Ingrown toenail

An ingrown toenail develops when the sides of the toenail grow into the surrounding skin. The nail curls and pierces the skin, which becomes red, swollen and tender.

The big toe is often affected, either on one or both sides.

Other symptoms include:

• pain if pressure is placed on the toe
• inflammation of the skin at the end of the toe
• a build-up of fluid in the area surrounding the toe
• an overgrowth of skin around the affected toe
• bleeding
• white or yellow pus coming from the affected area

If you have diabetes

Seek medical advice if you have diabetes and an ingrown toenail. Foot problems can be more serious if you have diabetes. Having diabetes could affect how your toenail heals.

Causes of ingrown toenails

Several things can cause an ingrown toenail to develop.

Badly cut toenails

Cutting toenails too short, or cutting the edges, can make the skin fold over the nail and the nail grow into the skin.

Wearing tight-fitting shoes, socks or tights

This places pressure on the skin around your toenail; the skin may be pierced if it's pressed on to your toenail

Sweaty feet

If the skin around your toenails is soft, it's easier for your nail to pierce it and embed itself within it

Injury

For example, stubbing your toe can sometimes cause an ingrown toenail to develop

Natural shape of the nail

The sides of curved or fan-shaped toenails are more likely to press into the skin.

Treating ingrown toenails

Without treatment, an ingrown toenail can become infected.

You should:

• keep your feet clean by washing them regularly with soap and water
• change your socks regularly
• cut your toenails straight across to stop them digging into the surrounding skin
• gently push the skin away from the nail using a cotton bud - use a small amount of olive oil to soften the skin
• wear comfortable shoes that fit properly

You may need surgery if your toenail does not improve. Depending on the severity of your symptoms, this may involve either:

• partial nail avulsion – removing part of your toenail
• total nail avulsion – removing your whole toenail

Partial nail avulsion

Partial nail avulsion is a common and effective operation for treating ingrown toenails.

A local anaesthetic will numb your toe and the edges of your toenail are cut away. A chemical called phenol is applied to the affected area. This prevents the nail from growing back and becoming ingrown in the future.

You may need antibiotics if your nail is infected. Any pus will be drained away.

Total nail avulsion

You may need total nail avulsion if your nail is thick and pressing into the skin surrounding your toe.

You will have an indentation where your nail used to be. But it's safe for you not to have a toenail.

After surgery

After toenail surgery, your toe will be wrapped in a sterile bandage. This helps to stem any bleeding and prevent infection. Rest your foot and keep it raised for 1 to 2 days after the operation.

You may need to take a painkiller, such as paracetamol or ibuprofen. You may also need to wear soft or open-toed shoes for the first few days.

Preventing ingrown toenails

Taking care of your feet will help prevent foot problems such as ingrown toenails. It’s important to cut your toenails properly - straight across, not at an angle or down the edges.

Wash your feet every day, dry them thoroughly and use foot moisturiser. You can also use a foot file or pumice stone to remove hard or dead skin.

Wearing shoes that fit will help to ensure your feet remain healthy. You should also change your socks (or tights) every day.

Visit your GP or a podiatrist as soon as possible if you develop problems with your feet.