Disease Index Skin Diseases

Ingrown Toenail

An ingrown toenail occurs when the nail on a toe grows into the skin. Ingrown toenail is due to poor foot care and unsuitable footwear. It may also result from tearing of the nail so that the edge is unprotected, and nails that are cut incorrectly.

An ingrown toenail occurs when the nail on a toe grows into the skin. The condition can be painful and look unpleasant, but it seldom does much damage. It occurs when one of the sides of the toenail grows into and under the skin, rather than lying over the top, as is normal. The edge of the toenail disappears under the skin, making it impossible to trim. As it grows longer, the ingrown toenail cuts through the skin, when the person pushes down on the toe when walking, the toenail is forced farther into the skin, a condition that can be extremely painful.

Ingrown toenails seldom happen on their own, they form because toenails have been cut badly or a person’s shoes do not fit properly. If a toenail is cut very short, it will need to grow over a lot of skin before reaching the end of the toe. That makes it more likely that the toenail will become ingrown. The problem is made worse when the corners of the toenail are cut away. The skin along the side of the nail grows to fill the gap. When the corner of the toenail grows into that area, it will start to cut into the new skin.

Tight shoes press the toenail down into the skin and stop it from growing over the top. If the shoes are not replaced, the nail will become ingrown. Most ingrown toenails occur on the big or little toes, because they are on the edges of the foot. The big toe is the most flexible and is used most during walking, so an ingrown nail on the big toe is most painful of all.

Avoiding tight shoes and cutting toenails so they keep a straight, square shaped front edge will help prevent ingrown toenails. People who get ingrown toenails often make things worse by trying to cut the nail free. That makes it more painful and leads to infections.

Causes and Symptoms of ingrown toenail

Ingrown toenail is due to poor foot care and unsuitable footwear. It may also result from tearing of the nail so that the edge is unprotected, and nail that are cut incorrectly. Tight shoes pressing on the growing nail and hot sweaty feet are two other factors that can cause an ingrown toenail.

An ingrown toenail is painful and looks deformed. The pain disappears when the foot is rested, but it resumes when the person walks and the shoe presses down on the toe. Initially the area around the nail becomes slightly red and swollen, and in time it may become infected. Infection leads to increased swelling and a possible discharge of pus, so that the area becomes painful and sticky.

Staging of ingrown toenail

For the ease of understanding, labeling and treatment planning, Heifitz classified the ingrown toenail into 3 stages:

Stage I: Pain with mild erythema and swelling of the nail fold.

Stage II: increased swelling, sero purulent discharge, and laceration of the nail-fold.

Stage III: Chronic inflammation with granulation and marked fold hypertrophy.

Treatment for ingrown toenail

The initial treatment involves resting the foot; relieving any pressure from footwear; bathing regularly in hot salty water; and, if there is an infection present, using an antibiotic (where conventional medicine is concerned). These measures relieve a large proportion of cases, but in some people the condition is both chronic and recurrent; the tendency to develop the condition never completely disappears, and the site continues to become infected from time to time. Various surgical operations have been used to treat ingrown toenails, but they tend to immobilize the patient for two to three weeks. The first option is a nail wedge resection, in which the affected part of the nail is cut off under a local anesthetic; this simple procedure provides a full cure for many patients.

Another possibility is pulling of the whole nail under a local anesthetic. This allows a new nail to grown again over a period of several months. In most cases, patients find that the condition does not recur after this treatment.

In the case of an irregularly shaped nail, a plastic gutter is place along the side of the nail. This treatment allows growth to continue without the nail’s growing into and damaging the soft tissue. A local anesthetic is used for this procedure.

If all else fails, in the small minority of chronic cases, the nail and the nail forming tissue (nail bed) can be removed. This surgical procedure is usually performed under a general anesthetic. When the site heals, the nail never re-grows, and the area where the nail used to be eventually becomes covered in a tough protective skin.


The outlook for this common condition depends on the individual patient. In some cases rest and bathing produce relief within two or three days. When there is an infection, it may take several days to clear up.

It can take several months for the nail to grow back after surgery. Dressing and loose fitting, open shoes must be worn for some time. Occasionally the newly growing nail is the site of a recurrence, and then there is no solution other than to have the nail and the nail bed removed. Although this procedure provides a complete and permanent cure, the nail will never re-grow.

Homeopathic treatment of ingrown toenail – Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat ingrown toe nail but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to cure ingrown toe nail that can be selected on the basis of cause, sensations and modalities of the complaints.  For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of ingrown toe nail:

Silicea Terra, Teucrium, Nitric Acid, Graphites, Magnatis Polus Australis, Sulphur, Phosphoric Acid, Thuja, Causticum, Natrum Mur, Colchicum, Plumbum, Alumina, Kali Carb, Tuberculinum and many other medicines.

What can we do to prevent recurrence of this condition?

The following can be done in an attempt to prevent recurrence, but sometimes an ingrown nail just occurs again. Prevention can include the following:

  • Wear properly fitting socks and shoes.
  • If there is trauma to the toe or nail, inspect it. If it appears that the nail is damaged or this is discomfort, start soaks.
  • Properly trim the nails, using appropriate toenail trimming tools. Do not cut the toenail too short, and cut the nail straight across. (If you have a sharp corner, use a nail file to round the corner).


Encyclopedia of Health, Volume 9; 569; 2009

Gary Morchower, Gary C. Morchower; 1001 Healthy Baby Answers: Pediatricians’ Answers to All the Questions You; 2008; 351

David B. Jacoby, R. M. Youngson; Encyclopedia of Family Health; 951-952; 2004

VN Sehgal: Dermatologic Surgery Made Easy; 230; 2006

About the author

Ashish Sharma

Ashish Sharma

Leave a Comment