The Ultimate guide to ingrown toenails
Written by: James Gill BOst GOsC 6039. Registered Osteopath, Founder & Clinic Director
Medically Reviewed: Soula Henderson, BAFHP 18020807 HCPC CH037187, Registered Podiatrist & Foot Health Specialist
What is an ingrown toenail?
When a toenail gradually curls and grows into the skin of the toe, this is medically known as Onychocryptosis, or more commonly, an Ingrown Toenail. They mostly affect the big toes, but can also occur on any other toe and can grow on either one, or both sides of the toe. People suffering from ingrown toenails will typically present with redness, swelling, tenderness or bleeding in the surrounding area.
Clinical Insight: At Bodytonic Clinic, we frequently observe that early intervention prevents the need for full surgical removal. If the nail is tender to the touch, it is already beginning to pierce the dermal layer.
Ingrown toenails can affect everyone, however, some people are at higher risk of serious complications, such as those with nerve-related disabilities, poor blood circulation, injuries, an ongoing toe infection, or those living with diabetes. If you are diabetic, do not attempt home treatment; seek professional podiatry immediately to avoid the risk of foot ulcers.
What are the symptoms of an ingrown toenail?
The symptoms of an ingrown toenail include:
- Inflammation around the area.
- Redness.
- Fluid build-up which can cause tissue swelling
- Pain on palpation, or direct pressure on the toe.
- Secondary Infection Signs: The toe may be hot to the touch and have yellow/white pus discharge.
What are the common causes of an ingrown toenail?
There are a number of circumstances which may lead to an ingrown toenail, including:
- Poorly maintained toenails: cutting off the edges will prompt the skin to grow over the nail and dig into the skin. Always trim nails straight across.
- Poor foot hygiene: sweaty feet can soften the skin, creating an environment where the toenail can easily grow into it.
- Poor walking pattern (Gait): Our specialists can assess your gait at our Stratford and Canada Water clinics to prevent recurrence.
- The shape of the toenail: a curved and irregular shape may increase the risk.
- Toe injuries: such as dropping heavy objects directly on the toes, repetitive stress, or stubbing the toe.
- Fungal-related toe infection.
- Wearing tight and pointy shoes: Pressure will develop around the toenails, causing the nail to pierce the skin.
How is an ingrown toenail diagnosed?
Ingrown toenails are diagnosed through a physical examination by a professional podiatrist or doctor. The main purpose of the examination is to rule out any signs of infection. Our podiatrists use clinical-grade magnification to determine the depth of the nail penetration. If there are any signs of infection, an X-ray may be suggested to see how deep into the skin the nail has progressed.
What are the treatment options for an ingrown toenail?
There are many different treatment options available for an ingrown toenail, including home treatment; conservative treatment; and surgical intervention.
Safe Home Management
Note: These techniques are for mild cases only. If pain persists for more than 48 hours, professional intervention is required.
- Put the affected foot in warm water for 15 to 20 minutes per day to soften the nail. Keep the foot dry at all other times.
- Gently push the skin away from the toenail until it fully detaches, then apply antibiotic cream. Do not use “bathroom surgery” tools (scissors or tweezers) as this significantly increases infection risk.
- Carefully pick shoes. Loose and breathable shoes are recommended during the healing process.
- Take painkillers or anti-inflammatory medication for pain management.
Professional & Surgical Intervention
In severe or recurring cases, surgical intervention (Nail Avulsion) is the gold standard. Bodytonic Clinic provides these minor surgeries in our sterile treatment rooms across London.
- Partial Nail Avulsion: The edges of the toenail are trimmed until straight. A chemical (Phenol) may be applied to prevent that section from regrowing.
- Total Nail Avulsion: Removal of the entire nail under local anaesthetic.
All surgical procedures at Bodytonic Clinic are performed under strict sterile conditions by HCPC registered specialists.
What are the complications of an ingrown toenail?
If left untreated, the chances of infection are high. An open wound can lead to:
- Foot ulcers and pressure sores
- Cellulitis (a serious deep-skin infection)
- Loss of blood flow to the toe
- Tissue damage and, in extreme cases, limb loss.
Patients with diabetes or vascular disease must be monitored closely, as a lack of sensation (neuropathy) can mask the severity of the infection.
Can an ingrown toenail be prevented?
To help prevent ingrown toenails, you can change your daily routine accordingly:
- Keep your feet clean and dry
- Do not cut your toenails too short
- Trim your toenails straight and prevent the edge from cutting into the skin
- Wear fitted, but not tight shoes and socks
- Pay attention to the condition of your toenail. If it appears thicker and starts to grow into the skin, seek professional advice before it progresses
Do I need to go to the GP or visit my local hospital?
You should seek help from your GP or book an emergency podiatry appointment if:
- There is a health risk which could cause complications, such as diabetes, or other immune system diseases
- There are any signs of infection, such as swelling, redness and being hot to the touch
- Your toe condition is getting worse with at-home management
- You begin having allergic reactions
- You are not sure how to manage your ingrown toenail
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