Managing Ingrown Toenails: Prevention, Care, and When to Seek Help

Understanding Ingrown Toenails: Causes, Symptoms, and Treatment

If you’ve ever had an ingrown toenail you know firsthand that while the affected area is anatomically small, the pain feel enormous. Even the slightest touch from a shoe can make walking difficult. An ingrown toenail, also known as onychocryptosis, occurs when the side or tip of the toenail grows into the surrounding skin. This can lead to inflammation, pain, swelling, and sometimes infection. The big toe (or hallux) is most commonly affected, although any of the five toenails may develop this condition.

Who Is Most Affected and Why

Ingrown toenails most commonly affect teenagers and young adults, and they area seen more often in males than in females. The causes can vary and are generally categorized as extrinsic (external) or intrinsic (internal) factors.

From an extrinsic standpoint, improper nail care plays a major role. Cutting toenails too short or rounding the edges can encourage the nail to grow into the skin. Poor hygiene—such as failing to keep feet clean and dry—along with excessive sweating can also increase the risk. In addition, repetitive trauma from activities like running or kicking, or wearing shoes that are too tight in the toe box, can further irritate the area.

On the intrinsic side, certain structural abnormalities may predispose someone to developing an ingrown toenail. These include having nails that are too large for the toes, pincer-nail deformities, congenital misalignment of the nails, and thick nail plates. In some cases, people are simply born with a nail shape that makes them more prone to this condition.

Recognizing the Symptoms

Early recognition of symptoms can help prevent complications. Someone developing an ingrown nail may notice redness and swelling at the corner or along the edge of the nail, along with pain and tenderness. If an infection is present, white, yellow, or green drainage (pus) may appear. Severe infections can lead to systemic symptoms such as fever or chills, indicating that medical attention is urgently needed.

At-Home Treatments

For mild cases, there are several at-home treatments that may provide relief. Soaking the foot in warm water with Epsom salt can soften the surrounding skin and reduce inflammation. Wearing shoes with ample toe room helps relieve pressure on the affected area, while gently lifting the nail edge with a small piece of cotton or dental floss may help guide the nail to grow properly.

However, if symptoms persist or worsen within two to three days, or if signs of infection develop, it is important to see a healthcare professional. Individuals with diabetes, poor circulation, or peripheral vascular disease should seek treatment from a podiatrist immediately rather than attempting self-care, as they are at higher risk for complications such as infection, delayed healing, or ulceration.

Professional Treatment Options

When home care is not effective, a podiatrist (foot doctor) can offer more definitive treatment. If infection is present, antibiotics may be prescribed. In more severe or recurring cases, a partial nail avulsion—a procedure in which part of the nail is removed under local anesthesia—may be necessary. If symptoms continue despite this, the podiatrist may recommend permanent removal of part or all of the nail or perform a procedure to alter nail growth and prevent recurrence.

Conclusion

While an ingrown toenail might seem like a minor issue, it can cause significant discomfort and, if left untreated, may lead to serious infection. Practicing proper nail care, wearing well-fitting shoes, and addressing early symptoms promptly can help prevent complications. For persistent or severe cases, consulting a podiatrist ensures the best outcome and helps you get back on your feet—comfortably and pain-free.

References:

1.     American Academy of Orthopaedic Surgeons. Ingrown toenail. OrthoInfo. Updated February 2022. Accessed October 6, 2025. https://orthoinfo.aaos.org/en/diseases--conditions/ingrown-toenail

2.     Chabchoub I, Litaiem N. Ingrown toenails. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Updated September 18, 2022. Accessed October 6, 2025. https://www.ncbi.nlm.nih.gov/books/NBK546697/

3.     Mayo Clinic Staff. Ingrown toenails. Mayo Clinic. Updated June 22, 2023. Accessed October 6, 2025. https://www.mayoclinic.org/diseases-conditions/ingrown-toenails/symptoms-causes/syc-20355903

4.     NHS 24. Ingrown toenail. NHS Inform. Updated September 24, 2025. Accessed October 6, 2025. https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/ingrown-toenail/

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