What Causes Ingrown Toenails and How to Treat Them

If one day you're walking around normally, then gradually you start to notice painful, inflamed or swollen skin around your toenail, chances are you've got an ingrown toenail.

It's a common condition that happens when a toenail grows into the skin, per the Mayo Clinic.

At the very least it can be uncomfortable, but if left untreated, more serious complications like infection may happen.

Here, a dermatologist explains what causes ingrown toenails and weighs in on the most effective home remedies and other treatments.

The first sign of an ingrown toenail is a tender and swollen toe, says Bruce Robinson, MD, a board-certified dermatologist. The toe may also look red.

As the nail cuts into the skin, the skin grows over the nail and becomes inflamed, he adds.

Other symptoms might include:

• Pus coming out of the toe
• Pain
• Darkening around the affected toe
• Toe feeling warm or hot

The most common cause of an ingrown toenail is improper grooming habits — namely, cutting the toenail too short, Dr. Robinson says.

"If you cut it too short, it makes it more likely that it's going to grow into the skin," he says. "And when it does that, the skin gets inflamed and swells and actually begins to grow into the nail. So it becomes a very cyclical process."

According to the Cleveland Clinic, other causes include:

• Wearing tight shoes
• Toenail injury
• Nail infections
• Foot shape

Ingrown toenails can be treated with self-care at home or by a doctor, depending on the severity, Dr. Robinson says.

"If it's mildly uncomfortable, meaning that you can walk and it's not keeping you up at night, you can treat it at home," he notes.

On the other hand, ingrown toenails may need professional treatment if they've reached the point of infection.

"If it becomes more painful and you have difficulty walking, you see pus or have a fever, then you definitely need to see a dermatologist," Dr. Robinson says.

DIY treatments for ingrown toenails include the following, per the Cleveland Clinic:

• Take over-the-counter pain relievers to lessen the discomfort.
• Place a cold compress on the toe to reduce the swelling.
  
• Wear roomy shoes until the ingrown toenail clears up.
• Soak your foot in warm water (but otherwise keep your feet dry).
• Put a piece of cotton or floss in between the nail and skin to help the nail grow above the skin. Use fresh cotton or floss every day.

If an ingrown toenail is not improving at home, a doctor can help the healing process.

Don't try to remove an ingrown toenail yourself (no, cutting a 'v' in your nail will not work). Rather, a dermatologist can perform ingrown toenail surgery to partially remove the nail that's ingrown, Dr. Robinson says.

"First we'll numb the area, then cut out that piece of nail that's growing into the skin. So the skin can back off and heal, and the pain goes away," he explains.

If an ingrown toenail becomes infected, a doctor will treat it with antibiotics and possibly drain any pus, Dr. Robinson explains.

Keep your feet happy and prevent ingrown toenails with these tips, per the Cleveland Clinic:

• ‌Wear wide toe-box shoes:‌ Avoid tight, improper fitting shoes (which can also lead to brittle toenails).
• ‌Cut toenails properly:‌ Nails should be cut straight across (don't try to round the corners).
• ‌Don't cut nails too short:‌ Keep them even with the tips of your toes.
• ‌Always use a clean nail clipper:‌ Don't share with others.
• ‌Soak toenails in warm water before trimming:‌ This helps soften the nails so they're easier to trim.

If an ingrown toenail is causing you pain that's interfering with how you walk and your day-to-day function, it's time to see a doctor, Dr. Robinson says.

According to the American Academy of Orthopaedic Surgeons, if the toenail is extremely irritated, swollen, painful and has pus coming out of it, it's likely infected and should be treated by a doctor.