Ingrown Toenail

However, an ingrown edge of the nail plate should not be ignored. Without proper care and professional assistance, the condition can worsen, causing inflammation, swelling, and significantly affecting everyday comfort.

Self-treatment, questionable advice from the internet, or attempts to “cut out” the ingrown edge of the nail yourself are also not the best solution. In such cases, it is easy to worsen the condition of the surrounding tissue and complicate further treatment.

That is why, at the first signs of a toenail growing into the skin, it is important not to delay and to consult a specialist who can help resolve the problem safely and correctly.

What Does an Ingrown Toenail Look Like?

An ingrown toenail usually begins with changes that may seem minor at first, but gradually start causing increasing discomfort. Most commonly, ingrown toenails develop on the big toe, when the edge of the nail plate grows into the skin on one or both sides. As a result, the surrounding area becomes sensitive, irritated, and painful.

The most typical symptoms include redness around the ingrown nail, swelling of the side nail fold, and pain when pressing on the area, walking, or wearing closed shoes. Any touch to this area becomes uncomfortable. In some cases, the skin near the ingrown edge appears thickened, irritated, or injured.

If the condition progresses, the inflammation becomes more noticeable. Significant swelling, increased local skin temperature, and throbbing pain may develop around the ingrown edges of the nail plate. Sometimes discharge appears, and the tissue begins to overgrow in response to constant irritation. Because of this, the toe may look inflamed, while the ingrown edges of the nail can become partially “hidden” beneath the swollen skin.

Visually, ingrown nail edges are not just a cosmetic issue — they are a sign that the surrounding tissues are already being damaged. That is why it is important to pay attention even to early symptoms and not wait until the discomfort develops into significant inflammation.

Causes of an Ingrown Toenail

An ingrown toenail does not occur without a reason. Most often, the problem develops gradually under the influence of several factors at once: the way the nails are trimmed, pressure from footwear, the individual shape of the nail plate, or constant trauma. That is why it is important not only to eliminate the symptoms, but also to understand what exactly triggered the ingrown nail.

The most common reasons why a toenail grows into the skin include:

• improper trimming of the nail edges. If the corners are cut too deeply or the nail is shaped into a rounded form, the edge may begin to grow into the skin;
• tight, narrow, or uncomfortable footwear. Constant pressure on the foot and toes changes the direction of nail growth and injures the surrounding tissues;
• individual anatomical features. In some people, the nail plate is naturally more curved or wider, which increases the risk of ingrown nails;
• injuries to the toe or nail plate. Blows, compression, sports-related stress, or repeated mechanical irritation can trigger the problem.

Excessive sweating of the feet also increases the risk. Moist skin becomes softer, more sensitive, and more vulnerable to pressure from the ingrown nail edge. Insufficient or improper foot care may also worsen the condition. Ignoring the first symptoms or having an improper pedicure can make the situation worse.

Ingrown toenails in infants should also be mentioned separately. The causes may include the natural softness of the nail plate, the way it grows, tight socks, or improper nail trimming. In such cases, it is especially important not to self-treat or attempt to “correct” the nail edge independently, but instead to consult a specialist. A pediatrician can explain what to do about an ingrown toenail in a child.

Stages of an Ingrown Toenail

An ingrown toenail usually develops gradually — from mild discomfort to pronounced inflammation that becomes difficult to ignore. That is why it is important to pay attention to the problem at an early stage, without waiting until it interferes with walking, wearing shoes, or leads to complications. The standardized Heifetz / Mozena classification is as follows:

• Stage I — inflammation;
• Stage II — infection;
• Stage III — granulation tissue.

Based on symptoms, the condition typically progresses as follows:

1. Initial Stage. At this stage, the ingrown nail edge is only beginning to press against or grow into the skin. A person may feel slight discomfort, tingling, or pain when pressure is applied. Visually, mild redness and slight swelling around the nail fold are usually noticeable. The discomfort tends to become more pronounced while walking or wearing tight shoes.
2. Inflammatory Stage. If the problem is not addressed in time, the irritation worsens. The skin becomes more swollen, red, and sensitive. Pain may occur not only when pressure is applied, but also at rest. Sometimes there is a throbbing sensation, localized warmth, and ordinary footwear begins to cause significant discomfort.
3. Stage of Pronounced Inflammation. At this stage, the tissues are already significantly damaged. Severe pain, discharge, increased sensitivity, and noticeable tissue overgrowth may occur. The toe appears inflamed and swollen, and the condition begins to substantially affect daily activities.
4. Chronic Stage. If the ingrown toenail recurs or remains untreated for a long time, the condition may become chronic. In such cases, the discomfort may temporarily decrease and then return again, while the tissues remain constantly irritated. A chronic ingrown toenail often requires a more thorough and comprehensive approach to treatment.

What Should You Do If You Have an Ingrown Toenail?

So, what should you do when a toenail grows into the skin? The most important thing is not to try to solve the problem on your own. Home “methods” such as cutting out the corner of the nail, deeply trimming the edge, using sharp tools, or following questionable advice from the internet can only make the situation worse. Such actions often intensify inflammation, injure the skin, and complicate further treatment.

The right decision is to consult a podiatrist. The specialist will assess the condition of the soft tissues, examine the ingrown areas of the nail, and choose the most appropriate treatment approach for your specific case. Treatment for an ingrown toenail may be either conservative or surgical.

Surgical Treatment

In cases where the condition is advanced, accompanied by severe pain, significant inflammation, or frequent recurrence, resection of the ingrown toenail may be necessary. This is a surgical procedure during which the doctor removes the part of the nail plate that is injuring the skin and maintaining the inflammatory process. This approach helps eliminate the source of the problem and relieve the patient’s condition. The extent of the procedure depends on the specific clinical situation.

One surgical option is partial avulsion — the removal of only the ingrown part of the nail plate without removing the entire nail. If the condition is recurrent, a matrixectomy may also be performed. This involves treating part of the nail growth zone in order to prevent the problematic edge from growing back. A matrixectomy may be chemical or surgical. This approach is used when it is necessary not only to remove the ingrown fragment, but also to reduce the risk of recurrence.

Conservative Treatment

In the early stages, or in cases where surgery can be avoided, ingrown toenail correction is used. Its purpose is to change the direction of nail growth, reduce pressure on the surrounding tissues, and help the nail grow properly. Conservative treatment may also include professional podiatric care, as well as recommendations regarding hygiene, proper nail trimming, and footwear selection.

One conservative method is packing (tamponade) — the careful placement of a special material between the nail edge and the soft tissues. This helps reduce pressure from the nail plate on the skin, protect the injured area, and create conditions for more comfortable nail growth. This method may be used in the early stages or as part of comprehensive podiatric care.

Another conservative correction method involves orthonyxic systems, including braces or plates. These are attached to the nail plate and gradually help change its shape and direction of growth. As a result, pressure on the side nail folds is reduced, discomfort decreases, and proper nail growth is encouraged. Such systems are selected individually after examination, since it is important to consider the thickness and shape of the nail, the degree of deformity, and the condition of the surrounding tissues.

The earlier you consult a specialist, the greater the chances of resolving the problem with less trauma and fewer complications. That is why, at the first signs of an ingrown toenail, it is better not to wait, but to schedule a consultation with a podiatrist.

How to Prevent an Ingrown Toenail

Preventing an ingrown toenail is largely based on simple but consistent habits. Even if the problem has occurred before, proper foot care can help reduce the risk of recurrence and maintain everyday comfort.

To help prevent an ingrown toenail, follow these recommendations:

1. Trim your nails properly. Do not cut the corners too deeply or try to round the sides of the nail. It is best to keep the nail edge straight without over-shortening it.
2. Wear comfortable shoes. Footwear should not put pressure on the toes, squeeze the foot, or create constant friction.
3. Maintain proper foot hygiene. Regular care, clean skin, and timely sock changes help keep the tissues healthy.
4. Do not ignore early symptoms. If you notice pain, redness, or a feeling of pressure, it is better not to wait until the condition worsens.
5. Avoid injuring your nails. Being careful during sports, physical activity, and foot care is also important.
6. Do not self-treat. Attempting to cut out the ingrown edge or “correct” its growth on your own often only worsens the problem.
7. If necessary, schedule preventive check-ups with a podiatrist. This is especially important if you have previously had an ingrown toenail or are prone to recurrence.

What should you do if you have an ingrown toenail? This is a problem that should not be ignored. The earlier you consult a specialist, the easier and more comfortable it is to resolve the issue and prevent complications. If you are concerned about an ingrown toenail, need preventive care, or want to reduce the risk of recurrence, contact the podiatrists at the LeoDerm Clinic. The specialists will help choose the proper care and treatment approach specifically for your case.