Symptoms of an Ingrown Toenail

An ingrown toenail, medically known as onychocryptosis, is a common toenail condition that usually affects the big toe. It occurs when the edges of the toenail grow into the skin. One of the first signs of an ingrown toenail is pain. Other common symptoms are swelling and redness.

It's important to quickly identify and treat an ingrown toenail. If left untreated, the area can become infected, causing more pain and complications.

This article will cover the symptoms and complications of an ingrown toenail. It will also discuss when someone should see a healthcare provider.

Frequent Symptoms

One of the first symptoms of an ingrown toenail is pain. It is followed by swelling and redness. When the nail pushes into the skin, the body responds by sending more blood to the area. This is what causes redness and swelling.

The most common ingrown toenail symptoms are:

• Pain
• Swelling
• Redness

Symptoms of moderate to severe ingrown toenails include:

• Liquid or pus discharge
• Skin that is warm to the touch
• Foul smell

Staging an Ingrown Toenail

Ingrown toenails can cause several different symptoms based on their severity. There are three stages of an ingrown toenail, ranging from least severe to most severe. The stages are:

• Stage one: The toenail has started to grow into the skin. There is swelling, redness, and pain.
• Stage two: The skin around the toenail has become infected and swelling has increased. An open wound is present with pus or fluid draining.
• Stage three: New tissue (hypertrophic granulation tissue) grows over the nail causing more pressure, which creates more swelling and fluid discharge.
  

Rare Symptoms

Ingrown toenail symptoms tend to be straightforward, with pain, swelling, and redness as the predominant signs. However, if a person has complications from the ingrown toenail, a few rare symptoms may develop.

One of the rare symptoms of an ingrown toenail is an abscess, which is a pocket just under the skin that fills with pus or fluid. An abscess will need to be drained by a healthcare provider and may need antibiotic treatment.

Another rare symptom is cellulitis. Cellulitis is a bacterial infection of the deeper layers of the skin. The skin around the wound may be red, swollen, have blisters, and look pitted like the peel of an orange. If cellulitis is suspected, contact a healthcare provider for treatment.

Complications

Ingrown toenails may be thought of as a minor condition, but if they are left untreated they can cause serious issues.

When the toenail pushes into the skin, it causes a wound. Bacteria can get into the wound and cause an infection. An infection of the skin surrounding a nail is called paronychia. 

The infection from an ingrown toenail can spread from the skin to the bone (osteomyelitis). This is a very serious condition that is treated with intravenous (IV) antibiotics and by removing dead bone tissue.

People with diabetes, nerve problems, or other conditions that cause poor blood flow to the feet should be diligent with foot health in order to prevent complications from ingrown toenails.

When to See a Healthcare Provider

Mild ingrown toenails can be managed at home with simple treatments, including foot soaks in warm, soapy water or Epsom salts, separating the nail and skin using cotton or dental floss, and/or gentle massage.

When an ingrown toenail does not get better in a few days or has signs of infection, then it's time to contact a healthcare provider. It's important to not try to dig out the toenail yourself, as this could make the condition worse.

When visiting a healthcare provider for an ingrown toenail, treatment will depend on the severity of the condition. If an infection is present, your provider may prescribe an oral antibiotic. They may also perform a procedure to help remove all or part of the affected toenail, such as a:

• Slant back procedure (removing a small piece of the nail that's digging into the skin)
• Partial nail avulsion (removing part of the nail, freeing it from the surrounding soft tissue)
• Total nail avulsion (removing the entire toenail)

These procedures may be accompanied by a nail matricectomy, in which the healthcare provider will use a chemical to cauterize (kill) the nail matrix so that the nail will not grow back.

Summary

An ingrown toenail is a condition in which the toenail grows into the skin. The symptoms include pain, swelling, and redness. The skin can become infected and cause other symptoms, including pus drainage and a foul odor. Avoiding treatment can lead to severe complications, such as a bone infection. If home treatments are not effective, contact a healthcare provider.

A Word From Verywell

An ingrown toenail may sound like a minor condition, but if it isn't treated properly it can cause serious issues. Make sure to promptly treat your ingrown toenail. If it doesn't get better or becomes infected, contact your healthcare provider for additional treatment.