Ingrown toenails

Ingrown toenails overview

An ingrown toenail is a painful condition of the toe. It occurs when a sharp corner of the toenail digs into the skin at the end of or side of the toe. Pain and inflammation at the spot where the nail curls into the skin occurs first.

• If left untreated, an ingrown toenail can progress to an infection or even an abscess that requires surgical treatment.
• Ingrown toenails are common in adults but uncommon in children and infants. Any toenail can become ingrown, but the condition is usually found in the big toe.

Ingrown toenail causes

Tight-fitting shoes or high heels cause the toes to be compressed together and pressures the nail to grow abnormally.

• Improper trimming of toenails can cause the corners of the nail to dig into the skin. Nails should be trimmed straight across, not rounded.
• Disorders such as fungal infections of the nail can cause a thickened or widened toenail to develop.
• Injury near the nail may cause an ingrown toenail.
• If a member of your family has an ingrown toenail, then you are more likely to develop one too.

Ingrown toenail symptoms

Ingrown toenail is a common disorder that most often affects the outer edge of the big toe. However the nail on any toe, or the nail on both sides of a toe, can become ingrown. The most common signs and symptoms are pain, redness and swelling of the skin adjacent to the corner of a toenail.

• Early in the course of an ingrown toenail the end of the toe becomes reddened and painful with mild swelling. There is no pus or drainage. It may feel warm to the touch, but you may not have a fever.

• Once an infection has developed the swelling will become worse, and there may be white or yellow coloured drainage from the area. A lighter coloured area of the skin may be surrounded by red skin. You may develop a fever, although this is unusual.

When to seek medical care

Any time an ingrown toenail has developed into an infection (drainage, a fever, lighter skin surrounded by red skin, or worsening pain and swelling), seek medical advice.

Even if the ingrown toenail is only inflamed without infection, seek medical advice if the following conditions also occur:

• If you have incomplete primary immunisation for tetanus or have not had your booster tetanus immunisations, then you need to discuss your tetanus status.
• If there is no improvement after three days of home care.
• If you are a diabetic, have poor circulation, AIDS, are on chemotherapy or have another reason for poor healing or increased risk of infection.

Most ingrown toenails can be managed in the doctor's surgery or by a podiatrist. However you may need to attend the emergency department for treatment if these circumstances develop.

• If you are a diabetic or at increased risk of infection and your regular physician is unavailable (even if the toe is not infected yet).
• If you are a diabetic or at increased risk of infection and have any fever or sign of infection in the toe.