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What is an ingrown toenail?
An ingrown toenail is a toenail that has grown
into the skin instead of over it. This usually happens to the big toe, but it
can also happen to other toes. An ingrown toenail can get infected. It may be
painful, red, and swollen, and it may drain pus. See a picture of an
Anyone can get an ingrown toenail, but adults get
them more than children do. People who have curved or thick nails are more
likely to get an ingrown toenail. This is more common in older adults.
What causes an ingrown toenail?
toenail can have a number of different causes. Cutting your toenail too short
or rounding the edge of the nail can cause it to grow into the skin. Wearing
shoes or socks that don't fit well can also cause an ingrown toenail. If your
shoes are too tight, they might press the nail into the toe and cause it to
grow into the skin.
You can get an ingrown toenail if you hurt
your toe, such as stubbing it. This can cause the nail to grow inward.
Repeating an activity that injuries the nail, such as kicking a soccer ball,
can also cause an ingrown nail.
What are the symptoms?
The main symptom of an ingrown toenail is the
pain from the nail growing into the skin instead of over it. If the ingrown
toenail gets infected, it might be swollen or red, and it might drain pus. The
area around the ingrown toenail is often painful.
How is an ingrown toenail diagnosed?
Your doctor will do a physical
exam to diagnose an ingrown toenail. He or she will look at your toe where the
nail has grown into the skin.
How is it treated?
You can try the following steps at home to relieve
the pain caused by your ingrown toenail and help the nail to grow out
Use these home treatment steps for 3 days. If they do not
help, you might need to see your doctor. Be sure to see a doctor if
your toe gets infected. Your toe might be infected if it hurts more than it did
before you tried the home treatment. Call your doctor if your toe is red, warm,
swollen, or drains pus, or if there are red streaks leading from your
Your doctor might give you antibiotics. If your toenail is
very ingrown, your doctor might suggest minor surgery to remove all or part of
the ingrown nail. He or she may refer you to a podiatrist.
this surgery, the doctor will numb your toe. Then he or she will cut the edge
of the ingrown toenail and pull out the piece of nail. To prevent the nail from
growing into the skin again, your doctor might destroy all or part of the nail
root. This is called ablation. If your doctor removes all or part of your nail
but does not destroy the root, it will begin to grow back within a few months.
After the surgery it is important to take care of your toe so
that it can heal. Your doctor will give you specific instructions to follow. He
or she may tell you to:
How can ingrown toenails be prevented?
You may be able to prevent ingrown toenails by wearing roomy and
comfortable shoes and socks that do not press on your toes. If you work in a
place where your toe might get hurt, wear sturdy shoes such as steel-toed boots
to protect your toes.
Be sure to trim your toenails
properly. You can do this by cutting your toenail straight across, not curved.
Make sure you do not cut your toenail too short. You can also leave your
toenail a little longer at the corners to help it grow over the skin.
If you have
peripheral arterial disease, talk with your doctor
before you trim your own toenails. People with diabetes have a hard time
feeling their toes and might cut themselves without realizing it. Peripheral
arterial disease can cause toes to be very painful.
hospitals and health care centers have foot care clinics, where someone can
help you trim your toenails. Ask your doctor to recommend a foot care clinic
near your home.
Other Works Consulted
Frey C (2005). Ingrown toenail section of Foot and
ankle. In LY Griffin, ed., Essentials of Musculoskeletal Care, 3rd ed., pp. 651–654. Rosemont, IL: American Academy of
Mann JA, et al. (2003). Disorders of the toenails
section of Foot and ankle surgery. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 3rd ed., pp. 483–485. New York:
Melio FR (2004). Onychocryptosis (ingrown toenail)
section of Soft tissue problems of the foot. In JE Tintinalli et al., eds.,
Emergency Medicine: A Comprehensive Study Guide, 6th
ed., p. 1802. New York: McGraw-Hill.
October 7, 2012
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & H. Michael O'Connor, MD - Emergency Medicine
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