From the Guidelines
Ingrown toenails should be treated with a combination of home remedies and medical interventions, prioritizing prevention of infection and promotion of healthy nail growth, as the condition can significantly impact quality of life, particularly in individuals with underlying health conditions such as diabetes or poor circulation, as noted in studies 1. To treat a mild ingrown toenail at home, soak your foot in warm water with Epsom salt for 15-20 minutes, 3-4 times daily to reduce inflammation and soften the nail. After soaking, gently lift the edge of the nail using a clean cotton swab or dental floss and place a small piece of cotton under it to redirect growth. Apply an antibiotic ointment like Neosporin and cover with a bandage. Over-the-counter pain relievers such as ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) can help manage pain. Wear open-toed shoes or sandals until healing occurs. If you notice signs of infection (increasing pain, pus, spreading redness), or if you have diabetes or circulation problems, see a healthcare provider promptly. They may prescribe oral antibiotics or perform a partial nail removal procedure.
Some key points to consider in the management of onychocryptosis (ingrown toenails) include:
- Cutting nails straight across rather than curved to prevent pressure on the surrounding skin
- Keeping nails at moderate length to reduce the risk of trauma
- Wearing properly fitting shoes to minimize pressure on the toes
- Maintaining good foot hygiene to prevent infection
- Being aware of the potential for fungal infections, such as onychomycosis, which can contribute to the development of ingrown toenails, as discussed in studies 1
It is essential to prioritize the prevention of infection and promotion of healthy nail growth, particularly in individuals with underlying health conditions, as the condition can have a significant impact on quality of life, as noted in studies 1.
From the Research
Causes of Onychocryptosis
- Many anatomic and behavioral factors contribute to ingrown toenails, such as improper trimming, repetitive or inadvertent trauma, genetic predisposition, hyperhidrosis, and poor foot hygiene 2
- Nail care habits and footwear are also contributory factors, with the great toe being most often affected 3
- Ingrown toenails can occur due to the nail acting as a foreign body, causing an inflammatory reaction and opening the way to secondary infection 4
Treatments of Onychocryptosis
- Conservative treatment approaches include soaking the foot in warm, soapy water, placing cotton wisps or dental floss under the ingrown nail edge, and gutter splinting with or without the placement of an acrylic nail 2
- Nonsurgical treatments, such as correcting inappropriate footwear, managing hyperhidrosis and onychomycosis, soaking the affected toe, and applying a mid- to high-potency topical steroid, can be used for mild to moderate ingrown nails 3
- Surgical approaches, including partial nail avulsion or complete nail excision with or without phenolization, can be used for moderate and severe cases, and are superior to nonsurgical ones for preventing recurrence 2, 3, 5
- Operative treatment, consisting of partial nail extraction from the ingrown nail edge in combination with destruction of the corresponding part of the matrix, is recommended for stage II-III ingrown toenails and failing conservative treatment 5
- Chemocautery with phenol or a surgical partial matricectomy can be carried out if inflammation, localized cellulitis, and pain do not resolve rapidly 6