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Ingrown Toenail: Causes, Symptoms, Treatment, and Prevention

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An ingrown nail is a condition in which the nail grows inside. Learn causes, symptoms, treatment, and when to see a doctor.

Written byDr. Chithranjali Ravichandran

Medically reviewed byDr. Kartikay Aggarwal

Published At May 3, 2022
Reviewed AtJune 5, 2026

What Is an Ingrown Toenail?

A toenail often grows straight out over the skin. The nail edge curls and presses into the surrounding skin when a toenail becomes ingrown. In addition to causing pain, swelling, redness, and infection, this can irritate the skin.

One or both sides of the nail may be affected. Because it experiences the most pressure when walking or wearing shoes, the big toe is most frequently impacted.

Toenail Anatomy

Knowing the fundamental components of the toenail could help to explain why ingrown toenails occur.

Principal Components of the Toenail

  • Nail Plate: The hard, visible portion of the nail.

  • Nail Fold: The skin that surrounds the nail edges.

  • Nail Bed: The skin beneath the nail where it rests.

  • Cuticle: The thin layer of defense close to the nail's base.

The matrix, or nail-producing root area, is a deeper region from which the nail grows. There are two components to the matrix:

  • Germinal Matrix: The majority of the nail is produced.

  • Sterile Matrix: Aids in the nail's growth.

The nail edge may penetrate the skin rather than grow outward if the nail curves excessively or if the surrounding skin presses against it.

How Common Is It?

Two out of every ten people who see a doctor for a foot problem go in for an ingrown toenail. It is one of the most common nail conditions in general practice and orthopedic clinics.

Ingrown toenails affect all age groups but are most common in teenagers and young adults. Men are affected more often than women, partly because male nails tend to be thicker and wider.

Ingrown Toenail Causes

An ingrown toenail can result from a number of factors.

  • Inappropriate Nail Cutting: An excessively short nail or a deeply rounded nail might push the nail into the skin.

  • Shoes That are Too Tight: Steel-toed shoes, sports shoes, high heels, and narrow shoes can crush the toes and put more pressure on the nail.

  • Damage: The nail may be harmed by frequent sports injuries, dropping large things, or stubbing the toe.

  • Curved Nails: Naturally curved or fan-shaped nails are more likely to grow inward in some people.

  • Fungal Infection of the Nails: A fungal infection can cause nails to become thick, twisted, and difficult to cut correctly.

Risk Factors

Certain groups are more likely to develop ingrown toenails.

  • Teenagers, especially those with sweaty feet, are at higher risk. Sweat softens the skin and makes it easier for the nail to penetrate.

  • Athletes in running sports, such as football or soccer, are prone because the toe repeatedly hits the front of the shoe.

  • People with diabetes are at particular risk. Reduced sensation means the nail may go unnoticed until it is already infected.

  • People with poor circulation, including those with peripheral artery disease or chronic venous insufficiency, heal more slowly and are prone to complications.

  • Older adults often have thicker, harder nails that are more difficult to cut correctly.

  • Patients on certain medications, such as Isotretinoin or Indinavir, may develop nail changes that increase the risk.

Symptoms

Symptoms may range from mild discomfort to severe infection.

Early Symptoms

  • Redness at the site.

  • Pain in the area near the nail.

  • Swelling.

  • Walking becomes difficult.

Advanced Symptoms

  • Severe throbbing pain.

  • Bleeding.

  • Difficulty wearing shoes.

  • Pus formation.

  • Skin overgrowth around the nail.

What Are the Symptoms of an Infected Ingrown Toenail?

An infected ingrown toenail may become more painful and swollen.

Signs of infection may include:

  • Yellow or white pus.

  • Increased redness.

  • Warm skin around the toe.

  • Swelling that spreads.

  • Bad smell.

  • Bleeding.

  • Fever in severe infection.

If ignored, the infection may spread deeper into the skin or surrounding tissue.

What Does an Ingrown Toenail Look Like?

In the early stages, the toe looks mildly red and swollen at one corner. The nail edge may be barely visible beneath the skin fold.

As it worsens, the skin folds tightly over the nail edge and becomes visibly inflamed. A white or yellow discharge may appear near the nail groove.

In chronic or severe cases, a dome-shaped mass of red, moist tissue grows alongside the nail. This is hypergranulation tissue, not a tumor. The body produces it while trying to heal a wound that never fully closes.

When to See a Doctor?

Home care works for mild and early cases in healthy individuals. See a doctor if the pain is getting worse after two to three days of home treatment. Do not neglect if there is

  • Pus or spreading redness.

  • Swelling extends beyond the nail fold.

  • Fever.

  • Diabetes or any condition that reduces blood flow to the feet.

  • Immunocompromised.

  • Third or fourth episode on the same toe.

Diabetic patients should not attempt home treatment at all. Nerve damage can mask how serious a foot injury is. See a doctor at the first sign of any foot problem.

Diagnosis

A doctor usually diagnoses an ingrown toenail by examination alone. No tests are needed for a straightforward case. Additional tests may be ordered when needed.

  • A bacterial culture is used if the infection does not respond to standard antibiotics. It identifies the exact organism and its antibiotic sensitivity.

  • A fungal culture or nail clipping for microscopy is ordered when the nail looks thickened or discolored. Treating a fungal infection alongside an ingrown nail reduces recurrence.

  • An X-ray is taken in severe or long-standing cases to check for bone involvement or a bony spur under the nail that causes it to curve.

Recurrent cases may be referred to an orthopedic surgeon or podiatrist for a full foot and ankle assessment.

What Are Treatment Options?

1. Home Treatment

Home care for mild cases only:

Soak the foot in warm water for 15 to 20 minutes, three to four times daily. This softens the skin and reduces discomfort. After soaking, gently lift the nail edge with a thin piece of clean cotton or dental floss and tuck it under the nail to encourage it to grow above the skin fold.

Apply an antiseptic and cover with a clean bandage. Wear open-toed or wide-fitting shoes until symptoms improve. Acetaminophen or ibuprofen reduces discomfort.

Do not cut the nail in a V-shape or try to dig it out. These are common myths, and they make the problem worse.

A doctor may prescribe oral antibiotics if there is an infection. Topical antibiotics alone are usually insufficient for established infections. Phenol matrixectomy, applying carbolic acid to destroy a strip of nail matrix, is sometimes done in a clinic setting to prevent regrowth along the problem edge without full surgery.

2. Surgical Options

Surgery is recommended for infected cases, recurrent ingrown nails, or when conservative care has failed. All procedures use a local anesthetic. The toe is numb within minutes, and the procedure is not painful.

  • Partial Nail Avulsion: It removes the offending edge of the nail about 3 to 4 mm from one side. The remaining nail looks normal. This is the most common first surgical option.

  • Partial Nail Avulsion with Matrixectomy: It removes the nail edge and destroys the underlying matrix cells, usually with phenol, so that strip never regrows. This is recommended for recurrent cases and reduces recurrence from roughly 70% to under 15%.

  • Complete Nail Plate Avulsion: It removes the entire nail. It is used when the whole nail is diseased or severely distorted. The nail regrows over several months unless matrixectomy is also performed.

  • Permanent Nail Removal or Total Matrixectomy: It destroys the entire nail and matrix. No nail regrows. It is reserved for severe recurrent disease or patients who cannot tolerate any nail pressure.

If the nail matrix is not fully destroyed, the nail will regrow. In some cases, it grows back thickened or deformed. Your surgeon will explain this risk before the procedure.

3. Recovery and Nail Regrowth

  • After a partial nail avulsion, most patients return to normal footwear within one to two weeks. The toe stays tender for a few days. A small amount of discharge from the wound is normal for up to two weeks.

  • A full toenail takes 3 to 4 months to regrow completely. The "about a week" figure sometimes quoted refers to wound healing, not nail regrowth. These are two different things.

  • After total matrixectomy, there is no regrowth from the treated area.

  • Keep the dressing dry for the first 48 hours. Elevate the foot when sitting. Wear open sandals or loose shoes for the first one to two weeks. Return for a follow-up dressing change at 48 to 72 hours.

How to Prevent Ingrown Toenails?

Most ingrown toenails are preventable with correct trimming technique and sensible footwear.

Cut nails straight across. Do not round the corners. Cut nails level with the tip of the toe, not shorter. Use proper nail scissors or straight-edged clippers. Cut nails when they are dry, not right after bathing, when they are soft and may tear unevenly.

Wear shoes with a wide toe box. Athletes in running, football, or martial arts should make sure sports shoes have at least a thumb-width of space beyond the big toe. Steel-toed footwear protects against repeated impact to the nail. Avoid socks that bunch at the toes.

Diabetic patients should inspect both feet every day, top, bottom, and between toes. Use a mirror or ask a family member if needed. Report any redness, swelling, or skin break to a doctor right away without waiting.

Patients with poor circulation should apply a urea-based foot cream regularly to prevent dry, cracked skin that worsens nail problems.

Outlook

Most ingrown toenails improve with proper treatment. Mild cases may heal quickly with home care. Severe infections may need procedures or surgery. Some people may develop repeated ingrown nails if trimming habits or footwear problems continue. Early treatment usually gives good results and may help avoid complications.

Questions to Ask Your Healthcare Provider

  • Is my toenail infected?

  • Do I need antibiotics?

  • Will I need surgery?

  • Which nail procedure is best for me?

  • How long will healing take?

  • Will the nail grow back normally?

  • Can this happen again?

  • What type of footwear should I use?

Conclusion:

Ingrown toenails are a frequent problem that can cause pain if left untreated. It is possible to avoid any further problems if proper attention is given in early stages. Appropriate clipping of the nails, proper footwear, and clean feet may minimize this problem to a great extent. For more severe cases, it might require some medical treatment. Those who have diabetes or other such conditions need to be extra cautious.

If swelling, pain, or discharge continue despite home treatment, it is always better to consult a skin specialist early.

Key Takeaways

  • Ingrown toenails usually happen due to improper nail trimming, tight shoes, or repeated toe pressure.

  • Early treatment with proper foot care may help prevent infection and severe pain.

  • Persistent swelling, pus, bleeding, or difficulty walking should be evaluated by a doctor.

  • Cutting nails straight across and avoiding tight footwear may reduce the risk of recurrence.

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Frequently Asked Questions

Ingrown toenails can be prevented by avoiding cutting the nails too short, maintaining moderate length, trimming the nails straight, wearing proper-fit shoes, and maintaining foot hygiene. Diabetes patients should have a check on their foot condition often.
Ingrown toenails can be treated at home by soaking the feet in warm salt water for 15 to 20 minutes, three to four times a day. Soaking can reduce swelling and alleviate pain. Otherwise, one can seek the physician's help to fix ingrown toenails.
You may get an ingrown toenail if you cut your toenails too short, wear tight-fitting shoes, injure the toenails, put repetitive pressure on the foot, and do not maintain foot hygiene. Birth defect, familial history, and fungal infection may also cause ingrown toenails.
An ingrown toenail happens when the edges of the toenails break and grow into the skin, causing swelling and pain. The pressure exerted on the nail or the cut shape may direct the toenails to grow towards the skin instead of over the skin.
One of the most common reasons for toenails is cutting them too short or curved according to the toe shape. Sometimes, if you put repetitive pressure or often injure the toenail, you may keep getting ingrown toenails.
The pain associated with ingrown toenails can be relieved with a simple home remedy like soaking the feet in warm water for some time, applying numbness, or anti-bacterial cream. In addition, one should wear loose shoes till the symptoms subside.
Doctors may prescribe topical creams to reduce pain and prevent infection. If the symptoms worsen and restrict you from walking, doctors may opt for surgical removal of the nail, partially or totally, depending on the condition.
Over-the-counter pain killers may cease the pain as soon as possible. But it will be a temporary solution until the ingrown toenail is rectified. Keep the foot moistened, and place a small piece of cotton or floss under the ingrown edge to redirect the nail from growing over the skin.
In a rare case, the ingrown toenail can come out and grow normally. But it is better to treat them as ingrown toenails are associated with painful complications if left untreated. The treatment follows simple home care to rectify and prevent the occurrence of ingrown toenails.
The untreated toenail may lead to a foot ulcer, infection, and nail inflammation (paronychia). The inflammation may further lead to serious complications like cellulitis (bacterial skin infection, osteomyelitis (bone infection), systemic infection, and sepsis.
With proper home care or professional help, the ingrown toenail can be brought out of the skin, and the new nail begins growing over the skin in about two to twelve weeks. Once the toenail is out of the skin and the pain starts to alleviate.
When the symptoms worsen or do not improve on home treatment, and the pain restricts one from doing any movements or walking, you should start seeking a professional’s health. And it is also a concern if there is any bleeding or signs of infection.
The UV radiation from the sunlight can be unfavorable for the growth of fungi, lingering on the surface of the skin that is directly exposed to sunlight. Hence, sunlight can be added on with other cares to treat toenail fungus.
Usually, toenail surgery will be performed under local anesthesia on an outpatient basis, and hence you will not feel any pain during surgery. Once the anesthesia wears off, you may have little discomfort and pain, which will subsequently reduce overtime.
Toenail surgeries are painless during the procedure due to numbness from local anesthesia. After surgery, you will be prescribed antibiotics and pain killers to avoid infections and pain. The symptoms will diminish significantly down the lane.
Matixectomy (nail removal) is a surgical procedure done partially or totally to remove the ingrown toenail permanently. Sometimes, the nail matrix can be destroyed with a chemical to prevent the regrowth of the toenail.
Yes, one can walk after ingrown toenail surgery. It is a minor outpatient surgical procedure that will completely heal in a week. Hence one can resume all their normal activities within two days of toenail surgery provided following the post-treatment precautions.
The swelling of the feet during pregnancy is normal due to excess fluid collection. But, the shoes that you wear on the swollen foot may cause pressure over the nail, which causes the nails to curve and grow towards the skin. It is better to wear shoes or sandals with loose-fitting and open toes.
You may be applying extra pressure or repetitive stress on the toenails with your recent activities. It may be from your new ill-fitting shoes, sports involving feet, or any other medical condition. Trimming the nails curve or toot short may also be the reason.
Yes, ingrown toenails can go back to normal and grow over the skin with proper home care or professional treatment. Excess precautions should be taken after the treatment to prevent the reoccurrence of an ingrown toenail.
Cutting the nail too short or trimming them in shape to match the curvature of the toe tips are the main cause of ingrown toenails. Pressure over the toenails, congenital defects, and genetic predisposition are the other reasons for the ingrown toenails.
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