Ingrown Toenails

What Is an Ingrown Toenail?

An ingrown toenail (onychocryptosis) occurs when the edge of the nail — most often the big toenail — grows into the surrounding skin rather than over it. As the nail digs into the skin, the tissue becomes red, swollen, and tender. Without treatment, infection can develop and the condition can become significantly more painful.

Causes

• Heredity — some people are born with nails that naturally curve and are prone to growing into the skin; this tendency can be inherited directly from one or both parents
• Improper nail trimming — cutting toenails too short, or rounding the corners rather than cutting straight across, encourages the nail edge to grow into the skin
• Tight-fitting shoes — footwear that compresses the toes forces the nail into the surrounding skin
• Injury to the toe — trauma such as stubbing the toe or dropping something on it can disrupt normal nail growth
• Repeated pressure — activities like running that repeatedly push the toes against the front of the shoe

Symptoms

• Pain and tenderness along one or both sides of the nail
• Redness and swelling around the nail edge
• Skin that feels warm to the touch
• In infected cases: drainage of fluid or pus, and increased pain

Treatment

In-Office Nail Removal

For a painful ingrown toenail, removing the ingrown portion of the nail provides fast, immediate relief from pain and infection. This is a simple in-office procedure performed under local anesthetic — most patients feel dramatic relief before they even leave our office.

Permanent Correction for Recurring Problems

If ingrown toenails recur repeatedly, a portion of the nail and its underlying growth plate can be permanently removed using chemical or surgical treatment. This prevents that section of nail from ever growing back, eliminating the problem permanently.

If the nail is ingrown on both sides, it may be necessary to remove the entire nail and growth plate. In that case, a "false" cosmetic nail will grow in after a few months.

Follow-Up and Wound Care

• If the toe was infected, your doctor may prescribe antibiotics
• For chemical treatment: you can usually get your foot wet the next day; soak and care for the toe as directed
• For surgical correction: keep the foot dry until stitches are removed in approximately 10 days; some minor bleeding is expected