Ingrown toenail Maikuku tupu whakaroto

An ingrown toenail happens when part of your nail pierces the skin. This can often lead to infection. If an ingrown toenail is infected the toe will be red, inflamed and painful.

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Causes of an ingrown toenail

An ingrown toenail is typically in the big toe but it can affect other toes. There are a few main causes of ingrown toenails:

  • poorly cut toenails — cutting your toenails too short, or cutting and tearing the nail down into the corners, can cause ingrown toenails
  • the shape of the nail — most toenails lie flat but nails that arch or curve upwards in the middle are more likely to press into the sides of your toe
  • footwear — the style of footwear, including wearing 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
  • activities — lifestyle or sporting activities, including long-distance running, or lots of walking downhill can often cause 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.

If the toe becomes infected:

  • it might be red, inflamed and swollen
  • pus may develop
  • it might be painful to press on the nail.

Self care for an ingrown toenail

If you have poor circulation or diabetes, do not self manage an ingrown toenail — see a podiatrist or other healthcare provider. 

An ingrown toenail will usually improve with self care.

  • Soak the affected toe in warm water for 10 to 20 minutes, 3 times a day for 1 to 2 weeks. Soaking the toe softens the skin around the nail.
  • Starting at the cuticle, use a cotton bud to push the skin at the side of the nail away from the nail.
  • Place a small piece of cotton wool or dental floss under the end of the nail to separate the nail from the skin and stop the nail growing into your skin. Change the cotton wool or dental floss each time you soak your foot.
  • Let the nail grow and cut it straight across and not short at the corners (except if the nail is horseshoe shaped).

When to seek urgent medical attention

Seek urgent medical attention if your toe (or foot):

  • becomes swollen and you can see pus
  • is warm to touch
  • gets more painful
  • is red, and the redness has spread beyond your infected toe and into your foot or leg
  • causes you to feel unwell and have a fever.

This is especially important if you have diabetes or any other condition that reduces your immunity. It may be that you have cellulitis, which can lead to a life-threatening infection of the blood.

Cellulitis

Treating an ingrown toenail

In some cases, you may need to see your healthcare provider or a podiatrist.

Podiatrists specialise in working with the feet and lower leg. They can help you manage an ingrown toenail. They might:

  • carefully cut the ingrown toenail to remove the nail spike (the sharp edge that has grown into the skin) 
  • recommend removing the nail to prevent it happening again 
  • give you advice on the best way to cut your toenails.

Find a podiatrist — Podiatry NZexternal link

Preventing an ingrown toenail

  • Cut your toenails to the shape of the toe — do not round off the corners, as you might do your fingernails.
  • Do not cut your toenails too short.
  • Wear comfortable, well-fitting shoes. They should not be too loose or too tight around your toes.
  • Wash your feet every day and dry them well.

If you have toenails that do not lie flat but arch upwards in the middle you may also need to:

  • remove the corners of the nails to help stop them pressing down into your toes
  • get help from a podiatrist to cut your nails (this type of nail that arches upwards in the middle is more common as you age).