An ingrown toenail is one of the most common foot problems affecting people of all ages. While it may start as a minor irritation, an untreated ingrown toenail can become increasingly painful and even lead to infection. Fortunately, most cases are preventable, and early treatment can help you avoid unnecessary discomfort and complications.
Whether you've noticed redness around your big toe, are dealing with recurring ingrown toenails, or simply want to learn how to keep your feet healthy, this comprehensive guide covers everything you need to know. We'll explain what causes ingrown toenails, how to recognise the symptoms, treatment options available, and practical steps you can take to prevent them from coming back.
An ingrown toenail occurs when the edge or corner of a toenail grows into the surrounding skin instead of growing straight out over the tip of the toe. As the nail presses into the skin, it causes irritation, inflammation, and pain. If left untreated, bacteria can enter the damaged skin and lead to an infection.
Although an ingrown toenail can affect any toe, it most commonly develops on the big toe because it experiences the greatest amount of pressure from walking, running, and wearing shoes.
A healthy toenail grows forward in a relatively straight line. However, certain factors can cause the nail edge to dig into the surrounding skin. As the nail continues to grow, it acts like a small splinter beneath the skin, triggering inflammation and discomfort.
Initially, you may notice mild tenderness along one side of the nail. Over time, the skin can become swollen, red, and increasingly painful. In more advanced cases, infection may develop, producing drainage or excess tissue around the nail.
Recognising the early signs of an ingrown toenail can help you seek treatment before the condition worsens.
Early stage:
In the early stages, symptoms are usually mild and limited to the affected side of the nail.
Common signs include:
Moderate stage:
As the nail continues to grow into the skin, inflammation becomes more noticeable.
You may experience:
Advanced stage:
If bacteria enter the broken skin, an infection can develop.
Signs that may indicate an infected ingrown toenail include:
If you have diabetes, poor circulation, or a weakened immune system, it's extra important to seek medical attention promptly if you suspect an ingrown toenail, as infections may become more serious.
Ingrown toenails rarely develop because of a single cause. More often, several contributing factors increase the likelihood of the nail growing into the surrounding skin.
One of the most common causes is cutting toenails incorrectly.
Many people cut round the corners of their toenails to match the shape of the toe. While this may look neat, if done excessively round, it encourages the nail edge to grow into the surrounding skin as it grows back.
Similarly, cutting toenails too short leaves less nail extending beyond the skin, making it easier for the surrounding tissue to fold over the nail edge.
A best practice would be to have your toenails trimmed straight across, leaving the corners visible rather than cutting them away.
Shoes that squeeze the toes place constant pressure on the nail and surrounding skin.
Common examples include:
Tight shoeboxes often cause continuous pressure that can gradually force the nail into the skin, particularly during walking or running.
Trauma can alter the way a toenail grows.
Examples include:
Even seemingly minor injuries may change the nail's growth pattern over time.
Certain sports and occupations place repeated stress on the toes.
People who regularly participate in activities such as:
Some people inherit nails that naturally curve more than average. These nails are more likely to curl into the surrounding skin, even with proper nail care.
If ingrown toenails run in your family, genetics may play a significant role.
Feet that remain moist for long periods soften the surrounding skin, making it easier for the nail edge to penetrate the tissue.
People who wear enclosed shoes for long hours or experience excessive sweating may therefore be at greater risk.
Thickened or distorted nails can change the direction in which the nail grows.
Conditions such as fungal nail infections may increase the likelihood of the nail pressing into the surrounding skin.
Some health conditions make ingrown toenails more likely or increase the risk of complications if they occur.
These include:
Individuals with these conditions should avoid attempting to remove an ingrown toenail themselves and should seek professional assessment if symptoms develop.
Home treatment may be appropriate for mild ingrown toenails that are not infected. The goal is to reduce inflammation, relieve pressure, and prevent the condition from worsening. Here are some ways you can go about treating your mild ingrown toenails at home.
Foot Soaks
Soaking the affected foot in warm water for 15 to 20 minutes, three to four times a day, can help soften the surrounding skin, reduce discomfort, and keep the area clean. Some people choose to add Epsom salts to the water, although warm water alone is generally sufficient for soaking.
Keep the Toe Clean and Dry
After soaking, dry the toe thoroughly and keep it clean throughout the day. Avoid prolonged moisture, as damp skin is more vulnerable to irritation and infection.
Wear Footwear That Reduces Pressure
Choose shoes with a wide toe box or wear open-toed footwear when possible. This helps reduce pressure on the affected toe can help minimise pain and prevent the nail from digging further into the skin.
Avoid Digging Into the Nail
Yes we understand, it can be tempting to "dig" at the nail or cut away the painful corner of the nail yourself. B ut using sharp objects to dig beneath the nail often pushes the nail deeper into the skin, exposes the area to infection and might even cause additional injury.
The most appropriate treatment depends on the severity of the ingrown toenail and the effectiveness of remedies used. In most cases, ingrown toenails often keeps coming back.
Your podiatrist will assess your condition and recommend the most suitable treatment, which may include:
Although some mild ingrown toenails improve with home care, professional treatment is recommended if symptoms become more severe or fail to improve.
You should see a podiatrist if:
Early treatment is often simpler, less painful, and may help prevent infection or the need for more extensive procedures.
At East Coast Podiatry, we utilise scientifically proven methods of analysis combined with thorough examination and personalised care of each patient. We believe in addressing the root problems causing the issues instead of just symptom relief.