Ingrown Toenail (Excised)

An ingrown toenail occurs when the nail grows sideways into the skin next to the nail. This can cause pain and may lead to an infection with redness, swelling, and sometimes drainage.

The most common cause of an ingrown toenail is trimming your toenails wrong. Most people trim the nails too close to the skin and try to round the nail too tightly around the shape of the toe. When you do this, the nail can grow into the skin of the toe. While it may look nice, your toenail can grow into the skin and cause infection. It's safer to trim the nail to end in a straight line rather than a curve.

Other causes include injury or wearing shoes that are too short or tight. This can cause the same problem that happens when trimming your toenails. Sometimes you are born with a toenail that grows too large for your toe.

The most common symptoms of an ingrown toenail include:

  • Pain

  • Redness

  • Swelling

  • Drainage

It's important to treat an ingrown toenail as soon as you notice there is a problem. If the infection is mild, you may be able to take care of it at home. Home care includes:

  • Frequent warm water soaks

  • Keeping the nail clean

  • Wearing loose, comfortable shoes or open toe sandals

Another method to help the toe heal is to use a small piece of cotton or waxed dental floss to gently lift the corner of the problem nail. Change the cotton or floss frequently, especially if it gets dirty.

If your infection is mild but home care isn't working, or the toenail is getting worse, see your healthcare provider. Signs of worsening infection include:

  • Swelling

  • Redness 

  • Pus drainage

  • Pain gets worse

In some cases, part of the toenail needs to be removed by your healthcare provider so that the infection can be drained.

If there is a lot of redness and swelling, then an antibiotic may also be used. The redness and pain should go away within 48 hours. It will take about 2 weeks for the exposed nail bed to become dry and for the swelling to go down.

If only the side of the nail was removed, it will start to grow back in a few months. To prevent recurrence, sometimes the side of the nail bed may be treated with a strong chemical to prevent the nail from growing back.

Home care

Wound care

  • Twice a day for the first 3 days, clean and soak the toe as follows:

    • Soak your foot in a tub of warm water for 5 minutes. Or hold your toe under a faucet of warm running water for 5 minutes.

    • Clean any remaining crust away with soap and water using a cotton swab.

    • Put a small amount of antibiotic ointment on the infected area.

    • Cover with a bandage until the exposed nail bed is dry and there is no more drainage.

  • Change the dressing or bandage every time you soak or clean it, or whenever it becomes wet or dirty.

  • If you were prescribed antibiotics, take them as directed until they are all gone.

  • While your toe is healing wear comfortable shoes with a lot of toe room or wear open-toe sandals.

Medicines

  • You can take over-the-counter medicine for pain, unless you were given a different pain medicine to use. Talk with your healthcare provider before using these medicines if you have chronic liver or kidney disease. Also talk with your provider if you have had a stomach ulcer or digestive bleeding, or you are taking blood-thinner medicines.

  • If you were given antibiotics, take them until they are all gone. It's important to finish the antibiotics even if the wound looks better. This ensures that the infection completely clears.

Prevention

To prevent ingrown toenails:

  • Wear shoes that fit well. Don't wear shoes that pinch the toes together.

  • When you trim your toenails, don’t cut them too short. Cut straight across at the top and don’t round the edges.

  • Don’t use a sharp object to clean under your nail since this might cause an infection.

  • If the toenail starts to grow into the skin again, put a small piece of cotton under that side of the nail to help it grow out straight.

Follow-up care

Follow up as advised by your healthcare provider. If the ingrown toenail recurs, follow up with a foot specialist (podiatrist) for nail bed ablation.

When to seek medical care

Call your healthcare provider right away if any of these occur:

  • Increasing redness, pain, or swelling of the toe

  • Red streaks in the skin leading away from the wound

  • Continued pus or fluid drainage for more than 24 hours

  • Fever of 100.4°F (38°C) or higher, or as directed by your provider

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
Powered by Krames Patient Education - A Product of StayWell