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Ingrowing toenails

What is it?

What causes it?

An ingrowing toenail (known medically as onychocryptosis) is one that grows inwards, piercing the skin of the toe [1].

An ingrowing toenail can be caused by a variety of issues, including your gait (the way you walk), which can put abnormal pressure on the nail [1]. Sometimes the shape of your toe and the natural way your nail grows can cause the problem [2]. Poorly fitting footwear or tight socks, cutting your nails too short, or having particularly sweaty feet can also cause the toenails to grow inwards [3]. In some cases, the underlying cause of an ingrowing nail is a fungal nail infection, which can cause the nail to become thick and deformed [1].

Stage 3 ingrowing nail requiring nail surgery, evidence of infection by nail piercing the skin

What are the symptoms?

The affected toe will usually be painful, swollen and red, and in some cases there may be pus or blood coming from the area. The big toenails are most commonly affected, but any nail can become ingrowing [2].

What podiatry treatments are available?

  • Conservative treatment – our podiatrist will remove the nail spike and pack or dress the nail appropriately. If the toe is infected, we will arrange antibiotics. You will also be advised on the best way to cut and look after your toenails [4]. Your footwear will be assessed and you will be advised on the best type of shoes for your feet, to prevent further ingrowing nails. Sometimes, the problem will reoccur and you may need ongoing conservative treatment, especially if the ingrowing toenail is caused by the shape of your nail.

  • Biomechanical assessment and management – our podiatrist can assess your gait and determine if the way you walk and the subsequent pressure applied to your toe is causing the nail to grow inwards [4]. If appropriate, we can provide insoles to reduce this pressure and improve the problem. Visit us in Bradford for a full assessment to establish what treatment is best for you.

  • Nail surgery – if your ingrowing toenail is excessively painful or keeps recurring, our podiatrist can remove part or all of the nail permanently [2]. This technique is performed under local analgesia, which will numb your toe. The offending part of the nail will be gently released from its bed, and a chemical will be applied to the nail bed to stop regrowth. You will have a number of follow up appointments here at Open Podiatry over the following 8-10 weeks so that the toe can be redressed.


1.     Metcalfe, S., Bristow, I. (2015) The Ingrowing Toenail. Dermatological Nursing, 1, p48-51.

2.     Eekhof, J., Van Wikj, B., Knuistingh, N.A., van der Wouden, J.C. etc. (2012) Interventions for ingrowing toenails. Cochrane Database of Systematic Reviews.

3.     Park, D. (2012) The management of ingrowing toenails (Clinical Review). British Medical Journal, 344.

4.     Weaver, T.D., Ton, M.V., Pham, T.V. (2004) Ingrowing toenails: management practices and research outcomes. International Journal of Lower Extremity Wounds, 3 (1), p22-34.

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