Symptoms, causes and treatments| HealthPartners Blog

Have you ever wondered, “Why does the corner of my toenail hurt?”

If you’re experiencing pain or swelling around your toenail, you may have an ingrown toenail. The good news is that ingrown toenails can be treated at home. However, it’s important to know that if it’s just left alone, it’s possible for the toenail to become infected and require medical treatment.

Below, we’ll tell you more about ingrown toenails – symptoms to look for, what causes them, home remedies and when to talk to a doctor.

What is an ingrown toenail​?

Ingrown toenails happen when the toenail starts to grow into the skin next to it. It’s most likely to happen on your big toe, but it can happen on any of them. Ingrown toenails can be very painful and uncomfortable, as they make it difficult to stand, walk and comfortably perform normal daily routines.

Ingrown toenails are a common foot condition – in fact, 20% of people who complain to their doctor about foot problems have an ingrown toenail.

Ingrown toenail symptoms to watch for

Ingrown toenails can initially feel hard and achy, and symptoms can get worse over time. The skin surrounding the toe can become swollen, tender, warm and red. One of the first symptoms you may notice is toenail pain and tenderness, especially when you place pressure on the toe.

What does an ingrown toenail look like?

You’ll likely be able to tell if you have an ingrown toenail just by looking at your foot. The toenail itself will be curved down into the skin, and you may not be able to see the edges of the nail. You may also notice swelling, redness or pus around your toenail.

Signs of an ingrown toenail infection

If an ingrown toenail goes untreated, pain and inflammation are likely to increase, and can even lead to bleeding and an open wound. When the skin beside the toenail breaks, bacteria could enter and cause an infection.

There are a few signs that indicate you may have an ingrown toenail infection. It’s a good idea to see a primary care doctor or a foot specialist (such as a podiatrist) if you notice the following:

• Your toe is inflamed, swollen or bleeding.
• There’s white or yellow pus around your nail.
• Your toe is painful or feels warm when you touch it.
• You have a fever.

Pay extra attention if poor circulation is a concern

Poor circulation, which is common in people with diabetes, can cause poor blood flow to your feet and minimize feeling should an ingrown toenail occur. The lack of circulation can also increase the chances of infection since white blood cells will not be sent to the area.

Stages of ingrown toenails

Ingrown toenails can start as a mild irritation and evolve into more serious conditions. Catching the problem early can prevent an ingrown toenail from getting worse – and also prevent the need for medical treatments.

Identifying the stage of an ingrown nail can help you know which treatment option may work, and how to keep the ingrown nail from getting worse.

Stage 1 ingrown toenail

In this stage, the toenail has started to grow into the skin, resulting in a mild ingrown toenail. You may notice that your skin is slightly inflamed and a bit painful to touch. Ingrown toenails at this stage can usually be successfully treated at home.

Stage 2 ingrown toenail

During this stage, new inflamed tissue grows over the edges of your toenail. If the tissue around the ingrown toenail has become very inflamed or is producing pus, it’s time to see a primary care doctor or foot specialist. They can recommend medical treatments or antibiotics depending on the cause and severity of your symptoms.

Stage 3 ingrown toenail

At this stage, the inflamed skin has started to grow over the rest of the toenail, and pus is continuing to ooze out of the wound. You will want to make an appointment with a foot specialist as soon as possible if you notice these symptoms. For stage 3 symptoms, a doctor will likely recommend surgery. You may also need an oral or topical antibiotic.

Ingrown toenail causes

Ingrown toenails can be caused by factors that range from wearing footwear that is too tight to foot injuries.

Tight footwear

One of the most common causes of ingrown toenails is wearing footwear that is too tight or doesn’t fit properly. Tight footwear can crowd the toenails. Stockings, shoes or socks that are too small or narrow can constrict the toes, causing ingrown toenails to form over time.

Tight footwear can also make you sweat more, softening the skin around your toenail and making it easier for your nail to pierce and grow into it.

Improperly cut toenails

Grooming your toenails improperly is a common cause of ingrown nails. Why is that? There are a few reasons:

• Cutting the toenails too short leaves room for the nail to grow into your nail bed.
• Cutting your toenails in an arch to match the shape of the toe can cause your toenail to grow into your skin. You want to be sure to cut your toenails straight across.
• Ripping your nails instead of cutting them can result in jagged corners, leaving room for a new corner to grow under the skin.

Large curved toenails

If you have naturally large toenails or if they are naturally curved, you could be more likely to get ingrown toenails.

Thick toenails

Thicker toenails increase your chances of getting an ingrown toenail. The causes of toenail thickness include:

• Aging
• Poor circulation
• Fungal nail infections
• Nail psoriasis

Injury to a toenail

Minor injuries to your toe could lead to ingrown toenails. Stubbing your toe, having your toe stepped on, dropping something heavy on your foot or kicking a ball repeatedly can increase the risk for ingrown toenails.

Ways to prevent ingrown toenails

There are several things you can do to prevent ingrown toenails:

• Monitor your feet – Regularly check the area around your toenails for redness, swelling or pus. This is especially important if you have limited feeling in your feet because of diabetes or another condition.
• Practice proper nail care – When trimming your toenails, cut the nail straight across rather than at a curve or angle. To avoid them growing back into the nail bed, don’t cut your toenails too short.
• Choose proper footwear – Choose footwear that fits properly and doesn’t put too much pressure on your toes. Make sure to wear protective footwear when you participate in activities that could cause a foot injury.

What happens when ingrown toenails aren’t treated?

When left untreated, ingrown toenails can lead to infections that range from moderate – like pus and swelling at the infection site – to severe, like a bone infection, ulcers and tissue decay.

If you start to see symptoms like redness or inflammation, take steps to prevent them from getting worse.

At minimum, an ingrown toenail can make it uncomfortable to walk, and at worst, it can cause serious infections.

In cases where an ingrown toenail infection is combined with a preexisting illness that causes poor circulation, like diabetes, the infected wound can be dangerous and even life threatening.

How to treat an ingrown toenail: Home remedies

It’s quite possible that you’ll be able to care for mild ingrown toenails on your own. Since ingrown nails usually get worse without treatment, you’ll want to give your feet some extra care if you have tenderness and redness near your toenails.

The following are treatments you can try at home. But see a doctor right away if you have signs of an infection, such as a fever or a toe that’s warm or leaking pus.

• Soak your toe – Soak your foot in warm water for about 20 minutes two or three times a day until the soreness improves. If your toe is red or swollen, adding castile soap or Epsom salt to the water may help reduce inflammation.
• Push the skin back – You can push skin away from the toenail edge with a cotton swab or cotton ball soaked in olive oil. This can be helpful even if the ingrown toenail is very minor.
• Try lifting the nail – If the edge of your nail has started to grow into the surrounding skin, you’ll want to carefully separate it. Gently lift the ingrown edge of your toenail from the surrounding skin and place cotton, dental floss or a splint under it. This separates the nail from the surrounding skin and helps the nail grow above the skin edge. Your doctor may also recommend you use a corticosteroid cream. You may need to soak your toe and replace the splint daily for 2-12 weeks before seeing results.

Other home remedies to try

If you’re still feeling discomfort but don’t see any signs of infection, these home remedies might help.

Wear shoes and socks that aren’t too tight

Choose comfortable footwear that doesn’t press down on or squeeze your toes. Be sure to wear socks or stockings with room for your toenails to grow properly. Open-toed shoes or sandals are a great option while your toe heals.

Use over-the-counter medications to reduce pain and inflammation

Over-the-counter medications can be used to lessen the discomfort you may experience while waiting for your toe to heal. Pain relievers, like acetaminophen, may help ease your toe pain. Anti-inflammatories, like naproxen and ibuprofen, can help to reduce inflammation. Steroid creams or topical antibiotics, such as polymyxin and neomycin (both present in Neosporin), can be used to prevent infection. You should always consult with your doctor before starting a new over-the-counter medication.

“Home remedies” you shouldn’t try

Avoid the following remedies to prevent the ingrown toenail from getting worse.

• Don’t pick at your toe or toenail.
• Don’t use a sharp object, like manicure scissors or needle to dig under your nail, as this can cause infection.
• If you have an infection, don’t try to drain pus from your toes on your own.

If you have an infection or your toe pain is severely uncomfortable, make an appointment with a foot specialist – they’ll be able to safely treat an ingrown toenail.

Medical treatment for ingrown toenails

If home remedies haven’t helped the ingrown toenail or if it is at a more advanced stage, your doctor can recommend additional treatments.

When to see a doctor

There are a few reasons why you want to see a doctor for an ingrown toenail, especially after you’ve attempted home remedies:

• Your toe isn’t getting better from home treatments after 2-3 days, or it gets worse.
• You experience severe discomfort, pus or inflammation that may be spreading.
• You have a fever.
• You have diabetes or another disease that causes poor circulation.

Antibiotics

If the ingrown toenail is infected, you will likely need antibiotics – and the sooner the better. Infections can spread to other areas of the body, causing more issues than an ingrown toenail.

If you think you have an infection, make an appointment with a primary care doctor or foot specialist right away. The doctor will treat the infection first. Once the infection is gone, you may need another treatment to help fix the ingrown toenail.

Surgical nail removal

Your doctor may recommend surgery to remove part or all of your toenail if an ingrown toenail is severely inflamed or infected.

The type of surgery that your doctor recommends will depend on several factors, including the severity of the ingrown toenail and if the ingrown nail is likely to come back.

Get help treating ingrown toenail symptoms

Our foot specialists can help you identify and treat a range of foot problems, including ingrown toenails and toe infections – and you don’t need a referral before making an appointment.

If you prefer, you can talk to your primary care doctor about an ingrown toenail. They’re often able to treat ingrown toenails, especially ones that are in the early stages. If needed, they’ll refer you to a foot specialist for more advanced treatment.