Ingrown toenails are one of those conditions that start small and become very hard to ignore. What begins as a bit of tenderness at the corner of a toenail can escalate into significant pain, swelling, and infection if it's not addressed. The good news: with the right technique and habits, most ingrown toenails are preventable — and when they do occur, early care can resolve them quickly.
Why Ingrown Toenails Happen
An ingrown toenail (onychocryptosis) develops when the edge or corner of a toenail grows into the surrounding skin rather than over it. The big toe is most commonly affected, but any toe can develop the problem. Several factors contribute:
- Improper nail trimming — cutting nails too short or rounding the corners instead of cutting straight across encourages the nail edge to grow into the skin
- Tight or narrow footwear — shoes that crowd the toes press the nail into the surrounding tissue, guiding it inward (the same pressure contributes to bunion development)
- Nail shape — some people have naturally curved or fan-shaped nails that are more prone to ingrowing
- Injury — stubbing a toe or dropping something on it can cause the nail to grow abnormally
- Hyperhidrosis — excessive foot sweating softens the skin around the nail, making it easier for the nail to penetrate
5 Ways to Prevent Ingrown Toenails
Most ingrown toenails are preventable with simple, consistent habits:
- Cut straight across — trim toenails in a straight line, not curved, and not too short. Leave the nail long enough that the corners aren't buried in the skin. Aim to keep nail length roughly even with the end of the toe.
- Use proper nail tools — use sharp, clean nail clippers designed for toenails (not scissors), and trim after a shower when nails are softer and easier to cut cleanly
- Wear well-fitting shoes — shoes should have enough room in the toe box that your toes aren't compressed or forced against the front of the shoe. Avoid pointed-toe shoes for extended wear.
- Protect your feet — wear protective footwear in environments where toe injuries are possible. Stubbed or crushed toenails are a common precursor to ingrown nail development.
- Keep feet clean and dry — moisture softens the periungual skin, making it more susceptible to nail penetration. Change socks if your feet tend to sweat.
Home Care for Mild Ingrown Toenails
If caught early — before infection has set in — a mild ingrown toenail can sometimes be managed at home. This approach is appropriate for otherwise healthy adults with no signs of infection:
- Epsom salt soaks — soak the affected foot in warm water with dissolved Epsom salt for 15–20 minutes, two to three times daily. This softens the skin, reduces inflammation, and helps the nail edge lift away from the surrounding tissue.
- Gently lift the nail edge — after soaking, use a clean cotton ball or piece of dental floss to gently elevate the ingrown nail edge away from the skin. Place the cotton or floss under the corner of the nail to guide it to grow in the correct direction. Replace it daily.
- Topical antibiotic ointment — applying a thin layer of over-the-counter antibiotic ointment (such as Neosporin) and covering with a bandage helps reduce the risk of infection while the nail is actively growing into the skin.
- Wear open-toed shoes or sandals — reduce pressure on the affected toe while it heals
Do not attempt to cut out the ingrown portion yourself (the so-called "bathroom surgery"). This increases the risk of infection and rarely resolves the underlying problem.
Warning Signs That Need Professional Care
Home care is not appropriate for everyone, and some situations require prompt professional evaluation:
- Signs of infection — warmth, spreading redness, pus or drainage, increasing pain, and swelling indicate the nail bed may be infected and will require professional treatment and possibly antibiotics
- No improvement within a few days of home care
- Recurring ingrown toenails on the same toe — a permanent procedure may be appropriate to prevent future episodes
- Diabetes, peripheral vascular disease, or neuropathy — any ingrown toenail in a patient with diabetes or circulation problems should be evaluated by a podiatrist immediately; do not attempt home treatment
What Treatment Looks Like at the Office
Treating an ingrown toenail in our office is a quick, straightforward procedure. The toe is numbed with a small local anesthetic injection, and the ingrown nail border is carefully removed. For recurrent ingrown toenails, a small amount of the nail matrix (the tissue responsible for nail growth) can be treated with a chemical to permanently prevent that portion of the nail from growing back. This is called a partial nail avulsion with matrixectomy, and it has a very high success rate. Most patients experience same-day relief and return to normal activities within one to two days.
For more details about our approach, visit our ingrown toenail treatment page.
If you're experiencing a painful or infected ingrown toenail, our podiatrists at Big Sky Foot & Ankle can help. Serving Butte, Bozeman, Anaconda, and Ennis, Montana.