An ingrown toenail happens when the corner or side of a toenail grows into the surrounding skin instead of straight across, causing pain, redness, and sometimes infection. Most ingrown toenails can be managed with simple at-home care, but some need a quick in-office procedure to resolve for good — especially if the problem keeps coming back.
Ingrown toenails are one of the most common reasons patients visit our office, and they tend to affect the big toe most often. Left untreated, a mild case can progress to swelling, drainage, and infection that spreads into the surrounding tissue. Here's what causes them, how to treat one at home, and when it's time to have it looked at.
What causes an ingrown toenail?
An ingrown toenail develops when the edge of the nail digs into the skin alongside it. That can happen for several reasons, and often more than one factor is at play:
- Cutting nails at an angle instead of straight across, which leaves a corner that can catch on the skin as it grows
- Tight, narrow, or poorly fitting shoes that crowd the toes and press the nail into the surrounding skin
- Trauma to the toe — stubbing it, dropping something on it, or repetitive impact from sports
- Tearing nails instead of cutting them, which can leave a jagged edge that grows abnormally
- Heredity — some people are simply more prone to ingrown nails because of the natural shape of their toes or nails
- Cutting nails too short, which encourages the surrounding skin to fold over the nail edge as it regrows
- Circulatory issues, including those related to diabetes, heart disease, or tobacco use, which can affect how nails and skin heal
What are the early signs of an ingrown toenail?
Catching an ingrown toenail early makes it much easier to manage. Watch for:
- A hardened, firm edge along the side of the nail
- Swelling or puffiness in the skin next to the nail
- Redness and tenderness when the area is touched or bumped
- Drainage, oozing, or bleeding, which can signal an infection has set in
If you notice any of these signs, especially increasing redness or drainage, it's worth addressing the nail before it progresses.
How do you treat an ingrown toenail at home?
Mild ingrown toenails caught early often respond well to consistent at-home care:
- Warm water soaks — soaking the foot in warm water, with or without Epsom salt, several times a day softens the skin and nail and can ease pain
- Keeping the area clean and dry between soaks, with a light bandage if needed
- Switching to roomier, properly fitted shoes so nothing is pressing on the toe
- Over-the-counter pain relief for discomfort
- Topical antibiotic ointment if the skin looks irritated, to help prevent infection
- Gently lifting the ingrown edge away from the skin with a small piece of cotton or waxed dental floss, changed daily, to help redirect the nail's growth
Home care works best for nails that are only mildly ingrown and show no signs of significant infection. If you have diabetes, poor circulation, or a compromised immune system, skip home treatment and have a podiatrist evaluate the toe instead — even a minor nail problem can become serious for these patients.
When does an ingrown toenail need a procedure?
If home care doesn't resolve the problem, or the toenail keeps growing in the same way, an in-office procedure is usually the most reliable fix. Options include:
- Partial nail removal — the ingrown portion of the nail is removed under local anesthesia, and a chemical called phenol is often applied to the nail bed to prevent that portion of the nail from regrowing
- Complete nail removal — reserved for nails that are severely thickened, deformed, or repeatedly ingrown across the whole nail
These procedures are quick, performed right in the office, and are typically far more comfortable than patients expect. Learn more about our approach on our ingrown nails treatment page.
How can you prevent ingrown toenails?
A few habits go a long way toward preventing ingrown toenails from developing in the first place:
- Trim nails straight across — avoid rounding or curving the corners
- Avoid cutting nails too short; leave a small amount of white edge visible
- Choose shoes and socks with enough room in the toe box
- Address foot trauma promptly and keep an eye on the nail as it heals
- If you have diabetes or circulation problems, have your foot and nail care managed by a podiatrist rather than treating nail issues yourself
Medically reviewed by the physicians at Wasatch Foot & Ankle Institute. Our board-certified, fellowship-trained podiatrists provide foot and ankle care in Farmington and South Ogden, Utah. This article is for general education and is not a substitute for an in-person evaluation.