Most ingrown toenails can be managed at home with warm soaks, proper nail care, and a few days of patience. The key is catching it early, before infection sets in, and knowing when the situation calls for professional help. Here’s what to do at each stage.
Start With Warm Soaks
The first thing to do when you notice an ingrown toenail is soften the area with warm water. Mix 1 to 2 tablespoons of unscented Epsom salt into one quart of warm water and soak your foot for 15 minutes at a time. Do this several times a day for the first few days. The warm water reduces swelling, eases pain, and softens both the nail and the surrounding skin so the nail is less likely to keep digging in.
After each soak, gently dry your foot and try to lift the edge of the nail slightly away from the skin. Some people tuck a tiny piece of clean cotton or dental floss under the nail corner to encourage it to grow above the skin rather than into it. Replace this cotton after every soak to keep bacteria from building up. Wear open-toed shoes or loose-fitting footwear while you’re treating it, since tight shoes press the nail further into the skin and make everything worse.
Over-the-Counter Pain Relief
If the area is sore, you have a couple of options. Standard anti-inflammatory pain relievers like ibuprofen help with both pain and swelling. There are also OTC products sold specifically for ingrown toenails that contain sodium sulfide, which works by softening the nail itself so it stops pressing into the skin as aggressively. These come as gels or drops you apply directly to the affected area. They can help bridge the gap while you wait for the nail to grow out, but they won’t fix an ingrown nail that’s already deeply embedded or infected.
How to Tell If It’s Infected
An ingrown toenail that’s just irritated will be tender and a little red. An infected one is a different situation. Watch for these signs:
- Pus or liquid draining from the side of the nail
- Increasing redness or darkening that spreads beyond the immediate nail edge
- Significant swelling that makes the toe look puffy or distorted
- Warmth or heat radiating from the toe
- Pain that worsens rather than improving over a few days of home care
If you notice pus, spreading redness, or the toe feels hot to the touch, home treatment alone isn’t enough. You’ll need to see a doctor or podiatrist, who will likely prescribe antibiotics and may need to address the nail itself. People with diabetes or circulation problems should skip the home treatment phase entirely and go straight to a professional, since infections in the feet can escalate quickly with these conditions.
What Happens at the Doctor’s Office
For an ingrown toenail that keeps coming back or won’t resolve with home care, the most common procedure is a partial nail avulsion. The doctor numbs your toe with a local anesthetic, then removes the strip of nail that’s growing into the skin. The procedure itself takes about 15 to 20 minutes, and the numbing means you won’t feel pain during it. Most people can walk out of the office and resume normal activities within a day or two, though the toe will be tender for a week or so.
The catch with simply removing the nail edge is that it tends to grow back the same way. Nail removal alone, without any additional treatment, has a recurrence rate as high as 70%. That’s why most doctors pair the nail removal with a chemical treatment called matrixectomy, where they apply a chemical to the root of the removed nail section to prevent it from regrowing. This combination drops the recurrence rate dramatically, to roughly 5% to 10%. The two chemicals used most often produce nearly identical results in terms of preventing the nail from coming back, so the choice between them is largely up to your doctor’s preference.
Recovery after a chemical matrixectomy involves keeping the toe clean and bandaged for a couple of weeks. There may be some drainage from the treated area as it heals, which is normal. Most people are back in regular shoes within two to three weeks.
Preventing Ingrown Toenails
How you trim your toenails is the single biggest factor you can control. Cut your nails straight across rather than rounding the corners or cutting them at an angle. Rounded or angled cuts encourage the nail edge to curve down into the skin as it grows. Aim for a square shape and then use a nail file to gently smooth the edges so sharp corners don’t catch on socks or shoes.
Just as important: don’t cut your nails too short. Leave a small bit of white nail visible at the edge. When nails are trimmed very short, the skin at the sides can fold over the nail as it starts to grow, trapping it underneath. Use toenail clippers rather than fingernail clippers, since they have a straighter, wider blade that makes a clean horizontal cut easier.
Footwear matters too. Shoes that squeeze the toes together, especially in the toe box, push the nail into the surrounding skin with every step. If you’re prone to ingrown toenails, choose shoes with a roomy toe area. Moisture also plays a role: feet that stay damp and sweaty have softer skin that’s easier for a nail edge to penetrate, so breathable socks and shoes help reduce your risk.