An ingrown toenail forms when the nail edge grows into the surrounding skin, leading to irritation that gradually worsens as pressure increases. It most often affects the big toe and can result from trimming practices that leave the nail too short or curved. Tight footwear, toe injuries, and naturally curved nails also make a person prone to ingrown toenails. Symptoms typically begin with swelling or tenderness and progress as the tissue becomes more inflamed.
Ingrown Toenail Causes
An ingrown toenail develops when the nail’s lateral edge presses into the skin, and this process frequently starts with minor irritation. The condition tends to form along the side of the big toe because it is consistently under pressure from walking and footwear. Nail structure influences how the edge grows, and curved or thickened nails may create more friction against nearby tissue. Footwear that compresses the toes increases this friction and contributes to tissue irritation.
Improper trimming also plays a role, as nails that are cut too short or rounded at the edges are more likely to curve inward as they grow. Stubbing the toe or experiencing a repeated impact may change the nail’s direction as it heals. Moisture trapped around the toe softens the surrounding skin, allowing the nail edge to press deeper into the tissue. As the nail penetrates the skin, inflammation develops, and symptoms begin to progress.
Common Symptoms and Early Signs
Early symptoms often include tenderness to touch or pressure. Redness appears along the nail border, and swelling gradually increases as inflammation progresses. The affected area may feel warm, and walking sometimes becomes uncomfortable because the skin continues to react to the ingrown edge. Mild drainage can occur when the skin breaks down or irritation persists.
A more advanced ingrown toenail may produce additional symptoms linked to infection. The surrounding skin can thicken, and the area can become firmer as irritation persists. Pus may appear when the skin barrier weakens, and this change usually indicates infected tissue. Persistent discomfort, expanding redness, or noticeable drainage signal the need for medical attention, as the nail will continue pressing into the softened skin.
At-home Treatments
Warm water soaks are often recommended for early cases because they soften the skin and reduce mild inflammation. Soaking the foot several times a day can also ease pressure along the nail border. After washing, applying a small amount of antibiotic ointment can reduce the risk of bacterial growth. Wearing shoes with a wider toe box reduces friction, and open-toe footwear may limit pressure entirely.
Home care has limitations, and attempts to lift or trim the nail without guidance may worsen symptoms. Increasing pain, persistent drainage, or signs of spreading redness indicate that home treatment is no longer appropriate. If you have diabetes or if at-home treatment is not working, consulting a medical provider is the next step.
Medical Evaluation and Treatment
A medical provider examines the toe to confirm whether the nail edge is pressing into the surrounding skin. The evaluation can include identifying swelling, infection, and tissue damage caused by the nail border. Providers sometimes lift the nail edge to create space between the nail and the skin, which can reduce discomfort in early cases. When the condition is more advanced, partial nail removal may be recommended to relieve pressure.
If infection is present, the provider can prescribe medication to support healing. Persistent or recurring ingrown toenails may benefit from a procedure that prevents the affected nail edge from growing inward again. Treatment decisions depend on the severity of symptoms, and providers adjust their approach based on inflammation, drainage, and nail shape.
Learn More About Ingrown Toenail Care
Appropriate care for an ingrown toenail depends on the severity and progression of symptoms, and on how quickly the skin reacts to pressure from the nail. Early treatment often leads to better outcomes because the nail has less opportunity to damage surrounding tissue. Timely evaluation also helps identify infection, and a healthcare provider can determine the most appropriate approach to reduce irritation and support long-term comfort. For more information about the treatment of ingrown toenails, consult your healthcare provider.
