An ingrown toenail is one of the most common foot problems we see in podiatry clinics. While it may start as a minor annoyance, an untreated ingrown toenail can quickly become painful, infected, and begin affecting your daily activities.
The good news? Most ingrown toenails can be successfully treated, and many can be prevented with the right foot care habits.
What is an ingrown toenail?
An ingrown toenail occurs when the edge or corner of a toenail grows into the surrounding skin instead of growing straight out. This most commonly affects the big toe but can occur on any toe.
As the nail presses into the skin, it can cause:
- Pain and tenderness
- Redness
- Swelling
- Infection
- Bleeding or discharge
- Difficulty wearing shoes
In more severe cases, excess tissue known as hypergranulation tissue or "proud flesh" may develop around the nail edge. Hypergranulation tissue develops as part of the body’s healing response when the toenail repeatedly presses into or pierces the surrounding skin. While it indicates the body is attempting to repair the area, it can cause pain, bleeding, and delayed healing if left untreated
What causes ingrown toenails?
Several factors can contribute to an ingrown toenail:
Incorrect Nail Cutting
Cutting toenails too short or rounding off the corners is one of the most common causes. This encourages the nail edge to grow into the skin.
Tight Footwear
Shoes that squeeze the toes place pressure on the nail and surrounding skin, increasing the risk of ingrown nails.
Genetics
Some people naturally have curved or fan-shaped nails that are more likely to become ingrown.
Trauma
Stubbing your toe, dropping something on it, or repetitive pressure from sports can alter nail growth.
Sweaty Feet
Excess moisture can soften the skin around the nail, making it easier for the nail to penetrate.
Poor Foot Mechanics
Abnormal walking patterns and biomechanical issues can place additional pressure on certain toes.
Signs that your ingrown toenail may be infected
An ingrown toenail can sometimes become infected. Signs include:
- Increased redness
- Swelling
- Warmth around the toe
- Throbbing pain
- Yellow or green discharge
- Bad odour
- Bleeding
- Difficulty walking
If you have diabetes, poor circulation, or a compromised immune system, seek professional care promptly, as infections can become serious more quickly.
How are ingrown toenails treated?
Treatment depends on the severity of the condition.
Early-Stage Ingrown Toenails
For mild cases, treatment may include:
- Careful nail care
- Reducing pressure on the toe
- Footwear advice
- Education on proper nail trimming
Moderate to Severe Cases
A podiatrist may:
- Remove the offending nail edge
- Clean infected tissue
- Provide dressings
- Recommend ongoing management
Nail Surgery
For recurring ingrown toenails, a minor procedure called a partial (or total) nail avulsion may be recommended. This involves removing the problematic nail edge (or total nail) and applying a chemical solution to help prevent that section from growing back.
This procedure is commonly performed under local anaesthetic and generally provides an excellent long-term solution.
