Ingrown Toenails 101: Causes, Treatment and Prevention

Emily Boynton Fact Checked
Woman stretches and touches her toes
© Christine Love Hewitt / Stocksy United

Maybe you ordered those new shoes a size too small, cut your nails at a wonky angle or simply stubbed your toe (sigh). 

Whatever the cause, now you have a throbbing, irritated ingrown toenail. 

“Ingrown nails are common and can be extremely problematic, preventing someone from wearing shoes comfortably or performing athletic activities,” says Dr. Cherie Johnson, a board-certified foot and ankle surgeon at the Sports Medicine Clinic at Northwest Outpatient Medical Center. 

While Johnson notes most ingrown toenails will heal on their own in a week or two, that time can feel excruciatingly long if you experience sharp pain with every step you take.  

But fear not: From at-home care and pain relief to prevention tips, Johnson shares how to put a pep back in your step. 

What is an ingrown toenail?

An ingrown toenail occurs when the edge of your toenail grows into the skin, causing irritation and pain when pressure is applied to the toe.

This sore spot can also become infected, leading to redness, swelling and occasionally an odor, drainage or pus, Johnson notes.

In most cases, ingrown toenails — while painful and annoying — are unlikely to cause larger health concerns. 

That said, you should reach out to your doctor if you develop a fever or notice the redness extending up your foot, as these symptoms could indicate a more serious condition.

What causes an ingrown toenail?

A lot of factors can contribute to an ingrown toenail. Pinch-y shoes? Check. Stubbed toe? Check. Picking at your nails? Check plus. 

Diabetes, poor blood circulation and activities that can cause toe injuries (think ballet, soccer or construction work) also increase your likelihood of developing an ingrown toenail. In some cases, the shape of you nail can predispose you for nail problems as well. 

“Ingrown nails are not always preventable,” Johnson says. “They can be hereditary in respect to width or shape of your nails.”

This means if your parents have frequent ingrown toenails, you have a wide nail plate or your toes push against each other and create pressure, you have a higher chance of developing ingrown nails. 

How do you prevent an ingrown toenail?

Finding comfortable, supportive footwear is a great place to start. 

For those who work in environments where they are prone to injury, this may mean wearing steel-toed boots; for others, it might look like giving the pointy-toed flats a rest.

Another essential part of ingrown nail prevention is to avoid picking, prodding and otherwise messing with your toes. 

In contrast, trimming your nails is helpful when done correctly — though Johnson cautions against cutting the nail back too far, as this can lead to the nail digging into the skin and causing irritation.

“It’s best to trim the nails straight across,” she says. “If the corners are a little sharp, gently use a nail filer to soften the edge.” 

If you have a condition like bunions that causes your toes to lean on each other, put a cotton ball or toe spacer in the gap between your toes to prevent them from pressing against each other and creating ingrown nails. 

How do you treat an ingrown toenail at home?

“The best form of treatment is to perform Epsom salt foot soaks in warm water followed by drying well and applying a topical antibiotic and bandage,” Johnson says.

Soak your feet for 10-15 minutes twice a day for the first couple of days, then continue with soaks once a day until your toe heals.

This will not only reduce inflammation and help drain any pus but will also help ease discomfort and sensitivity. In addition to antibiotic cream, you can also apply a non-scented moisturizer afterward to help keep your skin around the nail soft and take acetaminophen as needed to relieve pain. 

As for other at-home remedies or “bathroom surgeries” — like putting dental floss under the nail, olive oil soaks or applying apple cider vinegar — Johnson’s advice is simple: steer clear. 

“There are all sorts of ideas out there that I wouldn’t recommend,” she notes. “Go with what is most effective. You don’t need to get fancy.”

What procedures are available to treat an ingrown toenail?

In some cases, an ingrown nail is unable to heal on its own and instead continues to grow into the surrounding skin. 

Your doctor can help provide relief through a simple surgical procedure that removes the portion of the nail that’s piercing your skin. 

“We perform the procedure with local anesthesia to numb the toe, then remove a portion of the nail,” Johnson says. “Sometimes antibiotics are required, depending on how infected the patient presents.”

It takes about 7-10 days after the procedure for your toe to heal, but once it does, the nail should regrow without causing any further irritation. 

If you repeatedly have ingrown nails, even after the partial removal, your doctor can also perform a matricectomy, a procedure in which they will permanently remove the problematic segment of your nail and then treat the nail root so it doesn’t regenerate. 

While even a small surgery may seem stressful, the procedure is extremely effective in preventing reoccurring ingrown nails, providing you — and your tootsies — some much-needed relief.