An ingrown fingernail (onychocryptosis) occurs when the edge of the nail plate curves and grows into the surrounding soft tissue of the nail fold, causing inflammation and discomfort. While ingrown toenails are more common, fingernails can also be affected, often due to improper trimming, nail biting, or trauma. The sharp nail edge creates pressure against the skin, which can lead to an infection called paronychia. Knowing when to seek medical intervention and which healthcare provider to visit is key to effective treatment.
When to Seek Professional Help
Mild ingrown fingernails can often be managed at home using warm soaks and topical antibiotic ointment. However, if symptoms progress beyond simple irritation, prompt medical attention is required to prevent serious complications, especially those related to infection.
A doctor’s visit is necessary if you notice pus or fluid draining from the nail fold, or if redness and swelling intensify over 48 to 72 hours despite home care. Severe, throbbing pain that interferes with daily activities also signals a need for professional assessment. Signs of a spreading infection include red streaks developing up the finger or systemic symptoms like fever or chills.
Individuals with underlying health conditions, such as diabetes or poor circulation, should contact a healthcare provider immediately upon noticing an ingrown nail. These conditions impair the body’s ability to fight infection and heal, increasing the risk of serious complications like a deep tissue infection (felon) or bone infection (osteomyelitis). Proactive medical care is necessary to manage these risks.
Primary Care Physicians and Specialists
The initial point of contact for an ingrown fingernail is a Primary Care Physician (PCP) or an urgent care clinic. These providers can diagnose the condition, prescribe oral antibiotics for mild to moderate infections, and perform minor procedures. They also assess the severity and determine if a specialist referral is necessary.
For chronic inflammation, recurring ingrown nails, or complex nail pathology, a Dermatologist is often the most appropriate specialist. Dermatologists specialize in conditions of the skin, hair, and nails, offering expertise in managing the nail matrix, the tissue responsible for nail growth. They are skilled in surgical techniques specific to the nail unit, which is helpful when the problem relates to the nail’s shape or growth pattern.
In severe instances where the infection is deep, involves trauma, or affects the underlying bone, a Hand Specialist may be recommended. This specialist is often an Orthopedist or Plastic Surgeon focused on hands. They have the surgical expertise to manage complex finger anatomy, ensuring that function and long-term appearance are preserved, and are best suited for addressing complicated abscesses or ruling out osteomyelitis.
Understanding Medical Treatment Options
Treatment for an ingrown fingernail varies based on its severity and the presence of infection. For early-stage cases without significant pus or inflammation, a conservative approach is used. The doctor lifts the offending nail edge and places a small piece of cotton or a splint underneath. This technique, known as packing, separates the nail from the skin, allowing the nail fold to heal.
When the ingrown nail is more advanced or infected, a minor surgical procedure is performed under local anesthesia. The most common intervention is a partial nail avulsion, or wedge resection, where only the small portion of the nail plate growing into the skin is removed. This removes the source of the irritation while preserving the majority of the natural nail.
For patients with chronic recurrence, the physician may recommend a matrixectomy. This involves a partial nail avulsion combined with the permanent destruction of the nail matrix cells responsible for growing that specific edge of the nail. A chemical agent, such as phenol, is often applied to the exposed nail bed to achieve permanent removal, preventing the nail from growing back into the skin fold.