Ingrown Toenails

By Marisa Ramiccio. May 7th 2016

That dull ache in your toe may not be just a regular ol’ ache or pain. It may actually be an ingrown toenail. Ingrown toenails are a common condition that can affect any toe in any person at any time, although it mostly affects the big toenails of teenagers and people in their 20s and 30s. Although it may seem like a minor condition, it can quickly turn into a major problem if not treated.

What Is An Ingrown Toenail?

An ingrown toenail occurs when the toenail begins to grow back into the skin, usually near the corner or the side of the nail. You’ll know that you have an ingrown toenail if you display these symptoms:

  • Pain in the affected toe, usually down one or both sides of the nail
  • Redness around the ingrown toenail
  • Swelling of the toe around the ingrown toenail
  • An infection around the ingrown toenail

If you ignore these symptoms or fail to notice them in the beginning stages, the condition will continue to get worse. Eventually, the bone in the toe may become infected if the ingrown toenail is left untreated.


If you have an ingrown toenail, you may be wondering what caused it. An ingrown toenail is most commonly caused by not cutting your toenails correctly. If you cut them unevenly as opposed to straight across, those jagged bits of nail can easily pierce the soft skin around the toe. Other common causes include:

  • Having unusually curved nails – If you come from a family that has unusually curved nails they may be prone to growing back into the skin.
  • Wearing tight, narrow shoes – Shoving your foot into a shoe that has little wiggle room can pinch your toes and essentially push a piece of the toenail into the skin.
  • Sustaining a foot injury – If you stub your toe or if someone steps on your toe, this could also cause an ingrown toenail.

Teenagers who tear off their nails as opposed to cutting them have a higher risk of developing ingrown toenails as do those who are prone to foot problems. People who have diabetes, for instance, may not be able to feel sensations, including pain, in their feet. If that’s the case, they may not notice the symptoms of an ingrown toenail, if they have one, which could lead to an infection or worse.

[Related – Diabetic Foot Pain And Complications]

When To See A Doctor

Even if you don’t have diabetes, your ingrown toenail may still become infected. An infected toenail is a sign that your ingrown toenail has progressed into a stage 2 ingrown toenail. Stage 1 ingrown toenails include the symptoms mentioned above. Aside from infection, other symptoms of stage 2 ingrown toenails include:

  • Increased swelling
  • Increased redness
  • Increased pain
  • Leakage of pus from the affected area

If the ingrown toenail continues to be left untreated, it may progress into stage 3. Symptoms of a stage 3 ingrown toenail include:

  • Magnified pain, swelling an redness
  • Granulation tissue
  • Lateral nail-fold hypertrophy

Before your ingrown toenail gets to this point, you should visit a doctor. The best time to do so is at the first sign of any redness, pain or swelling because the toenail can be treated more easily that it can in stage 2 or stage 3.

What The Doctor Can Do

Once you’ve made it to the doctor’s, he or she will examine the nail and will diagnose it as ingrown. From there, the doctor will present some treatment options based on what stage the ingrown toenail is in. Those options include:

  • Lifting the toenail – If the ingrown toenail is still in stage 1, the doctor can probably lift up the nail, no surgery needed. During this procedure, the doctor will separate the top of the nail from the skin using a piece of cotton or a splint to prevent the nail from growing back into the skin.
  • Prescribing a topical ointment – If the ingrown toenail is still in stage 1, but looks like it might progress into stage 2, the doctor make prescribe a topical ointment to prevent an infection from forming.
  • Partially removing the toenail – If the ingrown toenail has moved on to stage 2, part of the nail may need to be removed. Before the procedure, the doctor will inject the toe with an anesthetic to numb it and will apply pressure on the sides, either with a tourniquet or rubber band to prevent bleeding. Using bandage scissors, the doctor will cut the side of the nail off, from top to bottom. Once the nail has been removed, antibiotic ointment and a bandage will be applied.
  • Removing the nail altogether – If the ingrown toenail has progressed to stage 3, the doctor may need to remove a significant portion of it, if not all of it, and the surrounding tissue. This surgery can be done with chemicals or a laser, but will ensure that the damaged nail will not grow back.

After having a part or portion of the nail removed, patients should expect their nail to be permanently narrower. The nail will not grow back where it was removed, however, the tissue of the nail bed will eventually fill in the concave gap. There is a risk of developing an infection, but as long as antibiotic ointment is applied regularly to the area, this should be prevented.

There is, of course, always the risk of developing another ingrown toenail, even on the toe that’s been infected once before. But as long as you continue to properly groom your feet, stay away from tight shoes and keep careful watch for the signs and symptoms, your ingrown toenails should be a problem of the past.


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