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Ingrown toenail

Key points

  • An ingrown toenail occurs when the edge of your nail, or a splinter of nail, grows into the skin at the side of your nail.
  • Symptoms include swelling, redness and pain in the nail area.
  • They can be treated by surgically removing the nail and treating part of the nail bed with a chemical called phenol.
  • Wearing comfortable shoes and cutting your toenails correctly can help prevent ingrown toenails.

Close up of feet - ingrown toenail information

An ingrown toenail occurs when the edge of your nail grows into the skin at the side of your nail, causing pain and swelling.

About ingrown toenail

Ingrown toenails can develop on just one or both sides of your toe. Your big toes are most likely to be affected. A recent clinical review suggests that ingrown toenails are most common among young adult men aged between 15 and 40. However, anyone can get an ingrown toenail at any age. They are often caused by wearing tight or ill-fitting shoes, and trimming your nail incorrectly.

Example of an ingrown toenail with red, swollen skin around the sides of the nail

Ingrown toenail

Symptoms of ingrown toenail

As your nail starts to grow into the skin at the side of your nail, your toe may become red, swollen and tender. Eventually, your ingrown toenail may become painful, especially if you put pressure on the area.

You don’t usually need to see your GP if you think you have an ingrown toenail. However, if you think you may have a bacterial infection or your symptoms get worse and aren’t helped by self-help measures, see your GP.

Complications of ingrown toenail

As the ingrown nail penetrates the surrounding skin, you can get a secondary bacterial infection. Your ingrown toenail can also damage the area at the side of your nail. It may blister and start to bleed or ooze pus. If left untreated, your symptoms can become so severe that they stop you from doing your everyday activities.

Causes of ingrown toenail

There are several things that can cause, or contribute to, an ingrown toenail.

  • Wearing shoes that don’t fit you properly. Tight shoes, high heels and pointed toe shoes can push your toes together so that your nails grow into your skin.
  • Cutting your toenails incorrectly. Tearing, picking or cutting them too short or down the sides is more likely to make your nail grow into your skin.
  • An injury to your toenail. A ripped nail, or a nail that has peeled off at its edge, can cause an ingrown toenail.
  • Fungal infections. These can cause your nail to become thickened or widened, making it more likely to grow into your skin. Fungus also makes your nail crumble and brittle, so spikes of nail can break off and penetrate into your skin.
  • Sweaty feet. Perspiration makes your skin and nails softer, so your nails are more likely to split and grow into your skin.
  • Wide nails or curved edges. If you have inherited wide (fan-shaped) nails or have nails with curved edges, you’re more likely to get an ingrown toenail. This is because the nail constantly irritates the skin along the nail edge.
  • Swollen feet. If you have chronic swelling in your feet, you’re more likely to get an ingrown toenail.

Diagnosis of ingrown toenail

Your GP will look at your nail and the skin around it. He or she may refer you to a podiatrist (a health professional who specialises in conditions that affect the feet). Alternatively you may need to see one privately. Your GP may also prescribe you with antibiotics if there is any bacterial infection present.

Treatment of ingrown toenail

Depending on your symptoms and the condition of your nail, you may be able to treat your ingrown toenail at home. Alternatively, you may need to visit a chiropodist or a podiatrist (specialists in foot care) for treatment.

Self-help

Soak your foot in warm salty water three or four times a day to soften the nail. Then use a toothbrush or cotton bud to gently clean around the nail – make sure that the cotton bud or brush is sterile. Be very careful about putting anything underneath your nail. Putting anything under your nail can damage it and cause infection and complications. Keep your foot dry for the rest of the day and wear comfortable shoes with enough space for your toes.

Medicines

If your ingrown toenail is causing you pain, over-the-counter painkillers such as ibuprofen or paracetamol may help with the symptoms. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice. Painkillers can only help with the symptoms, but won’t treat your ingrown toenail.

Surgery

If your toenail is causing you a lot of pain, your GP or podiatrist may recommend you have part, or all, of your toenail removed. This procedure is called a partial, or total, nail avulsion. It’s a simple procedure and is performed as a day case under local anaesthetic.

Your toe will be cleaned with antiseptic and a local anaesthetic injected into your toe. This completely blocks pain from the area and you will stay awake during the procedure. The ingrown section of the nail is cut away to create a new, straight nail edge. Sometimes, the whole nail is removed if it has become thick or deformed. If part of your nail is removed, the final shape of the nail will be narrower than the original nail plate.

Your nail bed (the cells from which your nail starts growing) can be surgically removed. However, your podiatrist is more likely to use a chemical called phenol. This is a chemical used to destroy cells in the area of the nail bed where the nail plate grows from. Phenol has been proven to be more effective at stopping the nail from re-growing in the treated area.

After your procedure, your toe will be covered with a dressing. You will be given advice about how to keep your healing wound clean, and your podiatrist may prescribe you antibiotics for a few days. For more information, see our FAQs.

Prevention of ingrown toenail

There are a number of things you can do to prevent an ingrown toenail.

  • Cut your toenails straight across, with clean, sharp nail trimmers, without rounding the corners.
  • Wear shoes that are wide and deep enough for your feet, and that don’t apply pressure on your toes.
  • Keep your feet clean and dry.

Illustration showing how to trim your toenails correctly

 

Reviewed by Natalie Heaton, Bupa Health Information Team, October 2013.

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For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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