Ingrown Toenail: A Red, Painful Toe, Home Care and When to Be Seen

What it involves

MedlinePlus defines an ingrown toenail as the edge of the nail growing into the skin of the toe. The skin along the nail can turn red and infected, and the big toe is affected most often, though any toenail can become ingrown.

Who this is for

• Patients with a red, swollen, or painful toe beside the nail edge
• Patients who have tried soaking and padding the nail with little relief
• Patients with diabetes, poor circulation, or numb feet who notice any toe problem
• Patients whose ingrown nail keeps coming back

What to expect

• Questions about when the pain began, your shoes, how you trim your nails, and any past toe injury
• A look at the toe for redness, swelling, or drainage, since MedlinePlus says tests or x-rays are usually not needed
• A review of diabetes, nerve, or circulation problems that make toe infections riskier
• A plan that may include antibiotics for an infection, home care guidance, or a referral to a foot specialist

How the nail ends up in the skin

MedlinePlus lists tight or poorly fitting shoes as the most common cause, and toenails trimmed too short or with rounded edges so the nail curls into the skin. Picking or tearing at the corners, stubbing the toe, foot or toe deformities, and naturally curved or oversized nails can also be behind it. People who walk a lot or play sports are more prone, because even a slightly tight shoe presses the toe.

What it feels like

The usual symptoms MedlinePlus names are pain, redness, and swelling around the nail. If the area becomes infected, it may also drain or feel warm. In severe cases MedlinePlus says the infection can spread through the toe and into the bone, which is why a toe that keeps getting worse should not be waited out.

Safe home care

MedlinePlus suggests soaking the foot in warm water 3 to 4 times a day, keeping the toe dry afterward, gently massaging the inflamed skin, and placing a small piece of cotton or dental floss, wet with water or antiseptic, under the nail edge. It also advises wearing sandals until the problem clears. It tells people not to try to cut out the ingrown part themselves, because that usually makes it worse.

When to skip home care

MedlinePlus says people with diabetes, nerve problems in the leg or foot, poor circulation to the foot, or an infection around the nail should contact a provider right away and not treat an ingrown nail at home. The diabetic foot care guide explains why, and the numbness and tingling guide covers loss of feeling in the feet. Pus, spreading redness, or a fever points toward infection, as the cellulitis guide describes.

If it does not settle

MedlinePlus says that if the nail does not heal or keeps coming back, a provider may remove part of the nail after numbing the toe with an injection, a procedure called partial nail avulsion, and the nail takes 2 to 4 months to regrow. Antibiotics may be prescribed if the toe is infected. Nail removal is not among the procedures listed for this practice, so a provider here would refer you to a foot specialist if that step is needed.

Preventing a repeat

MedlinePlus advises shoes with plenty of room around the toes, both for everyday wear and for brisk walking or sports. When trimming, soak the foot briefly in warm water, use a clean, sharp trimmer, and cut straight across without tapering or rounding the corners or cutting too short. Thick or hard-to-reach nails are better trimmed by someone else. Thickened skin from shoe pressure is covered in the calluses and corns guide.

Sources

• MedlinePlus — Ingrown toenail
• MedlinePlus — Nail Diseases