Ingrown Toenail: Causes, Prevention, and Treatment
An ingrown toenail (Ingrown Toenail), also called Onychocryptosis, is a condition in which the edge or corner of a toenail, especially the big toe, grows into the surrounding skin. It causes pain, swelling and pus, carries a risk of infection, and can sometimes make it uncomfortable to wear shoes or walk. The condition can be prevented and treated with proper care, and severe cases can be treated effectively with medical procedures.
What causes an ingrown toenail?
Incorrect nail cutting: Cutting the nail in a curve or too short makes the nail edge dig into the flesh.
Ill-fitting shoes: Tight or narrow shoes rub against the sides of the nail.
Nail shape and injury: Naturally curved nails, or an injury to the nail.
Other factors: Fast nail growth, as well as an accompanying fungal or bacterial infection.
Symptoms of an ingrown toenail
Early symptoms: Pain at the side of the nail, together with redness, swelling and a feeling of warmth.
When infected: If infection develops, there may be pus (Purulent discharge) and severe pain that makes walking difficult.
Overgrowth around the nail: New tissue (Granulation tissue) may grow around the nail edge.
If the nail edge becomes more swollen, red and tender and starts to produce pus, it means there is an overlapping inflammation around the nail (Paronychia), so the infection needs to be treated together with correcting the nail edge. If the nail plate is thick and deformed so that its edge digs into the flesh again and again, you should also be checked for nail fungus, because a nail thickened by fungus makes an ingrown toenail return easily. For details on correcting the nail edge so it does not come back, read about ingrown nails (onychocryptosis), and for an overview of all nail conditions, see the nail disease guide.
Severity stages
Ingrown toenails are divided into 3 stages of severity.
Stage 1: Swelling, redness and pain, but no infection yet.
Stage 2: More inflammation, tissue overgrowth, and possibly a mild infection.
Stage 3: Severe infection, more pain, overgrowth of tissue and pus.
Home care
For early-stage cases (Stage 1), you can start with basic care as follows.
Warm foot soaks: Soak the foot in warm salt water about 3 times a day, 15 minutes each time, to reduce swelling (Epsom salt may be used).
Pain relief: Use pain relievers such as Paracetamol or Ibuprofen as directed.
Antibiotic ointment: Apply Antibiotic ointment to the ingrown area every day.
Lifting the nail edge: Slip Dental floss under the nail edge to lift it slightly and keep it from growing deeper (Dental floss method).
Medical treatment
Partial nail avulsion: Removing the ingrown edge of the nail. This is the most commonly used method for ingrown toenails.
Total nail avulsion: Removing the whole nail. It is used when the nail becomes ingrown often or the nail is abnormal.
Chemical cautery: Using Phenol or other chemicals to destroy the nail matrix and stop the ingrown part of the nail from growing.
Surgical removal: Other types of surgery when necessary, as assessed by the doctor.
Preventing ingrown toenails
Cut nails correctly: Cut nails straight, not curved inward, and not too short.
Choose well-fitting shoes: Choose shoes that fit, are not tight or narrow at the toe, so the nail has room to move.
Foot hygiene: Keep feet clean and dry, and avoid foot injuries.
Frequently asked questions
Can an ingrown toenail go away on its own? Early-stage cases (Stage 1) without infection often improve with home care, such as warm salt-water soaks and lifting the nail edge with Dental floss. However, if it does not improve within 1-2 weeks, there is pus, or the pain is severe, you should see a doctor.
When should I see a doctor? See a doctor if there is no improvement after 1-2 weeks of home care, if there are signs of infection such as pus or severe redness and swelling, if the pain is severe, or if the nail becomes ingrown often.
Is medical treatment painful? Procedures such as Partial nail avulsion or Chemical cautery with Phenol are done under local anesthesia, which helps reduce pain during the procedure. The doctor will choose the method that suits the severity in each case.
How can I prevent an ingrown toenail from coming back? Cut nails straight and not too short, choose well-fitting shoes, and keep feet clean and dry. If the nail is naturally curved and becomes ingrown often, the doctor may consider removing the side of the nail as a permanent treatment.
An ingrown toenail is a condition that responds well to treatment when cared for from the early stage, but if left until it becomes infected, medical procedures may be needed. If you have pain, swelling or pus at the nail edge, consult a dermatologist at Siam Dermatology, call +66 61 448 7000 or LINE @siamderm.
Written by Dr. Patara Voravutinon, Dermatologist · Last reviewed July 16, 2026
Comments