How to Fix an Ingrown Toenail With or Without Surgery
Medically reviewed by Sarah Richards, DPMMedically reviewed by Sarah Richards, DPM
Ingrown toenails are a common foot complaint. They occur when the edge of a toenail starts growing into the surrounding skin, causing pain, swelling, and discoloration, potentially leading to an infection.
Some mild ingrown toenails may be managed with at-home remedies, but severe or infected cases require treatment from a healthcare provider with prescription medication or surgical procedures.
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When to Treat an Ingrown Toenail at Home
Treating an ingrown toenail at home will depend on the severity of the case and whether there's an infection.
At-home management may be appropriate for most mild and some moderate ingrown toenail cases. This includes ingrown toenails that present with symptoms like:
Redness or discoloration
Slight swelling
No pus or discharge (which would suggest that there's an infection)
If you have diabetes, poor circulation, or nerve damage in the foot, do not treat the ingrown toenail at home. See a healthcare provider.
Evidence-Based Ingrown Toenail Home Remedies to Try
The goals of treating your ingrown toenail at home are to relieve symptoms, prevent it from getting worse, promote healing, and reduce the chances of it happening again.
For mild (and some moderate) ingrown toenail cases, here are some evidence-based tactics to start with:
Wear open-toed or wide-toed shoes to allow room for the affected toenail to heal. This helps alleviate pressure, reduce pain, and reduce other risks like excessive sweating or a nail fungal infection.
Soak your foot in warm, soapy water for 10 to 20 minutes a few times a day. This helps soothe and soften the affected area.
Apply an over-the-counter (OTC) steroid cream to the toe after soaking or several times daily for up to 14 days. Place a bandage or gauze over the area afterward to prevent infection.
Place cotton or dental floss underneath the nail edge. The goal here is to gently lift the ingrown part of the nail away from the skin. Switch out the cotton or floss daily to keep the area clean and infection-free.
If home treatment of an ingrown toenail appears to be working or improving, it may still take several days or more to resolve fully. Experts note that successful at-home treatment should continue until the nail grows past the curved edge, which can take two to 12 weeks.
Medical Ingrown Nail Treatment
Your ingrown nail may require medical treatment if it's a moderate or severe case that isn't getting better with home treatment—or even seems to be getting worse.
A moderate to severe case is generally classified as presenting with the typical ingrown toenail symptoms like pain, swelling, and discoloration, but to a much more severe degree. In addition, the skin around the edge of the affected nail may thicken, start to grow abnormally, or appear red or discolored.
Healthcare providers recommend medical treatment for ingrown nails if:
Pain is severe, worsening, and interferes with your daily life
There are signs of infection, like pus or discharge
You have a nail disorder like onychogryphosis (thick, curved nails) or paronychia (infection of the skin around the nail)
Home remedies do not seem to be providing relief or improvement within two to three days
When to See a Provider for an Ingrown Toenail
People with a health condition that can increase the risk of developing foot issues, like diabetes, poor circulation, or nerve damage to the foot, should not attempt at-home treatment for an ingrown toenail. Instead, see a healthcare provider for diagnosis and medical treatment.
Infection
An infected ingrown toenail will likely require prescription antibiotics—like Keflex (cephalexin)—to clear the infection. The entire course of antibiotics must be taken to help prevent recurrence, even if symptoms improve.
A healthcare provider may recommend surgical treatment for severe or frequently recurring infected ingrown toenails.
Reliving Pain Symptoms
Ingrown toenails can be quite uncomfortable. Generally, over-the-counter (OTC) pain relievers like Tylenol (acetaminophen) or Advil (ibuprofen) can help temporarily reduce pain. Advil can also help relieve inflammation.
Otherwise, a healthcare provider may offer the following:
A toe protector or brace to help cushion the area and alleviate irritation
A nail splint that your healthcare provider methodically places on the edge of the ingrown nail to relieve pressure and pain
Prescription medication if needed for severe pain
Pain While Walking
Physical activities like walking can be difficult with an ingrown toenail. Until it's healed, consider:
Wearing comfortable shoes, like sandals, that offer toes plenty of room to breathe
Avoiding high heels and shoes that are too loose or too tight, as these may put too much physical pressure on toes during movement
Resting your feet in a raised position when possible to alleviate pain and swelling
How a Podiatrist Fixes an Ingrown Toenail
Sometimes, surgical intervention for a severe ingrown toenail is needed. Research suggests that surgical procedures help prevent future recurrences better than non-surgical treatment options.
Two common procedures for ingrown toenails aim to remove contact between the affected nail and the corresponding skin fold:
Partial nail avulsion: This procedure involves removing a part of the affected toenail. After numbing the area with local anesthesia, the healthcare provider will surgically cut that portion of the nail and lightly bandage the area to prevent infection during the healing process.
Total nail avulsion: Less commonly, this procedure involves using local anesthesia before lifting and removing the entire nail and nail bed underneath. The toenail typically grows back within three months.
People who have an allergy to local anesthetics, peripheral vascular disease (a blood circulation disorder), or a bleeding disorder may not be candidates for these surgical procedures.
Post-surgery, many people find they can go back to normal activities after a few days.
What to do After Fixing an Ingrown Toenail
Nail grooming can help prevent ingrown toenails and other nail issues. Here's what experts recommend:
Trim your toenails in a straight line.
Avoid picking at or tearing the corners of your toenails.
Wear shoes that fit properly (i.e., not too loose and not too tight), allowing plenty of room for toes.
Keep toes clean and dry to prevent infection.
Follow your healthcare provider's recommendations for caring for your feet during and after the ingrown toenail healing process.
Note that toenails grow more slowly than fingernails, so you may not need to trim them as often as you manicure the nails on your hands.
Repeat Ingrown Toenail Treatment
Ingrown toenails that keep coming back may require additional medical treatment.
In these cases, a procedure known as a matrixectomy may be performed at the same time as a nail avulsion. This removes or destroys the nail root, preventing the toenail from growing back. The different techniques that are generally used include:
Chemical matrixectomy, where a chemical solution (like phenol) is applied to destroy the nail root
Electrosurgical matrixectomy, which uses a high-frequency laser to destroy the nail root
Surgical matrixectomy, which involves surgical tools (like a scalpel) to remove the nail root
People who have certain health conditions like uncontrolled diabetes or peripheral vascular disease and people who are pregnant may not be eligible for a chemical matrixectomy due to chemical exposure. Check with a healthcare provider to discuss the best surgical options for you.
Summary
Ingrown toenails happen when the edge of the nail starts growing into the skin. In mild cases, at-home treatments like soaking the foot, applying a corticosteroid, and temporarily wearing open-toed shoes may relieve pain and resolve the issue.
People with diabetes, nerve damage to the foot, or poor circulation should see a healthcare provider rather than treating even a mild ingrown toenail at home.
For severe ingrown toenails, medical treatment is generally required, which involves antibiotics to clear an infection and surgical procedures to remove part or all of the affected nail if needed. See a healthcare provider for a suspected ingrown toenail that does not improve or worsens after a few days of home treatment.
Read the original article on Verywell Health.
