Ingrown Toenail – Why It Happens, How to Treat It, and How to Prevent the Pain

Sometimes something as small as a toenail can cause great pain. At first we feel a slight tenderness at the side of the big toe, then redness appears, and sometimes even the touch of a sock or a shoe becomes unpleasant.

An ingrown toenail is one of the most common conditions of the feet, and although it seems like a small problem, neglecting it can lead to inflammation, infection, and significant pain.

I think this condition is worth knowing, especially because in many cases it can be prevented through simple habits of nail trimming and choosing suitable shoes.

So why does the nail start to grow into the skin, what can be done at home, and when should we see a doctor?

What actually is an ingrown toenail?

An ingrown toenail, known medically as Onychocryptosis, forms when the tip of the nail or one of its corners presses against the surrounding skin, and sometimes actually grows into it.

The condition appears mainly on the big toe, but it can also appear on other toes.

When the nail presses on the skin, the body responds with an inflammatory process. The area becomes sensitive, red, and swollen, and sometimes an infection develops as well.

What is interesting is that it is not always a nail that grew in an abnormal way. Sometimes it is actually the way we trimmed it, or the pressure placed on it by the shoe, that causes the problem.

Why does an ingrown toenail form?

There are several factors that can increase the risk:

• Cutting the nails too short.
• Deeply rounding the corners of the nail while trimming.
• Narrow shoes that press on the toes.
• An injury to the nail or repeated pressure while walking and running.
• A natural structure of a particularly curved nail.
• Excessive sweating and prolonged moisture in the feet.
• Difficulty caring for the nails properly, for example when they are thick or hard to trim.

A family tendency can also affect the nail's structure and the risk of developing the condition.

How do we recognize an ingrown toenail?

In the first stage, there is usually sensitivity on one side of the nail, especially when pressing or putting on shoes.

Later, redness, swelling, and pain that increases when walking can appear.

If an infection develops, there may be pus discharge, local heat, and more significant pain.

In prolonged cases, the body may produce red, protruding tissue around the affected area, which sometimes bleeds easily.

It is important to understand that not all pain next to the nail is necessarily an ingrown toenail. Sometimes it is an injury, inflammation around the nail, or another problem that requires different treatment.

What do we do the moment we start to feel pain?

If it is a mild ingrown toenail, without pus, a significant infection, or underlying conditions that increase the risk of complications, we can try a few simple actions at home.

1. Soaking the foot in warm water

The foot can be soaked in warm water, not too hot, for 10–20 minutes, two to three times a day.

The goal is to soften the skin, ease the sensitivity, and help clean the area.

There is no need for boiling water or strong disinfectants.

After soaking, it is important to dry the foot well, especially between the toes.

2. Reducing the pressure on the nail

It is worth temporarily switching to wide shoes in the toe area or to sandals that do not press on the big toe.

Sometimes the very reduction of pressure allows the area to calm down and significantly eases the pain.

3. Keeping the area clean

The area can be gently washed with water and mild soap and dried well.

If there is a graze or a superficial wound, it can be protected with a clean dressing that does not press.

4. Not digging under the nail

This is one of the most common mistakes.

When we feel the nail entering the skin, the instinct is to take small scissors or tweezers and try to get the corner out.

But cutting too deep can leave a sharp edge that will keep growing into the skin, cause injury, and increase the risk of infection.

It is not recommended to try to remove on your own a part of a nail that has already grown into the skin.

Is it worth placing cotton wool under the nail?

There are methods based on gently lifting the edge of the nail using a small piece of cotton wool or dental floss, in order to move it away from the skin.

These methods may be suitable for some mild cases, but they are not suitable for every situation.

If the nail has already grown into the skin, if there is significant pain, bleeding, or signs of infection, trying to lift it on your own may worsen the injury.

In my view, it is better to let a podiatrist, a medical foot specialist, decide whether the method is suitable and to perform it properly.

Does Epsom salt really help?

Some people like to soak their feet in water with Epsom salt.

Soaking in warm water can ease the discomfort, but there is no good evidence that adding Epsom salt cures an ingrown toenail or treats an infection.

In mild cases, plain warm water can be enough.

It is important not to soak the foot for too long, because excessive moisture can soften the skin too much and worsen irritation.

What about tea tree oil, aloe vera, or natural remedies?

I like to examine natural options too, but it is important to understand what they can actually do.

Aloe vera may soothe irritated skin, but there is no proof that it corrects the nail's growth or releases the edge that grew into the skin.

Tea tree oil has been studied for its antimicrobial activity, but there is not enough evidence that it treats an ingrown toenail. It can also cause irritation or an allergic reaction, especially on injured skin.

Natural oils may soften dry skin around the nail, but they do not change its direction of growth.

I want to emphasize that even if something eases the sense of pain, it does not necessarily mean it solves the cause of the problem.

Should an antibiotic ointment be applied?

Not every ingrown toenail requires antibiotics.

In mild cases, without an infection, the treatment focuses on reducing the pressure and preventing further injury.

If pus, spreading redness, or other signs of infection appear, it is important to see a doctor.

Sometimes topical treatment or oral antibiotics are needed, but in many cases in which the nail keeps growing into the skin, the most important treatment is releasing or removing the offending part.

Antibiotics alone will not always solve the problem if the nail keeps injuring the skin.

What do we do if the ingrown toenail does not improve?

If the pain persists, if significant swelling appears, or if the problem returns again and again, it is worth seeing a podiatrist.

In some cases, the nail can be treated by conservative means, without surgery.

When the nail grows deep into the skin, the doctor may recommend partial removal of the nail's edge.

The procedure is usually performed under local anesthesia, so the patient is not supposed to feel sharp pain during the treatment.

In cases of recurrent ingrown toenail, part of the nail matrix, the area from which it grows, can also be treated, to reduce the risk that the problematic edge will grow again.

It may sound frightening, but it is a recognized medical procedure that sometimes provides an effective solution to a problem that has recurred for years.

When should we not treat it ourselves at home?

There are situations in which it is especially important to turn to an early medical examination.

If there is diabetes, reduced sensation in the feet, circulation problems, or suppression of the immune system, even a small wound in the nail area can become complicated.

In such situations it is not recommended to try to lift, cut, or treat an ingrown toenail on your own.

Also, if fever, spreading redness, pus, strong pain, or significant swelling appear, a medical examination should be sought as soon as possible.

How do we trim nails correctly?

One of the most important things in preventing an ingrown toenail is the way of trimming.

Toenails are trimmed in a straight line, without deeply rounding the corners.

The nail is left at a reasonable length, so that its edge is not too short and is not pressed into the skin.

If the corners are sharp, they can be gently smoothed with a file, without digging into the sides of the nail.

It is worth using a clean, suitable nail clipper, and not trying to tear off nail edges with the hands.

Do our shoes have an effect?

Definitely.

Shoes that are too narrow, especially those that press on the big toe, can push the skin towards the nail's edges and increase the risk of an ingrown toenail.

This is also true for sports shoes that do not suit the structure of the foot.

I think that sometimes we devote more attention to the shoe's appearance than to the room it leaves for our toes.

It is worth choosing shoes that allow the toes to move freely, especially if we walk a lot or exercise regularly.

Can a pedicure cause an ingrown toenail?

Yes, especially when the nail's corners are trimmed too deeply or when trying to aggressively clean the area under the nail.

A good pedicure is not supposed to be painful.

It is important that the tools are clean and sterilized, that the trimming is correct, and that no unnecessary cuts are made in the skin.

If there is already a painful or infected ingrown toenail, it is better to avoid a cosmetic pedicure and turn to suitable medical treatment.

Can an ingrown toenail return?

Yes.

If the cause of the problem remains, for example incorrect trimming, constant pressure from shoes, or a natural nail structure, the condition may return.

Therefore, it is important not only to treat the pain when it appears, but also to understand what caused it in the first place.

In recurrent cases, medical treatment that addresses the nail's edges and its growth area can significantly reduce the risk of recurrence.

In conclusion

An ingrown toenail is an excellent example of how even a seemingly small problem can affect our quality of life.

Sometimes every step hurts, the shoes become unbearable, and we try to find a quick solution using scissors or tweezers.

But precisely here, it is worth acting gently.

Correct trimming, suitable shoes, keeping the feet clean, and early treatment of sensitivity signs can help prevent a lot of unnecessary pain.

I believe that caring for the body does not start and end with the skin of the face. Our feet also carry us throughout the whole day, and they deserve our attention.

Sometimes the smallest habits are the ones that make the difference.

Professional sources

• Mayo Clinic – Ingrown Toenails: Symptoms, Causes and Treatment
• Cleveland Clinic – Ingrown Toenail: Causes, Symptoms and Treatment
• NHS – Ingrown Toenail
• American Academy of Orthopaedic Surgeons – Ingrown Toenail
• American Academy of Family Physicians – Management of Ingrown Toenails

With love,
Nurit Rozenblat
OrOrgani

The information in this article is for enrichment purposes only and does not replace medical advice, diagnosis or treatment by a doctor or podiatrist.

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