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Des Moines Foot & Ankle

What Are The Cause(s) of Ingrown Toenails & How Do You Fix Them?


If you have ever had the corner of a toenail grow directly into the surrounding skin and cause it to become inflamed, broken, or infected, then you know what it is like to have an ingrown toenail. While this is a common condition, it is one that is very painful and can cause quite a bit of swelling, redness, and bleeding if it goes untreated. Let’s take a look at what the most common causes are of ingrown toenails, how to go about fixing them, and how to prevent them in the future.

7 Causes of Painful Ingrown Toenails

There are numerous causes for why an ingrown toenail may develop. The root cause can range from congenital issues, to repeated trauma of the toe, to common situations like improper grooming, cutting, and ill-fitting shoes or socks. Here are 7 of the most common reasons behind ingrown toenails:

1. If you cut your toenails incorrectly, angling them with the curve of your toe. This encourages the toenail to grow towards and into the side of the toe, rather than outward and on top of the skin.

2. If you wear ill-fitting footwear that places a lot of pressure onto your big toes. Or, if you wear socks, stockings, or shoes that are too tight, narrow, or flat for your feet. This added pressure on your toes can cause the toenails to grow incorrectly.

3. Accidentally stubbing your toes, dropping items on them, or repeatedly kicking something like in sports: soccer, ballet, or kickboxing are good examples.

4. If you tear the side of your toenails instead of using proper cutters, this can cause ingrown toenails.

5. Having irregular foot shapes or proportions (hereditary). For instance, if your toenail is larger than the toe itself or if the surrounding tissue of the nail border grows too far around the upper edges of the nail; this can cause ingrown toenails.

6. Cutting your toenails too short, encourages the skin along the sides of the nail to fold over the nail, causing an ingrown toenail to develop.

7. If you have diabetes, heart disease, or use tobacco, you may be more susceptible to developing ingrown toenails, due to poor circulation.

What are the Symptoms of an Ingrown Toenail?

In the early stages of an ingrown toenail, you may notice that one or both edges of the toenail is hard to the touch and the tissue is swollen, red, and tender. You may notice this pain at first when you put on socks or place your foot into your shoes. As more fluid builds up in the surrounding tissue, the more painful it will become, and if it is left for too long, it can become infected. You may also notice dried blood when you take your socks off or small amounts of oozing pus draining from the area; especially if the toenail has broken the skin.

Treating Your Ingrown Toenails at Home - Non-Surgical

As soon as you realize that you have an ingrown toenail, treat it. By recognizing the symptoms early on, you may be able to prevent infection from setting in and the need to visit a medical center for care. Here is how to treat an ingrown toenail at home:

1. Soak your foot in warm water throughout the day. Ideally, you want to do this at least 3-4 times a day. If you are working, soak your foot in the morning before heading out and when you get home, and then 3-4 times on the weekends. Using Epsom salts will help bring down the inflammation.

2. Once you are done soaking the ingrown toenail, dry it completely. It is recommended that you place a bandage around it or some type of gauze so that it stays dry throughout the day.

3. Make sure that your shoes are not too tight. If they are, change your shoes out immediately or ear sandals until the ingrown toenail has healed.

4. If the toenail is extremely swollen or painful to the touch, consider taking ibuprofen or acetaminophen to relieve the pain.

5. If you have access to it, apply a topical antibiotic to prevent the ingrown toenail from becoming infected. Something like Neosporin would work well for this.

6. If the ingrown toenail is embedded into the surrounding tissue, you may need to gently lift it up and place either cotton or dental floss in between the nail and the skin. If you do this, change the cotton or dental floss out every single day.

If you see no improvement within 2-3 days, then make an appointment with your general practitioner to have them take a look.

Unresponsive Ingrown Toenails & Surgical Treatment

If your ingrown toenail does not respond to at-home treatment, or you develop a severe infection, it is best to seek out your medical healthcare practitioner and see if surgical treatment is needed.

1. Partial Toenail Removal: with a partial toenail removal, the piece that is digging into the surrounding tissue will be removed. This is done by numbing the toe, and then lifting out the ingrown toenail from the sides of your toe and narrowing them down so that they no longer dig in. Cotton is placed under the remaining portion of your toenail and phenol is applied, which keeps the sides of the nail from growing back.

2. Full Toenail Removal (Matrixectomy): if your ingrown toenail is caused by the nail thickening to an abnormal size, then the doctor may remove the nail completely. With this procedure, you are given anesthetic and the entire nail is removed. The exposed nail bed is going to be extremely painful to touch, and it may take 3-4 months for your nail to regrow. In that time period, the toe will need to be kept completely covered in bandages, and you will need to use antibiotics to keep infection away.

To prevent ingrown toenails from forming in the future, make sure that you trim your nails straight across (do not curve the edges), avoid cutting them too short, and wear proper fitting shoes and socks. If you are in work conditions here you are prone to dropping items on your feet, make sure to wear steel-toed boots.


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