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An ingrown toenail occurs when the edge of the nail grows down and into the skin of the toe. There may be pain, redness, and swelling around the nail.
Onychocryptosis; Unguis incarnatus; Nail avlusion; Matrix excision
An ingrown toenail can result from a number of things, but poorly fitting shoes and toenails that are not trimmed properly are the most common causes. The skin along the edge of a toenail may become red and infected. The great toe is usually affected, but any toenail can become ingrown.
Ingrown toenails may occur when extra pressure is placed on your toe. Most commonly, this pressure is caused by shoes that are too tight or too loose. If you walk often or participate in athletics, a shoe that is even a little tight can cause this problem. Some deformities of the foot or toes can also place extra pressure on the toe.
Nails that are not trimmed properly can also cause ingrown toenails.
Some people are born with nails that are curved and tend to grow downward. Others have toenails that are too large for their toes. Stubbing your toe or other injuries can also lead to an ingrown toenail.
An examination of the foot will show the following:
Tests or x-rays are usually not needed.
If you have diabetes, nerve damage in the leg or foot, poor blood circulation to your foot, or an infection around the nail, go to the doctor right away. Do NOT try to treat this problem at home.
To treat an ingrown nail at home:
You may trim the toenail one time, if needed. When trimming your toenails:
Consider wearing sandals until the problem has gone away. Over-the-counter medications that are placed over the ingrown toenail may help some with the pain but do not treat the problem.
If this does not work and the ingrown nail gets worse, see your family doctor, a foot specialist (podiatrist) or a skin specialist (dermatologist).
If your ingrown nail does not heal or keeps coming back, your doctor may remove part of the nail.
Sometimes your doctor will use a chemical, electrical current, or another small surgical cut to destroy or remove the area from which a new nail may grow.
If the toe is infected, your doctor may prescribe antibiotics.
Treatment will generally control the infection and relieve pain. However, the condition is likely to return if measures to prevent it are not taken. Good foot care is important to prevent recurrence.
This condition may become serious in people with diabetes, poor circulation, and nerve problems (peripheral neuropathies).
In severe cases, the infection may spread through the toe and into the bone.
Call your health care provider if you:
If you have diabetes, nerve damage in the leg or foot, poor blood circulation to your foot, or an infection around the nail, your risk for complications is higher. If you have diabetes, see your health care provider.
Wear shoes that fit properly. Shoes that you wear every day should have plenty of room around your toes. Shoes that you wear for walking briskly or for running should have plenty of room also, but not be too loose.
When trimming your toenails:
Keep the feet clean and dry. People with diabetes should have routine foot exams and nail care.
Heidelbaugh JJ, Lee H. Management of the ingrown toenail. Am Fam Physician. 2009;79(4):303-8.
Habif TP. Nail diseases. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 25.