closure, but the initial recovery period tends to be more uncomfortable. Either way, infection remains the main complication to watch for: increasing pain after the first few days (rather than decreasing), expanding redness, warmth, and thick discharge all warrant a call to your provider.

Do You Need Antibiotics?

Probably not. The Cochrane review found that none of the post-operative interventions studied, including antibiotics, showed any significant difference in infection rates, pain, or healing time.¹⁰ This tracks with the broader clinical view that locally infected ingrown toenails generally resolve with the procedure itself, and that routine antibiotic prescriptions add cost and contribute to resistance without clear benefit.¹⁵ If your provider does prescribe antibiotics, it’s typically reserved for cases with significant spreading infection, cellulitis, or in patients whose immune systems are compromised.

Preventing Recurrence

Whether you treated the ingrown nail at home or had a procedure, the steps to keep it from coming back are essentially the same. Cut your toenails straight across, leaving the corners slightly longer than the skin at the edges. Don’t curve the edges to match the shape of your toe. Keep the nail at a moderate length rather than trimming it very short. Wear shoes with enough room in the toe box that your toes aren’t being squeezed together. If you sweat heavily, change your socks during the day and consider moisture-wicking materials.

For people with naturally very curved nails, prevention may require periodic professional maintenance. Nail bracing, discussed earlier, can gradually reshape the curvature over time, and some patients keep a brace on for months as a preventive measure. If you’ve already had matrix destruction and the nail edge no longer grows back, recurrence on that side is unlikely, but the other side of the same nail or a different toe can still develop the same problem.

Special Concerns for People With Diabetes

This group deserves its own mention because the stakes are qualitatively different. Diabetes often causes peripheral neuropathy, meaning you may not feel pain from an ingrown nail until the infection is well advanced. Reduced blood flow to the feet slows healing and limits your body’s ability to fight infection. What starts as a simple ingrown toenail can progress to a deep soft-tissue infection, ulceration, or worse.⁴ If you have diabetes, routine foot checks, either by yourself or with a mirror, are important for catching problems early. Any sign of an ingrown nail, even at stage 1, should be evaluated by a clinician rather than managed at home.

The Impact on Walking and Balance

Ingrown toenails aren’t just a cosmetic nuisance. The big toe plays a critical role in balance and push-off during walking. Research has shown that the presence of an ingrown nail or tenderness of the big toe is significantly correlated with impaired balance and reduced muscular strength in the lower limbs.¹⁶ People unconsciously shift their weight away from the painful toe, which changes their gait and can lead to knee, hip, or back discomfort over time. In older adults, this altered balance is particularly concerning because it raises fall risk. Treatment of the ingrown nail improved lower-limb function in the same study, which reinforces a point that’s easy to overlook: this is a small problem that affects how your entire body moves, and addressing it promptly is worth more than toughing it out.

The Range of Surgical Techniques

Beyond the phenol and surgical matricectomy approaches covered above, the landscape of procedures is surprisingly broad. A comprehensive review cataloged techniques including the Winograd method (excision of the nail edge and matrix), the Vandenbos procedure (removing the skin fold rather than the nail itself), radiofrequency ablation, carbon dioxide laser ablation, the Zadik procedure (total nail matrix excision), and several more specialized approaches.¹⁷ In practice, the vast majority of cases are handled with partial nail avulsion plus phenol or surgical matricectomy. The more exotic techniques are typically reserved for complex or multiply recurrent cases, and availability depends on where you live and what your provider specializes in. If you’ve had a standard procedure fail more than once, it’s worth asking whether any of these alternatives might be appropriate for your specific anatomy.

1
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PubMed. A simple and practical method in treatment of ingrown nails: splinting by flexible tube
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PubMed Central. Ingrown toenails (unguis incarnatus): Nail braces/bracing treatment
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PubMed. Orthonyxia as a Noninvasive Treatment for Ingrown Toenails in Pediatric Patients: A Retrospective Study
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PubMed. Evaluation of the Recurrence Rate of Ingrown Toenail After a 45-Second Matrix Cauterization With Phenol
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PubMed. Exploring postoperative outcomes for ingrown toenails. NaOH vs wedge resection techniques
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PubMed. Ingrown nails and pachyonychia of the great toes impair lower limb functions: improvement of limb dysfunction by medical foot care
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