Toenail - Ingrown
Urgent or Emergency Care?
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- The corner of the toenail grows into the skin around it
- Almost always involves the big toe (great toe)
Symptoms of an Ingrown Toenail
- Toe pain from sharp corner of toenail cutting into surrounding skin.
- Redness and swelling around the corner of the toenail is usually present.
- The area may drain pus or yellow fluid.
- The red area is very tender to touch or pressure from a shoe.
- Some teens with an ingrown toenail can barely walk.
Cause of an Ingrown Toenail
- The toenail is usually pushed into the skin by wearing tight shoes.
- The tiny cut made by the nail allows bacteria to enter the skin. The cut then becomes infected.
- The sharp corner of buried nail keeps growing. The deeper it goes, the more painful it becomes.
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- You think your child has a life-threatening emergency
Call Doctor or Seek Care Now
- Spreading red area or streak with fever
- Spreading red area or streak that's very large
- Severe pain not improved 2 hours after pain medicine and antibiotic ointment
- Your child looks or acts very sick
- You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
- Spreading red area or streak, but no fever
- Entire toe is red and swollen
- Pus pocket (yellow or green) seen in skin around toenail or under toenail. (Reason: needs to be drained).
- You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
- Can't locate and free up corner of toenail
- After using Care Advice more than 2 days, pus discharge not gone
- After using Care Advice more than 3 days, still hard to walk
- After using Care Advice more than 7 days, not improved
- After using Care Advice more than 14 days, not gone
- Ingrown toenails are a frequent problem
- You have other questions or concerns
Self Care at Home
Care Advice for Ingrown Toenail
- What You Should Know About Ingrown Toenails:
- Ingrown toenails are always painful.
- Pain is caused by the sharp toenail edge cutting into the skin around it.
- The pain can be stopped. Find the toenail corner and lift it out of the raw tissue.
- This will allow the area to heal.
- Most ingrown toenails can be treated at home. Surgery or nail removal is rarely needed.
- Here is some care advice that should help.
- Warm Soaks:
- Soak the toe in warm water and soap for 20 minutes twice a day.
- While soaking, massage the swollen part of the cuticle (skin next to the nail). Massage away from the nail.
- While soaking, also try to bend the corners of the toenail upward.
- Dry the toe and foot completely.
- Elevate Corner of Toenail with Dental Floss:
- Goal: To help the toenail corner grow over the cuticle, rather than into it.
- Take a short strip of dental floss or fishing line. Try to slip it under the corner of the nail. Then, lift the nail upward. Cut off any sharp edge.
- Take a small wedge of cotton from a cotton ball. Try to place the wedge under the nail corner to keep it elevated. (Sometimes this step is impossible).
- Elevate the corner away from the cuticle with every soak.
- Antibiotic Ointment:
- After each soak, use an antibiotic ointment (such as Polysporin). Put it on the swollen part of the toe.
- You can buy this ointment without a prescription.
- Taking Pressure Off Toenail With a Cotton Ball:
- Until it heals, try to wear sandals or go barefoot.
- When your child must wear closed shoes protect the ingrown toenail as follows:
- Inner Edge of Toe. If the inner edge of the big toe is involved, try this technique. Tape a cotton ball or foam pad between the lower part of the first and second toes. This will keep the upper toes from touching.
- Outer Edge of Toe. If the outer edge is involved, use a cotton ball. Tape it to the outside of the lower toe.
- This will keep the toenail from touching the side of the shoe.
- Never wear tight, narrow, or pointed shoes.
- Pain Medicine:
- To help with the pain, give an acetaminophen product (such as Tylenol).
- Another choice is an ibuprofen product (such as Advil).
- Use as needed.
- Prevention - Nail Trimming:
- Cut your child's toenails straight across so you can see the corners. Use a nail clipper.
- Do not round off corners. Keep the corners visible.
- Do not cut them too short.
- After baths or showers, the nails are soft. Bend the corners of the toenails upward.
- Prevention - Wear Shoes That Fit:
- Make sure that your child's shoes are not too narrow. Give away any pointed or tight shoes.
- Tight narrow shoes are the most common cause of ingrown toenails.
- Shoes should have a wide toe box. The toes should not feel cramped.
- What to Expect:
- With treatment, the pus should be gone in 48 hours.
- Pain should be gone in 1 week.
- Area should be healed up in 2 weeks.
- Call Your Doctor If:
- Spreading redness or fever occur
- Pus pocket occurs
- Not improved after 7 days
- You think your child needs to be seen
- Your child becomes worse
The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.
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- Your child's doctor can perform a physical examination and any necessary tests.
- Your child could have an underlying medical problem that requires a physician to detect.
- If your child is taking medications, they could influence how he experiences various symptoms.
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Dennis Matthews, MD
Neuromuscular Medicine, Physical Medicine & Rehabilitation, Physical Medicine & Rehabilitation - Pediatric