The medical term for this painful condition is onychocryptosis. It develops, usually on the big toe, when a corner of the toenail curves down and digs into the skin. The symptoms may include soreness, swelling, redness, and warmth. If the toenail breaks the skin, bacteria may enter and cause an infection. Eventually, skin may start to grow over the ingrown part of the nail.

You can do several things at home to treat an ingrown toenail. However, if you suspect an infection, or if you have diabetes, circulation problems, or numbness in the toes, skip the home remedies and see your clinician or a foot specialist immediately.

What causes an ingrown toenail? There are many possible causes. One is trauma; for example, you stub the toe or drop something on it, or someone steps on it. Loss of the toenail, repetitive pressure from certain sports, a fungal infection, or psoriasis may be to blame. Thick or curved toenails (nails tend to curve more with age) are particularly susceptible, and some people have an inherited tendency to develop nail problems. Improper nail trimming — cutting the nail too short at the corners — may be implicated.

The risk of ingrown toenails is raised by wearing shoes that are too tight, too narrow, or too short. According to Dr. James Ioli, Chief of Podiatry at Boston’s Brigham and Women’s Hospital, women’s high heels are a common source of trouble.

HOME CARE: KEEP IT SIMPLE

If your symptoms are minor (the toe is irritated and red but not infected or very painful) and you don’t have a complicating medical condition such as diabetes, you can start at home with conservative measures.

Soak the foot in lukewarm water two or three times a day for 15 minutes (count a shower as a soak). You can add Epsom salts if you wish, although there’s no scientific evidence that this will improve pain relief or healing. Massage the skin at the side of the toenail (the nail fold), gently pushing it away from the nail. After each soak, dry your foot thoroughly; apply an antibiotic ointment such as Neosporin, bacitracin, or Polysporin to the affected area; and cover the area with a Band-Aid.

Wear sandals or other low-heeled open-toed shoes whenever possible. When you wear close-toed shoes, make sure the toe box (the front of the shoe) allows room for the toes to move freely. When the toenail grows out, cut it across in a line that mimics the curving line of the toe tip; do not round the corners down.

You may have read or heard about other measures. One approach is to relieve pressure by lifting the ingrown nail edge and placing a small piece of cotton or dental floss or a splint underneath it. According to Dr. Ioli, this is more likely to harm than help; for example, cotton under the nail could trap bacteria and other infectious organisms. Another risky practice strongly opposed by experts is “bathroom surgery” — trying to dig out and trim the corner of the ingrown toenail yourself.

PREVENTING INGROWN TOENAILS

–Wear low-heeled shoes that provide enough room at the toes, with stockings or moisture-wicking socks that allow your toes to move freely.

–Keep your feet clean and dry.

–Use a toenail clipper (not a fingernail clipper). If your toenails are especially thick, try a spring-handled tool called a toenail nipper.

–Cut your toenails across, going with the curve of the toe; don’t round the corners down as you might a fingernail. And don’t cut toenails too short. You should be able to get your fingernail under the end of the toenail.

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