Ingrown toenail

Definition

An ingrown toenail occurs when the edge of the nail grows into the skin of the toe.

Alternative Names

Onychocryptosis; Unguis incarnates; Surgical nail avulsion; Matrix excision; Ingrown toenail removal

Causes

An ingrown toenail can result from a number of things. Poorly fitting shoes and toenails that are not properly trimmed are the most common causes. The skin along the edge of a toenail may become red and infected. The great toe is affected most often, but any toenail can become ingrown.

An ingrown toenail may occur when extra pressure is placed on your toe. This pressure is caused by shoes that are too tight or fit poorly. If you walk often or play sports, a shoe that is even a little tight can cause this problem. Deformities of the foot or toes can also place extra pressure on the toe.

Nails that are not trimmed properly can also cause ingrown toenails:

Some people are born with nails that are curved and grow into the skin. Others have toenails that are too large for their toes. Stubbing your toe or other injuries can also lead to an ingrown toenail.

Symptoms

There may be pain, redness and swelling around the nail.

Exams and Tests

Your health care provider will examine your toenail and ask about your symptoms.

Tests or x-rays aren't usually needed.

Treatment

If you have diabetes, nerve problem in the leg or foot, poor blood circulation to your foot, or an infection around the nail, see a provider right away. Don't try to treat an ingrown nail at home.

Otherwise, to treat an ingrown nail at home:

When trimming your toenails:

Consider wearing sandals until the problem goes away. Over-the-counter medicine that is applied to the ingrown toenail may help with the pain, but it does not treat the problem.

If this doesn't work and the ingrown nail gets worse, see your family doctor, a foot specialist (podiatrist), or a skin specialist (dermatologist).

If the ingrown nail doesn't heal or keeps coming back, your provider may remove part of the nail:

If the toe is infected, your doctor may prescribe antibiotics.

After the procedure, follow any instructions for helping your nail heal.

Outlook (Prognosis)

Treatment usually controls the infection and relieves pain. The condition is likely to return if you don't practice good foot care.

This condition may become serious in people with diabetes, poor blood circulation, and nerve problems.

Possible Complications

In severe cases, the infection can spread through the toe and into the bone.

When to Contact a Medical Professional

Call your provider if you:

Prevention

Wear shoes that fit properly. Shoes that you wear every day should have plenty of room around your toes. Shoes that you wear for walking briskly or for playing sports should also have plenty of room, but not be too loose.

When trimming your toenails:

Keep your feet clean and dry. People with diabetes should have routine foot exams and nail care.

References

Habif TP. Nail diseases. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 25.

Ishikawa SN. Disorders of nails and skin. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 87.

Marks JG, Miller JJ. Nail disorders. In: Marks JG, Miller JJ, eds. Lookingbill and Marks' Principles of Dermatology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 21.


Review Date: 4/12/2017
Reviewed By: Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, Subspecialty Foot and Ankle, Camden Bone and Joint, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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