Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2004;70(5):927

What is an ingrown toenail?

When a toenail is ingrown, the sides or corners of the nail curl under and dig into the skin at the side of the toe. This causes swelling, pain, and redness.

What causes an ingrown toenail?

The major causes of ingrown toenails are shoes that do not fit well and nails that are not cut the right way. Shoes that are too tight press the sides of the nail and make it curl into the skin. Nails that are peeled off at the edge or trimmed down at the corners also are more likely to become ingrown. To avoid ingrown toenails, cut your nails straight across. The top of the nail should make a straight line.

What is the best treatment for a painful ingrown toenail?

When the problem is mild, you may only need to soak your foot in warm water for 15 to 20 minutes and then put a bit of dry cotton under the corner of the nail. Pain that gets worse, swelling, and drainage are signs that the problem is getting worse. Sometimes minor surgery is needed to remove the part of the nail that is poking into the skin.

What kind of surgery will I need?

Your doctor will numb your toe by injecting it with an anesthetic. Then he or she will cut your toenail along the edge that is growing into the skin and pull out the piece of nail. Your doctor also may apply a small electrical charge or a liquid solution to the exposed part of the nail bed. This helps keeps the toenail from growing into the skin again.

What should I do to care for my toe after surgery?

Soak your foot in warm water every day. Apply antibiotic cream (such as Neosporin) at least twice a day. Keep your toe bandaged until it heals. You can take acetaminophen (brand name: Tylenol) or ibuprofen (brand name: Motrin) as needed for pain. Keep the wound clean and dry.

Wear loose-fitting shoes for the first two weeks after surgery, and avoid running and strenuous activity. Call your doctor if the pain does not get better or if you have swelling, redness, or drainage.

Do not wear high heels and tight-fitting shoes. Make sure to always trim nails straight across. Do not pick at your nails or tear them at the corners.

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