An ingrown toenail shows up as a red, swollen area along one or both sides of the nail where the edge of the nail presses into or grows into the surrounding skin. It most commonly affects the big toe, and the earliest sign is tenderness and puffiness right at the nail border. What it looks like depends on how far it has progressed, from mild swelling to visible infection with pus and overgrown tissue.
What an Early Ingrown Toenail Looks Like
In the earliest stage, you’ll notice redness and slight swelling along the side of the nail. The skin next to the nail edge may look puffy and feel hard or firm to the touch. At this point there’s no drainage or sign of infection. The nail itself looks normal, but if you look closely, you can often see the corner or edge of the nail pressing into the skin fold beside it.
The pain at this stage is typically triggered by pressure, like wearing a tight shoe or pressing on the side of the toe. The affected side of the toe looks noticeably different from the other side, or from the same spot on your other foot. On darker skin tones, the inflammation may appear as a deeper or darker discoloration rather than bright red.
What a Moderate Ingrown Toenail Looks Like
As the condition worsens, the swelling increases and the skin along the nail edge becomes more inflamed. The key visual change at this stage is drainage. You may notice white or yellow pus seeping from the area where the nail meets the skin, and the skin fold itself can look wet or shiny. The redness typically spreads a bit further from the nail edge, and the toe may feel warm to the touch.
At this point, the nail edge is clearly embedded in swollen skin. You might see the skin starting to grow up and over part of the nail border. Pain is no longer limited to pressure. It can be constant, and even light contact with a bedsheet or sock can be uncomfortable.
What a Severe Ingrown Toenail Looks Like
A severely ingrown toenail looks dramatically different from a healthy toe. The hallmark of this stage is granulation tissue, sometimes called “proud flesh.” This is a small, reddish, bumpy mass of tissue that forms along the nail edge. It bleeds easily and produces ongoing discharge. The tissue looks raw, wet, and slightly raised, almost like a small growth sitting on top of the skin beside the nail.
The skin fold itself becomes visibly overgrown at this stage, thickening and swelling so much that it partially covers the nail edge. Pus discharge is more persistent, and the entire side of the toe can appear swollen, red, and misshapen compared to normal. The nail may be partially hidden under the inflamed tissue, making it hard to see where the nail ends and the skin begins.
How It Differs From Other Nail Problems
An ingrown toenail is easy to confuse with paronychia, which is a skin infection around the nail. The key visual difference is location. With an ingrown toenail, the pain and swelling concentrate specifically where the nail edge digs into the skin, usually on one side. You can often see the nail embedded in the swollen tissue. Paronychia, by contrast, causes swelling and redness around the entire nail fold, often including the cuticle area, and develops much faster, sometimes within hours.
Fungal nail infections also look different. A fungal infection causes the nail itself to thicken, turn yellow or brown, and become brittle or crumbly. The surrounding skin isn’t typically swollen or tender the way it is with an ingrown nail. An ingrown toenail affects the skin around the nail, not the nail plate itself, at least in the early stages.
Warning Signs the Infection Is Spreading
Most ingrown toenails stay localized to the nail fold, but infection can occasionally spread into the surrounding tissue of the toe or foot. Signs that this is happening include redness that extends well beyond the nail edge, spreading across the toe or onto the top of the foot. The skin may feel hot, and you might develop fever or chills. In some cases, red streaks can appear running away from the toe, which signals the infection is moving along tissue layers. A rapidly expanding area of redness, especially with fever, needs prompt medical attention.
What Makes Some Nails More Prone
Certain nail shapes make ingrown toenails more likely, and recognizing them can help you spot a problem early. Nails that curve sharply downward at the edges (sometimes called pincer nails) naturally press into the skin fold as they grow. Nails that are cut too short or rounded at the corners leave a small spike that can dig into the skin as it grows out. Tight shoes that compress the toes push the skin against the nail edge, creating the same effect. If your toenail is naturally wide relative to your nail bed, or if one side of the nail looks like it curves more steeply than the other, you’re looking at a nail that’s more likely to become ingrown over time.