Ingrown toenail

Author: Vanessa Ngan, Staff Writer, 2005.

What is an ingrown toenail?

An ingrown toenail is a painful condition of the toe that occurs when the sides or corner of the toenail digs into the skin at the end or side of the toe. The condition mostly affects the outer edge of the big toe, although the nail on both sides of the toe, or nail on any toe can become ingrown.

An ingrown toenail is also known as onychocryptosis.

What causes ingrown toenails?

The causes for ingrown toenails are listed below, but the two most common causes are ill-fitting shoes and improperly trimmed nails.

What are the signs and symptoms of an ingrown toenail?

Ingrown toenails can be classified into 3 stages according to severity.

Stage 1

Stage 2

Stage 3

Pseudo-ingrown toenail of the newborn

About 2% of newborn babies are noted at birth to have ingrown toenails. This is because the growing nail plate is very short. It is rarely painful. The appearance rights itself within a year or so.

What is the treatment for an ingrown toenail?

Treatment is dependent on the stage of the condition. However, at any stage of the condition, the patient should avoid tight-fitting or high-heeled shoes. If possible, wear sandals until the condition is cleared up.

Stage 1 ingrown toenail should be managed conservatively using the following methods.

Stage 2 ingrown toenail may require the administration of topical or oral antibiotics. Topical antibiotic ointments combined with local anaesthetic agents help to heal the toe faster and also provide pain relief by numbing the affected area. Surgical removal of the ingrown toenail may be required if the condition worsens.

Stage 3 ingrown toenail is often treated surgically. The surgical technique of lateral nail avulsion plus matricectomy is highly successful. A brief description of this procedure is given below.

The following post-surgery procedures should be followed:

Other treatment for an ingrown toenail

An ingrown toenail may also be treated by a gutter splinter using slit plastic tubing to keep the nail and the lateral nail folds apart. These are kept in place by using tape or acrylic adhesive. An artificial nail may be sculputured using formable acrylic solution.

Chemical or medical nail avulsion is a painless, slow way to remove damaged nails. As the whole nail is destroyed by the process, it is rarely used for ingrown toenails.

Can ingrown toenails be prevented?

Adhering to the following simple rules can easily prevent ingrown toenails:

Related information

Email Newsletter

Would you like to receive our dermatology updates by email?


Submit your images

We're seeking high-quality photos of skin diseases.  


Machine diagnosis

Watch DermNet's proposal to create a 'Skin Disease Image Recognition Tool' - winner of the 2017 'Clinicians' Challenge Active Award' by the NZ Ministry of Health and HiNZ.

Subscribe to our mailing list

* indicates required
DermNet NZ Newsletter