Overview

An ingrown toenail, medically known as onychocryptosis, happens when the edge or corner of your toenail grows into the soft flesh of the toe next to it. This can be quite uncomfortable and sometimes painful. It's often caused by a combination of factors, including how you trim your nails, the type of shoes you wear, or even just the natural shape of your nails.

Ingrown toenails can affect anyone, from active teenagers to older adults, and even babies if their nails are not trimmed carefully. While they aren't contagious, they can certainly impact your day-to-day life, making walking or wearing shoes uncomfortable. We understand that dealing with any foot pain can be frustrating, and we want to help you understand what might be happening.

Symptoms

You might be experiencing an ingrown toenail if you notice:

• Pain and tenderness - along one or both sides of the toenail, especially when pressure is applied.
• Redness - around the affected toenail.
• Swelling - of the toe around the nail.
• Skin that feels warm to the touch - around the ingrown area.
• Sometimes, you might see a small amount of pus or watery discharge - if an infection starts.
• The skin next to the nail may start to overgrow or look puffy.
• Difficulty wearing shoes due to discomfort.
• A feeling of pressure under the nail.

The severity can range from mild discomfort to significant pain that makes it hard to walk. Tight shoes or activities that put pressure on the toes can often trigger or worsen these symptoms.

Diagnosis

Diagnosing an ingrown toenail is usually straightforward. A doctor or podiatrist can typically identify it simply by looking at your toe and asking about your symptoms. They'll examine the area to see if the nail is indeed growing into the skin and check for any signs of infection.

In most cases, no special tests are needed. The physical examination is generally enough to confirm if you have an ingrown toenail.

Management & Treatment

Dealing with an ingrown toenail can be a painful nuisance, but the good news is that many cases can be managed effectively at home. The goal is to relieve your discomfort and prevent any infection from taking hold. For more persistent or severe cases, a little help from a healthcare professional might be needed.

Most ingrown toenails can be treated with simple home care. If your ingrown toenail is mild and not showing signs of infection (like pus or significant swelling), you can often find relief with these steps:

• Soak your foot. Submerge your foot in warm, soapy water or an Epsom salt bath for 15-20 minutes, 3-4 times a day. This helps to soften the skin and nail, which can ease swelling and tenderness.
• Gently lift the nail. After soaking, you can try to carefully place a small piece of clean, waxed dental floss or a tiny wisp of cotton under the edge of the ingrown nail. This encourages the nail to grow up and over the skin edge, rather than into it.
• Apply antibiotic ointment. Smooth a small amount of an over-the-counter antibiotic ointment on the tender area to help prevent infection.
• Choose sensible footwear. Wear open-toed shoes or shoes with a wide toe box to avoid putting pressure on the affected toe while it heals.

It’s so important to be gentle with yourself during this process. Never try to cut or dig out the nail yourself, as this can make the problem much worse and lead to a nasty infection. We know it's tempting, but "bathroom surgery" is not the answer.

When Prescription Treatments May Be Needed

If you've tried home remedies for a few days and the pain is getting worse, or if you see signs of infection, it's time to check in with a healthcare provider. An infection might show up as:

• Increased redness and swelling
• Pus or drainage from the area
• Pain that is severe or spreading
• Feeling warm to the touch

Your doctor might prescribe a course of oral antibiotics if an infection is present. In some cases, they may need to perform a minor in-office procedure. This usually involves numbing the toe and then either lifting the nail or removing the small portion of the nail that is digging into the skin. This provides immediate relief and helps the toe heal correctly.

We expect to see improvement with home care within a few days to a week. If a minor procedure is performed, the toe usually heals within a couple of weeks. Following your doctor's aftercare instructions is key to a smooth recovery.

If home treatments aren't providing relief, or if you have a condition like diabetes, nerve damage, or poor circulation, it's crucial to see a healthcare professional right away. These conditions can make it harder for your foot to heal and increase your risk of complications. Your well-being is the top priority, and getting the right care at the right time is essential.

Duration & Outlook

The timeline for an ingrown toenail can vary. If caught early and managed properly, mild cases might improve within a few days to a week. However, if left untreated or if an infection develops, it can become a more persistent, or chronic, issue.

With appropriate care, most ingrown toenails heal well. However, some people are prone to getting them repeatedly, especially if the underlying cause (like nail shape or improper trimming) isn't addressed. A key warning sign for complications is increasing pain, redness that spreads, warmth, pus, or a fever, which could indicate an infection that needs medical attention.

Prevention

The good news is that there are steps you can take to help prevent ingrown toenails:

• Trim your toenails straight across: Avoid curving the nails to match the shape of your toe. Use clean, sharp nail clippers.
• Keep toenails at a moderate length: Don't trim them too short. The corner of the nail should be visible above the skin.
• Wear shoes that fit properly: Avoid shoes that are too tight or narrow in the toe area, as they can crowd your toes and press the nail into the skin. High heels are a frequent trigger for some.
• Wear protective footwear if needed: If your work or activities put your toes at risk of injury, wear steel-toed shoes or other appropriate protection.
• Keep your feet clean and dry: Good foot hygiene can help prevent infections that might complicate an ingrown toenail.

Causes & Triggers

Several things can cause an ingrown toenail or make you more likely to get one:

• Improper nail trimming: Cutting toenails too short or rounding the edges are common culprits.
• Tight-fitting shoes or socks: These can put pressure on your toenails, forcing them to grow into the skin. High heels are a frequent trigger for some.
• Toe injuries: Stubbing your toe or dropping something heavy on it can sometimes lead to an ingrown toenail.
• Nail shape: Some people naturally have curved (involuted) toenails that are more prone to growing inward.
• Genetics: Sometimes, the tendency to get ingrown toenails can run in families.
• Poor foot hygiene: Not keeping feet clean and dry can increase the risk of infection if an ingrown nail develops.
• Repetitive pressure: Activities like running or kicking can put repeated stress on the toes.

Anyone can develop an ingrown toenail, but teenagers and people with sweaty feet are often more susceptible. Also, individuals with conditions that affect circulation or nerve function in the feet, like diabetes, should be particularly careful and inspect their feet regularly.

When to see a doctor:

While some mild ingrown toenails might improve with careful hygiene, it's important to see a healthcare professional if:

• You notice signs of infection: This includes increasing pain, significant swelling, redness that spreads, warmth around the toe, pus or discharge, or a foul odor.
• You have a fever - accompanied by any of the above symptoms.
• You have severe pain - that doesn't improve or makes it difficult to walk or wear shoes.
• If you have diabetes, poor circulation, or a weakened immune system - as these conditions can make foot problems more serious and infections harder to heal.
• If you've tried home care for a few days and the condition isn't improving or is getting worse.
• If you get ingrown toenails repeatedly.

A healthcare professional can provide an accurate diagnosis and discuss the best course of action for you.

Frequently Asked Questions (FAQs):

• Q: Is an ingrown toenail contagious? No, an ingrown toenail itself is not contagious. You cannot catch it from someone else. However, if an infection develops, the bacteria causing the infection could potentially spread if proper hygiene isn't followed.
• Q: Can I fix an ingrown toenail myself? For very mild cases without signs of infection, some home care might provide relief. However, it's very important not to try to cut out the ingrown part of the nail yourself, as this can worsen the problem or lead to infection. If you're unsure, or if there's pain, redness, or swelling, it's best to see a healthcare professional.
• Q: Why does my ingrown toenail keep coming back? Recurring ingrown toenails can be due to several factors, including your natural nail shape, consistently wearing ill-fitting shoes, or improper nail trimming habits. A doctor or podiatrist can help identify the reason and discuss ways to prevent future occurrences.
• Q: What kind of doctor should I see for an ingrown toenail? You can start with your primary care doctor, or you can see a podiatrist, who is a specialist in foot conditions. Dermatologists also sometimes manage nail conditions.
• Q: Can babies get ingrown toenails? Yes, babies can get ingrown toenails, often from their nails being cut too short or from wearing tight booties or socks. It's important to be gentle and careful when trimming a baby's nails.