An ingrown toenail (onychocryptosis) is a common and painful foot condition where the nail edge grows into the surrounding soft tissue of the toe. This causes inflammation, swelling, and significant discomfort, typically affecting the big toe. While many mild cases may resolve with home care, a persistent or complicated ingrown toenail requires professional medical intervention. Understanding when and where to seek professional help is the first step toward lasting relief.
When Professional Intervention is Required
The decision to move beyond home remedies is based on the severity of symptoms and underlying health factors. Seek professional care if the pain is severe, the toe is throbbing, or if discomfort makes walking difficult. Swelling, redness, and warmth that do not improve after a few days of soaking and careful management indicate the problem is worsening.
The presence of any signs of infection necessitates an immediate visit to a healthcare provider. These signs include pus or watery discharge, a foul odor, or redness that begins to spread from the site of the ingrowth. For individuals living with diabetes, peripheral artery disease, or other conditions that impair circulation or sensation in the feet, any ingrown toenail should be evaluated right away. These underlying issues increase the risk of serious complications, such as a rapidly spreading infection or an ulcer that is difficult to heal.
Which Medical Specialists Handle Ingrown Toenails
The most qualified professional for treating a problematic ingrown toenail is a podiatrist, who specializes in conditions of the foot and ankle. Podiatrists handle cases ranging from simple removals to chronic and complex situations, offering the full spectrum of treatment options. They are experts in performing minor in-office surgical procedures to provide both immediate and long-term solutions, including procedures to prevent recurrence.
For an initial evaluation or a simple, non-complicated case, your Primary Care Physician (PCP) can often help. A PCP can manage the initial stage of infection with oral antibiotics if the toe is acutely inflamed. They can also assess whether a referral to a specialist is necessary based on the severity of the infection or pre-existing health concerns.
Urgent care or walk-in clinics are an option for immediate attention regarding acute pain or a localized infection. These clinics can drain an abscess, prescribe necessary medication, or perform a simple partial removal to relieve pressure. However, they typically do not offer the permanent corrective procedures, like matrixectomy, that a podiatrist specializes in for recurring ingrown toenails. For a definitive solution to a chronic issue, consulting a foot and ankle specialist remains the best path.
What to Expect During the Removal Procedure
Before any removal procedure begins, the healthcare provider will conduct a thorough examination of the toe and review your medical history. The actual removal is performed as a minor in-office procedure, starting with the administration of a local anesthetic to numb the area completely. This injection is typically given at the base of the toe, ensuring the rest of the procedure is painless.
The two main procedural approaches are the partial nail avulsion and the matrixectomy, which is often combined with the avulsion. A partial nail avulsion involves the removal of only the offending portion of the nail edge that is cutting into the skin, leaving the majority of the nail intact. This technique provides immediate pain relief and allows the inflamed tissue to heal.
For patients who experience recurrent ingrown toenails, a podiatrist will often perform a matrixectomy to prevent future problems. This involves applying a chemical agent, most commonly phenol, to the nail matrix—the root tissue—at the side where the nail was removed. The chemical destroys the nail-growing cells in that specific area, which permanently stops the nail edge from regrowing.
Following the procedure, the toe is cleaned and a sterile dressing is applied, which should remain in place for the first 24 hours. Patients are instructed to keep the foot elevated for a day or two and to begin daily soaking and dressing changes as advised by the provider. While a simple avulsion may allow a return to normal activity within a day or two, a procedure that includes a chemical matrixectomy can involve a longer healing period, with drainage and irritation that can last for two to four weeks.