Ingrown toenails explained

What an ingrown toenail is

An ingrown toenail, medically called onychocryptosis, occurs when the side or corner of a nail curves down and grows into the soft skin beside it, or when the skin folds over the nail edge. This causes the nail to dig in, producing pain, redness, swelling, and tenderness along the edge of the toe, most commonly the big toe. As the skin is broken by the nail, bacteria can get in, and the area may become infected, with increased pain, warmth, pus, or bleeding, and sometimes an overgrowth of tissue at the nail edge. Ingrown toenails can affect anyone but are especially common in teenagers and young adults, whose feet may sweat more, and in people whose nails are naturally curved or fan-shaped.

Why they happen

Several everyday factors make ingrown toenails more likely. Cutting toenails too short, or curving the cut around the corners rather than straight across, leaves a spike of nail that can grow into the skin. Tight, narrow, or pointed shoes and socks that squeeze the toes push the skin against the nail. Sweaty feet soften the skin, making it easier for the nail to penetrate, which is why they are common in active young people. An injury, such as stubbing the toe or having it stood on, can also start the problem, as can naturally involuted, or curved, nails and a family tendency. Picking or tearing at toenails rather than cutting them cleanly is another frequent cause. Recognising these triggers helps both in treating a current ingrown nail and in preventing future ones.

Safe self-care

Mild ingrown toenails without infection can often be eased at home. Soaking the foot in warm, slightly salty water several times a day for around fifteen minutes softens the skin and reduces tenderness. After soaking, gently pushing the skin away from the nail edge with a clean finger, without digging under the nail, can relieve pressure. Keep the foot clean and dry, wear loose, comfortable footwear or open-toed shoes to reduce pressure, and use simple pain relief from a pharmacy if needed. Avoid the temptation to cut a notch in the nail or to dig the corner out yourself, as this often makes things worse and risks infection. A community pharmacist can advise on self-care and whether the toe needs to be seen by a GP or podiatrist.

Cutting nails to prevent them

How you cut your toenails makes a big difference to preventing ingrown nails. The key rule is to cut straight across the top of the nail rather than rounding the corners, and not to cut them too short, so the corners sit above the skin rather than digging into it. Use proper nail clippers or nail scissors on clean, dry, or slightly softened nails, and file any sharp edges smooth. Keep feet clean and dry to reduce sweating, change socks regularly, and choose well-fitting shoes with enough room for the toes rather than tight or pointed styles. Avoid picking or tearing at the nails. These simple habits, kept up over time, prevent most ingrown toenails and reduce the chance of a treated one coming back.

When to seek help and diabetes caution

See a GP or podiatrist if the toe becomes infected, with spreading redness, warmth, pus, or increasing pain, if self-care has not helped after a week or two, or if ingrown toenails keep returning. A GP may prescribe antibiotics for an infection, and a podiatrist can carefully remove the offending edge of nail. For stubborn or recurrent cases, a minor operation under local anaesthetic can remove part or all of the nail, sometimes treating the nail root to stop that portion regrowing. People with diabetes, poor circulation, or reduced sensation in the feet should take particular care and seek professional advice early rather than treating an ingrown toenail themselves, because foot infections can become serious more quickly and wounds may heal poorly. Regular podiatry input is often recommended for these groups.