Foot Conditions A-Z

Ingrown Toenails

Many people have experienced the pain of ingrown toenails. They occur when the corner or side of a toenail grows into the soft flesh of the toe, most often the big toe. Ingrown toenails can cause pain, swelling, redness and sometimes infection. According to the 2012 National Foot Health Assessment conducted by the NPD Group for the Institute for Preventive Foot Health, 18 percent of U.S. adults age 21 and older (40 million people) have experienced ingrown toenails.

Causes

Cutting the toenails too short and/or not cutting them straight across is the most common cause of ingrown toenails. Another common cause is shoes that are too short or that fit too tightly and compress the toes together. People whose toes are unusually curved are prone to having ingrown toenails. They can also be due to trauma or injury to the toe or the toenail.

Prevention and Treatment

IPFH suggests the best way to prevent ingrown toenails in people with healthy feet is to cut the nails straight across, but not too short, and to lightly refine any sharp edges with an emery board or clean metal file. Wear only properly selected and fitted, as part of an integrated approach,  padded socks with shoes with non-slip outsoles and any inserts or orthotics prescribed or recommended by a doctor or foot health professional. Peer-reviewed, published studies have shown that wearing clinically tested  padded socks can help protect against injuries to the skin/soft tissue of the foot due to impact, pressure and shear forces. By helping to prevent excessive pressure on the forefoot and toes, they reduce the likelihood that the toenails will be crowded too closely together.

If you have an ingrown toenail, soak your feet in warm water for 15 to 20 minutes several times a day.  This reduces swelling and relieves tenderness.

If you have a slightly ingrown nail (red and painful but with no discharge), placing cotton under the edge of the nail to separate it from the skin can provide relief. Use a clean file to lift the nail up slightly away from the skin. This helps the nail to grow back above the edge of the skin. Use alcohol to cleanse the area before and afterward.

If you have redness, pain and pus, your physician or podiatrist may trim or remove the ingrown portion of the nail. For chronic cases, your doctor may suggest removing a portion of the toenail together with the underlying tissue (nail bed) to prevent that part of the nail from growing back. This procedure is often done with chemical, laser or other mechanical procedures.

If you experience severe discomfort in the toe, and/or see signs that pus or redness seem to be spreading, your ingrown toenail might be infected. It’s time to see your doctor. Left unattended, infection can spread within the foot and into the bones.

Medical Considerations

People with diabetes and/or neuropathy or compromised circulation in the feet should never attempt to treat ingrown toenails or any other foot issues on their own but should see a physician for all foot issues.