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Ingrown toenail - Treatment

Alternative Names

Onychocryptosis; Unguis incarnatus; Nail avlusion; Matrix excision

Treatment:

If you have diabetes, nerve damage in the leg or foot, poor blood circulation to your foot, or an infection around the nail, go to the doctor right away. Do NOT try to treat this problem at home.

To treat an ingrown nail at home:

  1. Soak the foot in warm water 3 to 4 times a day if possible. Keep the toe dry, otherwise.
  2. Gently massage over the inflamed skin.
  3. Place a small piece of cotton or dental floss under the nail. Wet the cotton with water or antiseptic.

You may trim the toenail one time, if needed. When trimming your toenails:

  • Consider briefly soaking your foot in warm water to soften the nail.
  • Use a clean, sharp trimmer.
  • Trim toenails straight across the top. Do not taper or round the corners or trim too short. Do not try to cut out the ingrown portion of the nail yourself. This will only make the problem worse.

Consider wearing sandals until the problem has gone away. Over-the-counter medications that are placed over the ingrown toenail may help some with the pain but do not treat the problem.

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

If your ingrown nail does not heal or keeps coming back, your doctor may remove part of the nail.

  • Numbing medicine is first injected into the toe.
  • Using scissors, your doctor then cuts along the edge of the nail where the skin is growing over. This portion of the nail is then removed. This is called a partial nail avulsion.
  • It will take 2 to 4 months for the nail to regrow.

Sometimes your doctor will use a chemical, electrical current, or another small surgical cut to destroy or remove the area from which a new nail may grow.

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

Expectations (prognosis):

Treatment will generally control the infection and relieve pain. However, the condition is likely to return if measures to prevent it are not taken. Good foot care is important to prevent recurrence.

This condition may become serious in people with diabetes, poor circulation, and nerve problems (peripheral neuropathies).

Complications:

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

Calling your health care provider:

Call your health care provider if you:

  • Are unable to trim an ingrown toenail
  • Have severe pain, redness, swelling, or fever

If you have diabetes, nerve damage in the leg or foot, poor blood circulation to your foot, or an infection around the nail, your risk for complications is higher. If you have diabetes, see your health care provider.

  • Reviewed last on: 4/27/2011
  • Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Heidelbaugh JJ, Lee H. Management of the ingrown toenail. Am Fam Physician. 2009;79(4):303-8.

Habif TP. Nail diseases. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 25.

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