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Toenail - Ingrown

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 Toenail - Ingrown

When to Call for Toenail - Ingrown

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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