An ingrown toenail is a nail edge growing into the skin beside it. The skin responds the way it would to any foreign object — inflammation, swelling, and often infection. It hurts out of all proportion to its size.
Most of the damage done to ingrown nails is done by their owners.
Do not dig at it
The instinct is to get in there with clippers or a point and free the edge. This almost always leaves a spike of nail behind, which then grows forward into deeper tissue, and it introduces bacteria into skin that is already inflamed.
Do not cut a V into the middle of the nail either. This is a persistent myth — the idea that the nail will grow toward the notch. Nail grows forward from the base. Cutting the middle achieves nothing.
What actually helps
Soak the foot in warm water with Epsom salt for fifteen to twenty minutes, twice daily. This softens the nail fold, reduces swelling and eases the pain considerably.
Afterwards, apply two drops of geranium oil in a teaspoon of carrier oil around the sore edge. Geranium is anti-inflammatory, antibacterial and mildly styptic, which is a good match for skin that is swollen and sometimes bleeding slightly. Shea butter keeps the fold soft.
Wear open or wide shoes while it settles. Anything pressing on the toe makes it worse.
Go to a podiatrist when
- There is pus, or the toe is throbbing.
- Redness is spreading beyond the nail fold.
- It has not improved in a week of soaking.
- It keeps coming back on the same toe.
- You have diabetes or poor circulation — go now, not in a week.
A recurring ingrown nail can be permanently fixed in a short procedure. People put up with them for years unnecessarily.
The two habits that cause it
First, cutting nails too short or rounding the corners down. Cut straight across, level with the end of the toe. A rounded corner leaves the nail edge below the skin line, and it grows into it.
Second, tight shoes. Anything that squeezes the toes sideways pushes the fold onto the nail. Narrow toe boxes and shoes half a size too small are the usual culprits.
Soften the cuticle and nail fold with jojoba oil rather than cutting cuticles — cutting them is another common route to infection.
Full entry on ingrown toenails and geranium.
Cutting nails properly
Since most ingrown nails come from how they are cut, it is worth being precise about the method.
Cut after a bath or shower, when the nail is soft and less likely to split. Use proper nail nippers rather than scissors — scissors compress the nail and encourage it to crack. Cut straight across in several small cuts rather than one large one, and leave the nail level with the end of the toe rather than shorter.
Then leave the corners alone. Do not round them down, and do not dig into the corner to tidy it up. Smooth any sharp edge with an emery board instead, filing along the free edge rather than into the fold.
If you cannot reach your feet comfortably, or your eyesight makes this awkward, have a podiatrist do it. Nail cutting is a routine appointment, it is inexpensive, and it prevents a problem that is considerably more expensive and painful to fix. That goes double for anyone with diabetes, where self-trimming is a genuine risk rather than a convenience.