Ingrown Toenails: Top Causes and Best Solutions

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It’s a surprisingly common problem—pain, redness, and swelling in one of your toes. This affects both men and women, and happens most often in the big toe.

The Mayo Clinic estimates that ingrown toenails affects over 3 million people! But what caused it?

How do you treat it? And do you need to see a doctor? Here, we jump into all the details.

ingrown toenail treatment

What Is An Ingrown Toenail?

An ingrown toenail (also called onychocryptosis) happens when the corner or the edge of the toenail grows into the soft skin around it.

This happens most commonly because of trauma, such as stubbing your toe, wearing shoes that are too tight, cutting toenails too short, or cutting them at an angle.

Some people are prone to ingrown toenails simply because they have unusually curved toenails or other hereditary conditions.

See more: How to get toenails to grow straight

Common symptoms include pain and tenderness around the nail of your toe, redness in the same area, swelling around the nail, and possibly even an infection at the site. Young children may showcase limping to avoid putting pressure on the painful toe.

Athletes and adolescents are more prone to this condition, as increased perspiration causes the skin and nails to soften. This thin, softened nail can eventually break and pierce the skin, causing the ingrown toenail.

Even people who are not usually prone to them become more susceptible to ingrown toenails after increased activity or traumatic injury to the foot.

Other common causes of ingrown toenails include poor hygiene of the feet, abnormal gait or foot position, putting undue strain on the toes, or even foot or toe deformities such as flat foot, bunions, or hammertoes.

Even abnormally long toes may be more susceptible to this disorder, as it is difficult to find footwear that does not cause pressure on the nail. Diseases that cause foot swelling such as heart, kidney, and thyroid problems, diabetes, or even obesity can also make you more prone to having ingrown toenails.

How to Get Rid of an Ingrown Toenail

To prevent infection, treat this problem as soon as it occurs. Usually, mild cases can be cured at home with some simple remedies, but serious cases may need surgery.

Ingrown toenail treatment is pretty simple, and can be done even without a visit to the pharmacy in some cases.

ingrown toenail
By: Jmarchn (Creative Commons Attribution-Share Alike 3.0 licence)

If left untreated, this simple problem can turn into a major one. If infected, it can lead to bone infections, open sores, or even gangrene.

The warm, moist environment of your feet make ingrown toenails very prone to infectious bacteria and fungi, opening the door for greater problems such as chronic pain, disfigurement, bone infection, and cellulitis.

Occasionally, ingrown toenails will heal without any external treatment, but there are some simple home remedies you can start with in order to ensure this problem does not get any worse.

Home Remedies for An Ingrown Toenail

There are a variety of ways to treat ingrown toenails in the comfort of your own home, and many don’t even require a trip to your local pharmacy.

The first is a simple warm water soak. There are a few options for a warm soak, depending on your preference. For 15-20 minutes, three times a day:

  • One part white vinegar to four parts warm water; or
  • 2 tablespoons Epsom salts to one quart of warm water; or
  • One gallon of warm water to 1/3 teaspoon bleach; or
  • Soak it in apple cider vinegar, but make sure you dry your foot completely afterwards.

While you soak your foot, gently massage the affected area downwards, encouraging the nail and the skin to separate.

You can also apply an antibiotic ointment or cream up to three times daily to reduce infection risks. Bandage the affected area afterwards.

Elevating the leg and foot may also help to decrease the pain and swelling. Over the counter painkillers will help relieve the soreness and may reduce the inflammation as well.

To help pull the nail away from the skin, after you soak your foot, place fresh cotton or dental floss under the ingrown edge of the nail. Make sure you change this daily, otherwise it may allow bacterial growth and increase the risk of infection.

If the nail is too long, trim it straight across the top without digging into the corners.

To help aid the healing process, make sure that you are wearing comfortable shoes and socks that are not too tight. If possible, avoid shoes or wear sandals while your toenail is healing to limit the pressure on your nails.

There are also toe protectors available that wrap around the affected area to help cushion it, and some come with medicated gels to help the healing process.

If none of these help to alleviate the symptoms within a week, it may be time to see a podiatrist.

What To Do About an Infected Ingrown Toenail

What happens if your ingrown toenail becomes worse? Some common signs of infection are increased redness, throbbing pain, increased swelling, pus (this could be yellow, white, or green), warmth in the area, and foul odor.

Sometimes, the pain, redness, and swelling may even spread beyond the area of your nail. If you see these symptoms appear, go and see your doctor, and they may give you a variety of options.

While many doctors can treat ingrown toenails, a podiatrist is best equipped to help you. With infection, they will likely prescribe oral antibiotics.

If it gets too bad, your doctor may want to perform ingrown toenail surgery to remove part or all of the nail after using a local anesthetic. Ingrown toenail removal generally only happens in severe or recurring cases.

ingrown toenail surgery
By: Dr. Harry Gouvas (Creative Commons Attribution-Share Alike 3.0 licence)

If the issue goes too deeply, your doctor may remove not only the nail, but part of the nail bed via chemical, laser, or electronically by destroying part or all of the matrix cells that make up the cell bed. This is uncommon and generally only happens in chronic or recurrent situations, as this can lead to other issues with nail growth and infections.

Luckily, all of these surgeries only require local numbing, so they can be done in a day and there is little effect on walking or driving afterwards, so you can very likely take yourself home.

Typically, recovery from the surgery is very simple; keep the leg elevated for the remainder of the day to reduce swelling, then return to the clinic the following day to have the dressings removed.

Usually, the wound will need to be cleaned and dressed twice a day for one to two weeks to ensure that it is not infected, and open-toed or loose-fitting shoes must be worn to avoid pressure on the injury.

You should also see your doctor right away if you have an ingrown toenail and a compromised immune system, have diabetes or other underlying condition that causes poor circulation, or if you have an allergic reaction to any home remedy.

These conditions can cause complications that may be serious. Be sure that your podiatrist or doctor knows of all of your conditions before you start treatment so that you can work with them to best choose the treatment for you.

Above all, make sure you do not try to perform any kind of surgery on yourself, as this increases the risk of infection and further complications.

The video below shows a simple toenail removal surgery.

How to Prevent an Ingrown Toenail from Recurring

Luckily, ingrown toenails are not a serious condition, just irritating and painful. The best way to prevent it is to wear socks and shoes that fit comfortably and allow your toes enough room to move.

Socks should have plenty of cushion around the toes, and if you work in an environment that has the potential for trauma, wear protective foot gear like steel-toed boots.

You can have your shoes fitted properly at many specialized stores, which is especially important if you have nerve damage or poor circulation in your feet and may not be able to feel if there is too much pressure. Be careful, too, that your shoes are not too loose, as your foot may move around too much and knock against the inside of your shoe.

If you have a foot abnormality, make sure that you have corrective orthopedic shoes to keep from putting undue trauma on your toes. If you are an athlete, make sure you wear sport-specific shoes, as these are designed to support your feet in the best way possible based on the movements you need to make.

Watch where you walk and how you move to avoid stubbing your toes and other toenail trauma. When you trim your nails, trim them straight across and not curved to match the shape of your toe. Trim them no shorter than the tip of your toe, otherwise the pressure from your shoes may push the nail into your skin.

If you are diabetic or have other nerve or circulation problems, check your feet as part of your daily routine to look for any ingrown toenails or any other problems.

If you go to get a pedicure, make sure that you tell them not to curve your nails as well, and that the tools and water they use is clean and sanitized to avoid potential infection and cross-contamination.

Make sure you always treat your ingrown toenails. If left untreated, they may spread an infection into the bone, which can have very serious consequences.

Untreated or poorly treated nails are also more likely to turn into ingrown toenails again. With a little bit of care for your feet, this condition is easily treated and easily prevented.