Ingrown Toenails: Causes, Symptoms, and Treatment

When the corners or the edges of the nail grow into the skin, an ingrown toenail occurs.

When not infected, ingrown toenails will often respond to home remedies.

However, when there is an infection or when the toenail has pierced the skin, seeking medical treatment is often recommended.

Depending on the severity, treatment approaches can range from conservative treatments to ingrown toenail surgery.


What are the common causes of ingrown toenails?

While the development of an ingrown toenail can be attributed to a variety of factors, below are some of the most prevalent causes of the condition:

  • Cutting the toenails incorrectly (ideally, it should be cut straight across)
  • Curved toenails
  • Footwear that is too tight, too flat, or too narrow
  • Injuries
  • Lack of foot hygiene

What are some of the symptoms of ingrown toenails?

In its early stage, common ingrown toenail symptoms can include:

  • Pain (especially when there is pressure on the toe)
  • Swelling and tenderness of the skin next to the affected nail
  • Fluid build-up around the affected toe

When ingrown toenails become infected, symptoms that will manifest can include:

  • Swelling
  • Redness
  • Bleeding
  • Skin overgrowth around the affected area
  • Pus

How is the condition diagnosed?

In most cases, a physical examination would suffice when diagnosing the condition.

However, when there is an infection, an X-ray might be required. An X-ray may also be recommended when:

  • The pain is severe
  • The ingrown toenail is caused by injury
  • The patient has a history of chronic infections

What are the treatment options available?

For mild cases that do not require ingrown toenail surgery, home remedies are recommended.

Below are some of the ways you can treat mild cases of ingrown toenails at home:

  • Soak the affected toe in a warm salt water bath twice a day (for at least 15 minutes each time). Soaking can help reduce both the swelling and the pain.
  • Make sure the foot is always kept dry.
  • To relieve pain, taking over-the-counter pain medications (i.e. ibuprofen, acetaminophen) is recommended.
  • Separate the skin and the ingrown toenail by stuffing a tiny piece of clean and moist cotton (soaked in antiseptic) in between.
  • Put antibiotic ointment on the affected area to minimize the risk of developing infections.
  • Cover the affected area with bandage or Band-Aid for padding and protection.
  • Wear footwear that is easy on the toes. Sandals and shoes made from soft fabrics would be a good choice.
  • Inspect the affected toe every now and then so signs of infection (redness, pain, swelling, and pus) can be detected right away.

When the condition does not respond to conservative treatment approaches, ingrown toenail surgery will likely be recommended.

Partial nail removal – only the piece of nail that is digging into the skin is removed. Statistics show that the procedure is considered 98 percent effective as far as preventing ingrown toenail from recurring is concerned.


A compound called phenol may also be used on the affected area to keep the nail from growing back.

Total nail removal – this is often the procedure done when the ingrown toenail is caused by thickening. A local pain injection is administered and the entire nail is removed.

What can you expect after surgery?

After surgery, patients will be sent home with a bandaged toe. Raising the affected foot for a day or two will also be recommended. Bandage is often removed after a day or two. Saltwater soaks will also be recommended until the toe is healed. Antibiotics and pain medications are also prescribed to ease the pain and prevent infection.