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Ingrown toenail

Definition

An ingrown toenail occurs when the edge of the nail grows into the skin of the toe. There may be pain, redness, and swelling around the nail.

Alternative Names

Onychocryptosis; Unguis incarnatus

Causes, incidence, and risk factors

An ingrown toenail can result from curved toenails, poorly fitting shoes, toenails that are trimmed improperly, or a toe injury. The skin around the toenail may become red and infected. The great toe is usually affected, but any toenail can become ingrown.

The condition may become serious in people with diabetes.

Signs and tests

A doctor's examination of the foot is sufficient to diagnose an ingrown toenail.

Treatment

To treat an ingrown nail at home:

1. Soak the foot in warm water.
2. Use a nail file to separate the nail from the inflamed skin.
3. Place a small piece of cotton under the nail. Wet the cotton with water or antiseptic.

Repeat those steps, several times a day if necessary, until the nail begins to grow out and the pain goes away. Also, trim the toenail and apply over-the-counter antibiotics. If this does not work and the ingrown nail gets worse, see a foot specialist (podiatrist) or skin specialist (dermatologist).

The doctor may remove part of the nail or extra skin. If the toe is infected, your doctor may prescribe antibiotics. These may be applied to the skin or taken by mouth.

In recurrent cases, your doctor may permanently reshape your nail with chemicals or lasers.

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.

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 or have severe pain, redness, swelling, or fever.

If you have diabetes, your risk for complications is higher. See your provider.

Prevention

To prevent an ingrown toenail:

• Wear shoes that fit properly.
• Trim toenails straight across the top and not too short.
• Keep the feet clean and dry.
• People with diabetes should have routine foot exams and nail care.

References

Information from your family doctor. Ingrown toenails. Am Fam Physician. 2004; 70(5): 927.

Habif TP. Clinical Dermatology. 4th ed. St. Louis, Mo: Mosby; 2004.

Noble J. Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo: Mosby; 2001.

Review Date:4/12/2007
Reviewed By:Kevin Berman, MD, PhD, Associate, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network.

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