• Infections
• Pain
• Fungal Infections
• Nail Health

Infected Ingrown Toenail: What Do I Need to Know?

Medically reviewed and edited by Dr. Asunta Moduthagam

According to the statistics, 20 out of every 100 people who visit the doctor for foot problems seek treatment for ingrown toenails. It’s a common condition that typically affects the big toe.

While anyone can get an ingrown toenail, they most commonly occur in men between the ages of 15 and 40.

Treatments for ingrown toenails include conservative (noninvasive) and surgical (invasive) techniques. The choice of treatment depends largely on how severe the infected ingrown toenail is.

In this article, we’ll cover ingrown toenails, the infections they can cause, as well as what you can do to treat and prevent them.

What is an Infected Ingrown Toenail?

Sometimes called onychocryptosis or Unguis incarnatus, an ingrown toenail is a common condition that occurs when the corner of a toenail grows into the skin. This may result in discomfort, pain, and inflammation.

If an ingrown toenail is not treated, a bacterial or fungal infection can set in. Diabetics and people with peripheral vascular disease (poor blood flow — especially in the legs and feet) are most at risk of complications from ingrown toenails.

How Do I Know I Have an Ingrown Toenail Infection?

An ingrown toenail infection is easy to spot and can be self-diagnosed. Your ingrown toenail has likely become infected if:

• You experience pain when you apply pressure to your toe.

• The skin beside your nail is red, swollen, and tender to the touch.

• Skin is growing over a part of your toenail.

• Your toe is blistering, weeping, or leaking pus.

• There is a foul odor coming from your toe.

What Are Some Risk Factors for Ingrown Toenails?

There are certain factors that leave people more prone to developing infected ingrown toenails. You may have an increased risk of getting an ingrown toenail if you:

• Wear shoes or socks that are too tight.

• Sweat excessively.

• Cannot properly care for your toenails.

• Have diabetes or poor circulation.

• Engage in activities that may injure your toes, such as running or kicking.

• Practice poor hygiene.

• Are overweight.

• Have curved toenails.

• Are undergoing cancer treatment, such as chemotherapy.

Is an Ingrown Toenail a Serious Condition?

Ingrown toenails are not typically serious and can be treated at home by practicing good foot care. Minor cases may not even require treatment at all, and your toe will usually heal once the ingrown portion grows out.

However, toe infections that worsen or do not improve within a few weeks may require medical treatment.

What are some complications of an infected ingrown toenail?

If an ingrown toenail is left untreated and your toe becomes infected, complications can arise — especially if healing is compromised due to poor circulation in the feet and toes.

An infected toe may fester and cause one or more of the following problems:

• Oozing, painful sores

• Ulcers on the feet

• Staphylococcus (“Staph”) bacterial infections

• Cellulitis

• Osteomyelitis (bone infections)

• Gangrene (a life-threatening condition that causes death of the toenail's surrounding tissue)

• Loss of the toe

What Causes an Ingrown Toenail?

Ingrown toenails are inconvenient and uncomfortable, and — in very rare instances — they can even cause life-threatening complications. However, the good news is that most of the causes of ingrown toenails are quite preventable.

By making a few lifestyle adjustments, you can greatly reduce the risk of developing an ingrown toenail.

Some causes of ingrown toenails include:

Cutting your toenails incorrectly: It's important to cut your toenails straight across and avoid cutting them too short or they will grow into the sides of your toe.

Wearing shoes that are ill-fitted: By investing in comfortable shoes that don’t squeeze or put pressure on your toes, you can prevent the nail from growing into the toe.

Injured toes: If your toes are subjected to trauma (for example, they frequently get stubbed or things fall on them often), the toenail can also be negatively affected.

Your foot shape: If your toenail curves, or is broader than your toe, this increases your risk of ingrown toenails.

Not drying your feet properly: Your feet should be kept clean and dry to avoid toe infections.

Improper hygiene: Using public showers and visiting salons where the tools might not be properly sanitized can cause ingrown toenails.

Weakened immune systems: People with compromised immune systems are at a higher risk than those who can more easily heal from toe infections.

How Do I Treat Ingrown Toenails?

Treatment for ingrown toenails will depend largely on the severity of your case. Really mild cases may heal in a few days without treatment, while others could require surgery.

Home remedies

There are various home remedies and over-the-counter treatments that you can use for symptomatic relief and to prevent or treat infections. Some of these include:

• Soaking your foot in warm water with Epsom salts twice a day.

• Keeping your feet clean and dry.

• Carefully lifting the nail and placing dental floss, cotton, or a splint between the ingrown nail and the skin to separate them.

• Using an antibiotic ointment or cream and a bandage.

• Wearing sandals or comfortable shoes that don’t squeeze the toes.

• Taking over-the-counter medications such as ibuprofen to relieve pain and reduce inflammation.

Nail avulsion

Also known as nail removal, nail avulsion refers to surgery to partially or completely remove the nail. For those who experience recurrent ingrown toenails, complete removal of the nail may be the best solution.

How Do I Prevent Ingrown Toenails?

Treating an ingrown toenail can be a long process. Thankfully, there are some simple preventative steps you can take to avoid them.

Trim your toenails properly

Maintaining neat, trimmed toenails with straight edges is one of the easiest ways to prevent ingrown toenails.

Wear properly fitted shoes

Comfortable, roomy footwear that doesn’t exert pressure on the toes or foot decreases your risk of ingrown nails and infections.

Take proper care of your feet

A few simple steps can help you take good care of your feet and avoid infections and ingrown nails.

You should always try to:

• Practice proper hygiene.

• Wear shoes that protect your feet from bacteria and fungi.

• Wear clean socks every day.

• Change your socks or shoes if they feel sweaty.

• Wear open-toe shoes more often.

• Keep your feet clean and dry most of the time.

Avoid pedicures at salons

Salons are breeding grounds for bacteria and fungi if not professionally managed. Incorrectly sterilized tools can leave you exposed, so try to do your own pedicures at home to lower your risk of worsening a mild toenail infection.

When Should I See a Doctor for an Ingrown Toenail?

If your ingrown toenail is really painful and your infection doesn’t heal with home remedies or over-the-counter treatments, you may need to see your doctor, who might refer you to a podiatrist (foot specialist).

Diabetics and people who have poor circulation should see a doctor immediately to avoid complications.

Symptoms to watch out for

If you experience any of the following symptoms, be sure to get in touch with a doctor:

• Swelling, pain, redness, or tenderness in your toenail.

• A foul odor or pus around the nail.

• Fever or cold shivers.

Where Can I Learn More About Ingrown Toenails?

Has your big toe been troubling you? Does it hurt when you wear your favorite pair of shoes? Would you like to get treatment for your infected ingrown toenail, but you’re too embarrassed to visit the doctor? LifeMD can help, with licensed medical providers who can make a diagnosis and prescribe treatment options if necessary — all through a telehealth appointment on your smartphone, computer, or tablet. Book an appointment today.

Dr. Asunta Moduthagam

Dr. Moduthagam has been a family medicine physician since 2011. She loves working with patients to help them reach an optimal state of well-being. She’s dedicated to thoughtful, compassionate care and is committed to being her patients’ best advocate.

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