What is an ingrown toenail?

Ingrown toenails occur when the side corners of a toenail grow down into your skin and pierce the soft tissue.  Soak your foot in lukewarm water with Epsom salts two or three times a day and massaging the skin afterwards may help draw out an ingrown toenail.
Ingrown toenails occur when the side corners of a toenail grow down into your skin and pierce the soft tissue. Soak your foot in lukewarm water with Epsom salts two or three times a day and massaging the skin afterwards may help draw out an ingrown toenail.

Do your feet hurt when you put on shoes? More specifically, do the tips and sides of your toes hurt? Well, look closely — you may have an ingrown toenail.

Ingrown toenails are very common. They occur when the side corners of a toenail grow down into your skin and pierce the soft tissue. The medical term for this is onychocryptosis.  An ingrown toenail can occur anywhere, but it is most common on your big toe. If not tended to, the skin may eventually start growing over the ingrown nail.

Once the soft tissue has been pierced, bacteria can invade the area and cause infection and fungal growth. The resulting inflammation and infection can lead to other health problems. 

What causes an ingrown nail?

Simplistic causes of ingrown nails include:

  • Tight shoes 
  • Injuring the toenail
  • Improper cutting of the nails 
  • Very curved toenails 

There are several ways you can get an ingrown nail. Trauma — like dropping something on your toe or stubbing it — can cause an ingrown nail. An untreated fungal infection that thickens your nails can also cause an ingrown nail. Cutting your nails too short or not straight across can lead to the growth of an ingrown nail.

Too tight shoes press onto the edges of your toes and allow ingrown nails to form. Improper hygiene can lead to small particles of debris getting caught under your nail, allowing it to grow down into the skin edges. Also, genetics can play a part. 

Those with ingrown nails may experience:

  • Redness surrounding the affected nail 
  • Pain in your toe along the sides of the nails 
  • Redness around the toenail 
  • Infection of the surrounding soft tissue 

People of all ages can get ingrown nails, but some people are more at risk.

Who do ingrown nails affect more harshly? 

People with certain medical conditions can be particularly susceptible to complications from an ingrown nail. If you have diabetes or a condition that reduces the blood flow to the feet, you are at risk for complications. The untreated ingrown nail may not heal properly, causing infection and possible ulceration. This is true of other circulatory diseases like peripheral vascular disease too.

Also, those with nerve damage can be susceptible to complications. You may not be able to feel the ingrown nail digging into your skin. You may not even notice it until it is infected or bleeding into your sock. 

How do you fix an ingrown toenail?

For minor symptoms, conservative interventions can help. Soak your foot in lukewarm water with Epsom salts two or three times a day.  Afterward, dry your foot. Massage the skin on each side of the nail and push it away from the nail. This will cause the nail to relax its penetration of your skin and possibly reveal enough of a gap to be pulled out.

After each soaking, place a small piece of cotton or dental floss under the ingrown toenail edge. This will help direct the nail to grow above the skin edge. This will also reduce pressure and pain.

The application of antibiotic cream will help with tenderness and keep the infection risk down. Wear sandals or low-heeled shoes that do not squeeze your toes together.

If home remedies don’t work, you should see a podiatrist — a foot doctor. They will remove part of the nail after numbing your toe with an anesthetic.  This is called a partial nail avulsion. 

If your ingrown nail is severe or has a paronychia (inflamed and/or infected surrounding skin), your podiatrist may remove the nail border and the affected skin.  To permanently keep the nail border from growing back, the doctor may use a laser, chemical, or partial surgery and remove a portion of the nail bed. 

How can I prevent ingrown nails?

There are simple things you can do daily to prevent ingrown nails.

  • Wear comfortable shoes with a wide toe box. This prevents squeezing of the toes and causing nails to grow curved in. 
  • Keep your feet clean and dry.
  • Use a clipper that is for toenails, not fingernails. Cut the nails straight across going with the natural shape of the toe. Do not cut them too short.

If your nails are inflamed, in pain, and possibly infected, clean the toe and apply a bandage. If your symptoms do not improve, get to your doctor as soon as possible. This is especially true for those with diabetes, peripheral vascular disease, and nerve damage.   

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Medically Reviewed on 1/28/2022
References
SOURCES:

Cedar Sinai: "Happy Feet: 5 Tips to Remedy Ingrown Toenails."

Harvard Health Publishing: "Foot health: What to do about an ingrown toenail."

Mayo Clinic: "Ingrown toenails."