An ingrown toenail develops when the sides of the toenail grow into the surrounding skin. The big toe is often affected, either on one or both sides. The nail curls and pierces the  skin, which becomes red, swollen and tender. 

Symptoms include: 

∙ Pain if pressure is placed on the toe 

∙ Inflammation of the skin at the end of the toe 

∙ A build-up of fluid (oedema) in the area surrounding the toe 

∙ An overgrowth of skin around the affected toe (hypertrophy) 

∙ Bleeding 

∙ White or yellow pus coming from the affected area

When to see your GP/specialist 

See your GP or podiatrist (foot care specialist) if your ingrown toenail is badly inflamed,  bleeding or has pus coming from it as it may be infected. 

It's also important to seek medical advice if you have diabetes and an ingrown toenail.  Having diabetes could affect how your toenail heals and or lead to further complications. 

What causes ingrown toenails? 

A number of things can cause an ingrown toenail to develop, including: 

∙ Badly cut toenails – cutting your toenails too short, or cutting the edges, will encourage  the skin to fold over your nail and the nail to grow into the skin. 

∙ Wearing tight-fitting shoes, socks or tights – this places pressure on the skin around  your toenail; the skin may be pierced if it's pressed on to your toenail. 

∙ Sweaty feet – if the skin around your toenails is soft, it's easier for your nail to pierce it  and embed itself within it.

∙ Injury – for example, stubbing your toe can sometimes cause an ingrown toenail to  develop 

∙ Natural shape of the nail – the sides of curved or fan-shaped toenails are more likely to press into the skin surrounding the nail. 

∙ A fungal nail infection can cause your toenail to thicken or widen.

Treating ingrown toenails 

Left untreated, an ingrown toenail can become infected, so it’s important that you: 

∙ Keep your feet clean by washing them regularly with soap and water  ∙ Change your socks regularly  

∙ Cut your toenails straight across to stop them digging into the surrounding skin  

∙ Gently push the skin away from the nail using a cotton bud (this may be easier after  using a small amount of olive oil to soften the skin)  

∙ Wear comfortable shoes that fit properly  

∙ Surgery may be recommended if your toenail doesn't improve. Depending on the  severity of your symptoms, this may involve removing part or your entire toenail. 

Surgery 

Partial nail avulsion (removal) 

Partial nail avulsion removes part of your toenail and is the most commonly used operation  for treating ingrown toenails. It's about 98% effective. 

Usually, a local anaesthetic is used to numb your toe and the edges of your toenail are cut  away. A chemical called phenol is applied to the affected area to prevent the nail growing  back and becoming ingrown in the future. 

A course of antibiotics may be prescribed if your nail is infected. 

Total nail avulsion 

Total nail avulsion completely removes your toenail. This may be necessary if your nail is  thick and pressing into the skin surrounding your toe. After you toenail has been removed,  you’ll have an indentation where your nail used to be. However, it's perfectly safe for you  not to have a toenail. 

After surgery

After toenail surgery, your toe will be wrapped in a sterile bandage. This will help stem any  bleeding and prevent infection. Rest your foot and keep it raised for one to two days after  the operation. 

To help reduce the pain, you may need to take a painkiller, such as paracetamol, and wear  soft or open-toed shoes for the first few days after surgery. 

Preventing ingrown toenails 

Taking care of your feet will help prevent foot problems such as ingrown toenails. It’s  important to cut your toenails properly (straight across, not at an angle or down the edges). 

Wash your feet every day, dry them thoroughly and use foot moisturiser. You can also use  a foot file or pumice stone to remove hard or dead skin. 

Wearing shoes that fit properly will help to ensure your feet remain healthy. You should  also change your socks (or tights) every day.