HealthInfo Waitaha Canterbury
Ingrown toenail
Maikuku tupu whakaroto
An ingrown toenail (onychocryptosis) happens when part of your nail pierces the skin. This can often lead to infection.
How bad an ingrown toenail is can vary. Usually, the side of the nail penetrates (curves down) and it's difficult to see the edge of the nail. In some cases, the corner or a small spike of nail can penetrate the skin, which can result in an infection.
If an ingrown toenail is infected the toe will be red, inflamed and painful.
Causes of ingrown toenails
Lots of things can cause ingrown toenails:
Poor nail trimming (a very common cause)
Trimming or tearing down the sides of your toenail can cause an ingrown toenail. Leaving a sharp corner also puts pressure on your skin.
The shape of the nail
A curved nail is more likely to become an ingrown toenail than a flat one. The shape of your nails is usually inherited, but it can be influenced by trauma or shoe pressure.
Shoe pressure
Tight footwear is more likely to increase pressure between the nail and the skin in the nail fold.
Trauma
Injury can change the shape of the nail.
Toe pressure
Pressure from the toe next to the nail that is ingrown can be a cause.
A plump toe
If you have a plump toe or your feet swell, you're more prone to ingrown toenails.
Symptoms of an ingrown toenail
Pain is the main symptom of an ingrown toenail. It usually starts as minor discomfort and increases to pain.
Your toe is not necessarily infected, but this can develop after the nail breaks the skin to become ingrown. The infection can spread, making the toe red and inflamed (paronychia). Pus may also develop, and large growths of skin can develop if the ingrown toenail is left for too long.
Important
If your toe is swollen or painful, the redness has spread beyond your toe and into your foot or you're feeling unwell, you'll need urgent medical attention for Cellulitis.
Preventing an ingrown toenail
Take the following steps to prevent ingrown toenails:
- Cut your toenails to the shape of the toe. This can be difficult if the nail is very curved down the side. In this case do not dig down the sides.
- Avoid wearing shoes and socks that are too tight.
- Keep your feet clean to prevent the ingrown nail from becoming infected.
- If you have poor circulation or diabetes, do not self-manage ingrown toenails. See a podiatrist.
Other advice:
- It's a myth that a V should be cut in the end of the nail to treat an ingrown toenail.
- The shape of the nail is determined by the growing area at the base of the toe, not the end.
Self-care for an ingrown toenail
- Soak the toe in water for 10 minutes to soften the folds of skin around the affected nail.
- Then, using a cotton wool bud, push the skin fold over the ingrown nail down and away from the nail. Do this starting at the root of the nail and move the cotton wool bud towards the end of the nail.
- Repeat each day for a few weeks, allowing the nail to grow.
- As the end of the nail grows forward, push a tiny piece of cotton wool or dental floss under it to help the nail grow over the skin, not into it. Change the cotton wool or dental floss each time you soak your foot.
- Do not cut the nail but allow it to grow forward until it's clear of the end of the toe. Then cut it straight across and not rounded off at the end.
Getting help for an ingrown toenail
A podiatrist can help with an infected nail and in many cases can remove an ingrown toenail without surgery or too much pain. If needed, they will recommend minor surgery and, in some circumstances, refer you to your general practice team for medication. Many general practices can also help with infected nails and ingrown toenails.
If you have diabetes, it's important to get any foot problems treated quickly as sometimes seemingly minor things can progress to cause serious problems. If you have diabetes and there is any sign of infection (increasing redness, swelling, pus, pain or feeling unwell), seek medical attention urgently. If your doctor refers you to a podiatrist because you have diabetes, podiatry treatment could be publicly funded.
Written by Podiatry NZ. Adapted by HealthInfo clinical advisers. Last reviewed April 2023.
SourcesReview key: HICCA-28239
