An ingrown toenail, with the side edge of your nail growing into the skin, can make you painfully aware of a toe you don’t normally notice.
As the nail continues to dig into the skin, it irritates it, causing pain.
“If an ingrown toenail causes a break in the skin, bacteria can enter and cause an infection, which will make it even more painful. A red, swollen, hot and very painful ingrown toenail is probably infected,” says podiatrist Georgeanne Botek, DPM.
Common causes of ingrown toenails
Dr. Botek shares the most common causes of painful ingrown toenails:
Heredity. Many people inherit the tendency to develop ingrown toenails from one or both parents.
Ill-fitting footwear. Crowding your feet into socks and shoes that are too short or tight can set up an environment for painful ingrown toenails to develop. This is why adolescents and teens often get ingrown toenails.
“Due to sudden growth spurts and body changes, teens and adolescents may outgrow their footwear quickly and can end up wearing them a while before buying new, better-fitting shoes,” Dr. Botek says.
Trauma. Occasionally, stubbing or jamming your toe, dropping something on your toe or participating in activities that put repeated pressure on your toes (like running, soccer or ballet) can cause ingrown toenails to develop.
Improper trimming. One of the most common causes of ingrown toenails is cutting them too short. When nails are very short, it encourages the skin at the sides of the nail to fold over it. Don’t be overzealous with the clippers, and be sure to cut straight across.
Pedicures. Many women (and increasing numbers of men) enjoy getting pedicures. Nothing wrong with that, but make sure to go to an experienced technician. “Pedicures can cause ingrown nails if the nail technician is overly aggressive in cutting back a toenail,” says podiatrist Dina Stock, DPM.
What to do about ingrown toenail pain
Sometimes, you can treat your ingrown toenails at home. If your ingrown toenail doesn’t show any of the signs of infection — swelling, hot to the touch, oozing, foul odor — you might just try letting the nail grow out.
Soak it and wait. Dr. Stock suggests soaks in warm water with Epsom salts or a mild detergent, then applying an antibiotic ointment and bandage to the area.
Remove it yourself if there’s no infection. “First soak your feet in a very warm bath with Epsom salts. This softens the skin and reduces inflammation. Using clean nail-cutting tools, you can try to clip the affected area and apply antibiotic ointment afterward,” says Dr. Botek.
See a podiatrist. For infected ingrown toenails, or if you aren’t sure you can deal with treating yours at home, a podiatrist can perform the procedure under a local anesthetic.
“In the office, we can cut out the offending nail border after first numbing the area,” Dr. Stock says. This helps the pain and allows the infection to heal, but may not prevent recurring ingrown toenails.
Never ignore an infected ingrown nail. A prolonged infection can spread and lead to serious complications, especially if you suffer from poor blood flow, an impaired immune system, or diabetic neuropathy.
For recurring ingrown nails, your doctor may suggest a common office procedure called the phenol and alcohol matrixectomy.
“During a matrixectomy, the doctor numbs the region and removes the problematic nail portion. The chemical phenol is then applied to burn and kill the cells that form the nail,” Dr. Botek says. This offers a more permanent solution to recurring ingrown nails.
Preventing ingrown toenails
Of course, it’s best to prevent getting ingrown nails in the first place. Experts Dr. Stock and Dr. Botek offer these suggestions:
Avoid cutting nails too short and cutting unevenly at the corners. Cut straight across.
Make sure your socks and shoes fit properly. You should be able to wiggle your toes easily in your shoes.
Avoid trauma to the toe area. If you run, play soccer or participate in other sports where your toes get a lot of action, try to go barefoot for an hour or two afterward.