An ingrown toenail, medically known as onychocryptosis, occurs when the edge of the nail plate grows into the surrounding skin, causing discomfort and inflammation. This common and painful foot problem most often affects the big toe. Ingrown toenails account for a significant portion of all foot-related issues, affecting an estimated 2.5–5% of the general population. Knowing when to stop self-treating and which medical professional to consult is an important step toward resolution and preventing recurrence.
When Home Treatment Fails
An ingrown toenail can quickly progress past the point where soaking the foot or gently lifting the nail edge is effective. Persistent pain, especially when wearing shoes or walking, is a clear sign that professional intervention is needed, as this indicates the nail is causing mechanical damage to the adjacent soft tissue.
Immediate medical attention is required if signs of infection are present, such as increased swelling, warmth, redness that spreads beyond the toe, or the presence of pus or discharge. These symptoms suggest the initial inflammation has progressed to a bacterial infection. Systemic symptoms, like fever or chills, indicate a potentially severe infection that requires urgent care.
Individuals with underlying conditions like diabetes, poor blood circulation, or nerve damage must seek professional treatment immediately, even if symptoms appear mild. For these patients, a small break in the skin can quickly lead to severe complications, including foot ulcers and serious infection. The typical conservative approach of waiting is strongly discouraged in these high-risk cases.
Which Medical Specialists Treat Ingrown Toenails
The most specialized provider for foot and ankle conditions is the Podiatrist (Doctor of Podiatric Medicine). Podiatrists have the necessary training and specialized tools to perform the definitive, minor surgical procedures required for chronic or complicated ingrown nails. They are the preferred choice for patients with recurring issues, underlying health risks, or cases that have progressed to a moderate or severe stage.
A Primary Care Physician (PCP), such as a Family Doctor or General Practitioner, is a suitable first point of contact for mild, non-complicated cases. A PCP can assess the severity, prescribe oral antibiotics if a localized infection is present, and offer initial guidance. If the condition requires a minor surgical procedure to remove the nail edge, the PCP will often refer the patient to a podiatrist.
An Urgent Care center or Emergency Room is appropriate for acute, severe infections when a podiatrist or PCP is not immediately available. This is particularly true if the toe is throbbing, has extensive pus, or the patient has a fever, as these settings can provide immediate drainage and treatment. Dermatologists may also treat ingrown toenails, especially if the issue is complicated by a fungal infection or chronic nail disease.
What Professional Treatment Involves
Professional treatment often involves a minor procedure performed in the doctor’s office after the toe is numbed with a local anesthetic. The most common intervention is a Partial Nail Avulsion, where the problematic edge or spicule of the nail is carefully cut away and removed. This procedure relieves pressure on the surrounding skin, allowing inflammation to subside.
For severe or repeatedly returning cases, the procedure is often combined with a Matrixectomy. This involves applying a chemical, such as phenol, to the nail matrix (the root area) where the removed section of the nail originated. The chemical destroys the nail-forming cells in that specific area, which prevents the nail edge from growing back and resolves the chronic issue.
Following the procedure, the toe is dressed, and patients receive specific instructions for wound care and activity modification. Recovery is generally quick, with most patients able to resume normal activity soon after. Full healing of the nail bed area may take several weeks, and post-procedure pain is managed with over-the-counter medication.
Preventing Future Ingrown Toenails
Preventing recurrence depends on making consistent changes to nail care and footwear. The most impactful preventive measure is proper toenail trimming: nails should be cut straight across, avoiding the temptation to round the corners or cut them too short.
Wearing properly fitted shoes is another important factor. Footwear that crowds the toes, such as shoes with a narrow toe box or high heels, places excessive pressure on the toenails, forcing the nail to grow into the skin. Opting for shoes with ample room for the toes to move freely reduces this pressure.
Maintaining good foot hygiene helps reduce the risk of infection, which can complicate an ingrown nail. This includes washing the feet daily and ensuring they are thoroughly dried, particularly between the toes. Protecting the feet from trauma during activities like running or sports also minimizes the risk of injury that could cause improper nail growth.