Ingrowing Toenail

An ingrown toenail develops when the sides of the toenail grow into the surrounding skin.

The big toe is often affected, either on one or both sides. The nail curls and pierces the skin, which becomes red, swollen and tender.

If the nail fold becomes infected, symptoms include increasing pain, swelling and redness near the ingrown nail, and yellow or green pus near the nail or under the nearby skin. If the infection is getting worse, you may have a throbbing pain, redness spreading over the toe, or a high temperature (fever).

You should consult a doctor if you have symptoms of infection around the nail, particularly if you have diabetes, a poor immune system or other foot problems.

If treated early, an ingrowing toenail can be managed at home without the need to consult a doctor or podiatrist.

Causes

A number of things can cause an ingrown toenail to develop, including:

  • Badly cut toenails – cutting your toenails too short, or cutting the edges, will encourage the skin to fold over your nail and the nail to grow into the skin.
  • Wearing tight-fitting shoes, socks or tights – this places pressure on the skin around your toenail; the skin may be pierced if it’s pressed on to your toenail.
  • Sweaty feet – if the skin around your toenails is soft, it’s easier for your nail to pierce it and embed itself within it.
  • Injury – for example, stubbing your toe can sometimes cause an ingrown toenail to develop.
  • Natural shape of the nail – the sides of curved or fan-shaped toenails are more likely to press into the skin surrounding the nail.

A fungal nail infection can cause your toenail to thicken or widen.

Selfcare

Prevention

To help stop ingrown toenails:

  • do not cut your toenails too short.
  • cut straight across the nail, not the edges.
  • do not wear shoes that are too tight or do not fit properly.
Treatment At Home
  • soak your foot in warm water 3 to 4 times a day for a few days – this softens the skin around your toe and stops the nail growing into it. Dry your foot well in between soaks.
  • keep your feet clean by washing them regularly with soap and water.
  • gently push the skin away from the nail using a cotton bud (this may be easier after using a small amount of olive oil to soften the skin).
  • keep your foot dry for the rest of the day.
  • wear wide, comfortable shoes or sandals that fit properly, don’t wear tight, pointy shoes.
  • change your socks regularly.
  • cut your toenails straight across to stop them digging into the surrounding skin (or if painful, don’t cut your toenail at all – leaving it to grow out).
  • don’t pick at your toe or toenail.
  • take paracetamol or ibuprofen to ease the pain.

When to consult a healthcare professional

You should consider consulting your GP if:

  • treatment at home is not helping.
  • your toe is very painful and swollen with pus coming out of it.
  • your temperature is very high, or you feel hot or shivery.
  • you have diabetes – foot problems can be more serious if you have diabetes.
  • the problem keeps recurring.

Your GP will confirm the diagnosis and will prescribe antibiotics if there are signs of infection.

If the problem persists or recurs, then your GP may refer you to a foot specialist (podiatrist).

Specialist treatment

A foot specialist (podiatrist) may offer further treatments, such as:

  • Partial nail avulsion (wedge excision) – cutting away part of the nail
  • Total nail avulsion – removing the whole nail
  • Nail-bed ablation – the removal of the whole nail, plus a chemical or electric current directed at the area of tissue responsible for nail growth
  • Zadek’s procedure – the removal of the whole nail, plus cutting away the area of tissue responsible for nail growth

You’ll have an injection of local anaesthetic to numb your toe when this is done.

Referral to a podiatrist on the NHS may not be available to everyone and waiting times can be long. You can pay to see a podiatrist privately.

Useful information about ingrowing toenails:

Videos about ingrowing toenails

Understand and Manage: Ingrowing Toenail | Scholl UK

Published: 11 Mar 2020

Waiting for a specialist opinion

If you have been referred for a specialist opinion your details will be reviewed, and it may be recommended that you are seen by a hospital clinician. Information to support you in choosing your preferred hospital, including waiting times can be found using the links below.

How long will I wait?

If a hospital assessment and/or treatment is clinically recommended your information will be sent to a specialist. Click below to find out more about waiting times for routine hospital assessment and/or treatment.