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Ingrown Toenail

Is this your symptom?

  • The corner of the toenail grows into the skin around it
  • Almost always involves the big toe (great toe)

Symptoms of an Ingrown Toenail

  • Toe pain from sharp corner of toenail cutting into surrounding skin.
  • Redness and swelling around the corner of the toenail is usually present.
  • The area may drain pus or yellow fluid.
  • The red area is very tender to touch. Pressure from wearing a shoe may make it worse.
  • Some people with an ingrown toenail can barely walk.

Cause of an Ingrown Toenail

  • The toenail is usually pushed into the skin by wearing tight shoes.
  • The tiny cut made by the nail allows bacteria to enter the skin. The cut then becomes infected.
  • The sharp corner of the buried nail keeps growing. The deeper it goes, the more painful it becomes.

When to Call for Ingrown Toenail

When to Call for Ingrown Toenail

Call Doctor or Seek Care Now

  • You have a fever and spreading red area from your toenail
  • Spreading red area or red streak that's very large
  • Severe pain not getting better 2 hours after pain medicine

Contact Doctor Within 24 Hours

  • Spreading red area or streak, but no fever
  • Entire toe is red and swollen
  • Pus pocket (yellow or green) seen in skin around toenail or under toenail. Reason: needs to be drained.
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Can't locate and free up corner of toenail
  • After using Care Advice more than 2 days, pus is not gone
  • After using Care Advice more than 3 days, still hard to walk
  • After using Care Advice more than 7 days, not improved
  • After using Care Advice more than 14 days, not gone
  • Ingrown toenails are a frequent problem
  • You have other questions or concerns

Self Care at Home

  • Minor ingrown toenail

Call Doctor or Seek Care Now

  • You have a fever and spreading red area from your toenail
  • Spreading red area or red streak that's very large
  • Severe pain not getting better 2 hours after pain medicine

Contact Doctor Within 24 Hours

  • Spreading red area or streak, but no fever
  • Entire toe is red and swollen
  • Pus pocket (yellow or green) seen in skin around toenail or under toenail. Reason: needs to be drained.
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Can't locate and free up corner of toenail
  • After using Care Advice more than 2 days, pus is not gone
  • After using Care Advice more than 3 days, still hard to walk
  • After using Care Advice more than 7 days, not improved
  • After using Care Advice more than 14 days, not gone
  • Ingrown toenails are a frequent problem
  • You have other questions or concerns

Self Care at Home

  • Minor ingrown toenail

Care Advice

  1. What You Should Know about Ingrown Toenails:
    • Ingrown toenails are always painful.
    • Pain is caused by the sharp toenail edge cutting into the skin around it.
    • The pain can be stopped. Find the toenail corner and lift it out of the raw tissue.
    • This will allow the area to heal.
    • Most ingrown toenails can be treated at home. Surgery or nail removal is rarely needed.
    • Here is some care advice that should help.
  2. Warm Water Soaks:
    • Soak the toe in warm water and soap for 20 minutes twice a day.
    • While soaking, massage the swollen part of the cuticle (skin next to the nail). Massage away from the nail.
    • While soaking, also try to bend the corners of the toenail upward. Use your fingernail to lift it.
    • Dry the toe and foot completely.
  3. Raise Corner of Toenail with Dental Floss:
    • Goal: to help the toenail corner grow over the cuticle, rather than into it.
    • The area won't heal until you expose the corner of the nail.
    • Often you can lift it with your fingernail.
    • If not, take a short strip of dental floss or fishing line. Try to slip it under the corner of the nail. Then, gently lift the nail upward. Cut off any sharp edge.
    • Take a small wedge of cotton from a cotton ball. Try to place the wedge under the nail corner to keep it raised. Sometimes this step is not possible.
    • Raise the corner away from the cuticle with every soak.
  4. Antibiotic Ointment:
    • After each soak, use an antibiotic ointment (such as Polysporin). Put it on the swollen part of the toe.
    • You can buy this ointment without a prescription.
  5. Taking Pressure Off Toenail with a Foam Pad or Cotton Ball:
    • Until it heals, try to wear sandals or go barefoot.
    • When you must wear closed-toe shoes, protect the ingrown toenail as follows:
    • Inner Edge of Toe. If the inner edge of the big toe is involved, try this: Tape a cotton ball or foam pad between the lower part of the first and second toes. This will keep the upper toes from touching.
    • Outer Edge of Toe. If the outer edge is involved, use a cotton ball. Tape it to the outside of the affected toe, but lower than the painful area.
    • This will keep the toenail from touching the side of the shoe.
    • Weather-stripping from a hardware store makes the best foam pad. Reason: has adhesive on one side.
    • Never wear tight, narrow, or pointed shoes.
  6. Pain Medicine:
    • To help with the pain, take an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil). Ibuprofen works well for this type of pain.
    • Use as needed, but do not take more than the maximum recommended dosage as stated on the package.
    • If you are not sure what to take, ask a pharmacist.
  7. Prevention - Nail Trimming:
    • Cut you toenails straight across, so you can see the corners. Use a nail clipper.
    • Do not round off the corners. Keep the corners visible.
    • Do not cut them too short.
    • After baths or showers, the nails are soft. Bend the corners of the toenails upward.
  8. Prevention - Wear Shoes That Fit:
    • Make sure that your shoes are not too narrow. Give away any pointed or tight shoes.
    • Tight narrow shoes are the most common cause of ingrown toenails.
    • Shoes should have a wide toe box. The toes should not feel cramped.
  9. What to Expect:
    • With treatment, the pus should be gone in 48 hours.
    • Pain should be gone in 1 week.
    • The area should be healed up in 2 weeks.
  10. Call Your Doctor If:
    • Spreading redness or fever occur
    • Pus pocket occurs
    • Not improved after 7 days
    • You think you need to be seen
    • Your symptoms get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2000-2023. Schmitt Decision Logic LLC.

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