What Causes Ingrown Toenails & How to Recognize Them

Understanding Ingrown Toenails

An ingrown toenail occurs when the edge or corner of a toenail grows into the surrounding skin rather than over it. The big toe is most commonly affected, though any toenail can become ingrown. As the nail presses into the skin, the body responds with pain, redness, swelling, and sometimes infection.

Causes & Risk Factors

Ingrown toenails can develop for a number of reasons, including:

• Trimming nails too short or rounding the corners rather than cutting straight across
• Wearing shoes or socks that are too tight, compressing the toes, and pushing the nail into the skin
• An inherited tendency toward curved or wide nails
• Injury to the toe, such as stubbing it or having something dropped on it
• Repeated pressure from physical activity, like running or dancing
• Toenail fungus, which can cause the nail to thicken and grow irregularly

Symptoms

The most common signs of an ingrown toenail are pain and tenderness along one or both sides of the nail, particularly when pressure is applied. Other symptoms include:

• Redness and swelling around the nail border
• Skin that appears to be growing over the edge of the nail
• Drainage or a foul odor, which may indicate infection
• Warmth around the affected toe
• A visible area where the nail is digging into the skin

It's important to see a podiatrist promptly if you notice signs of infection, or if you have diabetes, neuropathy, or poor circulation, as these conditions significantly raise the risk of complications from an untreated ingrown toenail.

Ingrown Toenail Causes in Children & Adults

Ingrown toenails are common across all age groups. In children, rapid nail growth and improper trimming are frequent contributing factors. In adults, footwear choices and nail shape tend to play a larger role. Recurring ingrown toenails often indicate an underlying structural issue with the nail itself, which can be permanently addressed with an in-office procedure.

Ingrown Toenail Removal Options at Our Council Bluffs Office

How Dr. Barnes Treats Ingrown Toenails

Treatment depends on the severity of the ingrown nail and whether infection is present. Dr. Barnes will evaluate your toe and recommend the most appropriate approach.

Conservative Care

For mild cases caught early, conservative management may be sufficient. This can include gently lifting the nail edge, placing a small piece of cotton or a splint beneath the nail to redirect its growth, and soaking the foot in warm water to reduce inflammation. Proper nail trimming guidance is also provided to help prevent recurrence. However, once an ingrown toenail has become painful, infected, or recurrent, in-office treatment is typically the most reliable path to resolution.

In-Office Nail Procedure (Chemical Matrixectomy)

The most effective and lasting treatment for an ingrown toenail is a chemical matrixectomy, a simple in-office procedure that Dr. Barnes performs under local anesthesia. The toe is numbed first, so patients experience very little discomfort during the procedure itself.

Depending on the extent of the problem, Dr. Barnes will perform either a partial or total nail removal:

• Partial nail removal: The ingrown portion of the nail border is carefully removed, leaving the rest of the nail intact. This is the most common approach for a single ingrown edge.
• Total nail removal: In cases where the entire nail is severely affected or deformed, the full nail may be removed.

After the nail edge or nail is removed, a chemical called phenol is applied to the nail root to prevent that portion of the nail from regrowing. This is what makes the procedure a lasting solution rather than a temporary fix. Most patients can resume normal activities the following day, and the healing period involves simple daily dressing changes at home using over-the-counter antibiotic ointment and gauze.