An ingrown toenail occurs when the nail edge grows into the surrounding skin, causing pain, redness, and possible infection. Most commonly affects the big toe. A minor in-clinic procedure (partial nail avulsion with phenol) is highly effective and permanently prevents recurrence of the treated edge.
Ingrown toenails affect 2 to 5% of the population and are one of the most common nail problems seen by podiatrists. They cause pain, swelling, and redness where the nail edge digs into the skin. Left untreated, they can become infected. Most cases resolve with proper treatment, and a minor in-clinic procedure can permanently prevent recurrence.
An ingrown toenail (onychocryptosis) occurs when the edge or corner of the toenail grows into the soft flesh alongside it, rather than over it. The big toe is affected in the vast majority of cases, though any toe can be involved. The nail pierces the skin, which responds with inflammation, pain, and — if bacteria enter — infection.
The condition progresses through stages. Initially there is pain and mild swelling. If left, the skin can become red and warm, with discharge and granulation tissue (overgrown skin) forming at the nail edge.
Ingrown toenails are particularly common in:
Symptoms depend on severity:
If you notice red streaking up the toe or foot, fever, or increasing redness spreading beyond the toe, seek medical attention promptly as this may indicate a spreading infection.
Diagnosis is straightforward and based on examination. Your podiatrist will assess:
No imaging is needed in most cases. If underlying bone involvement is suspected, an X-ray may be taken.
Treatment depends on how severe the ingrown nail is.
For mild cases:
In-clinic conservative treatments:
Surgical treatment — partial nail avulsion with phenol matricectomy: This is the definitive treatment for recurrent or severe ingrown toenails and is performed in the clinic under local anaesthetic. The offending edge of the nail is removed, and a chemical (phenol) is applied to the nail root to permanently prevent that edge from regrowing. The procedure takes around 30 minutes. Recovery is straightforward — most people return to normal activities within a day or two, with full healing typically within 3 to 6 weeks. Evidence consistently shows this approach has a very low recurrence rate.
Surgery sounds significant but it is a routine minor procedure. The anaesthetic injection is the most uncomfortable part; the procedure itself is painless.
See a podiatrist if:
With appropriate treatment, the outlook is excellent:
Can an ingrown toenail go away on its own? Mild cases sometimes resolve if you change your footwear and nail-cutting technique, but once the nail has penetrated the skin, it rarely corrects itself without some form of treatment.
Will the nail look normal after surgery? The treated nail edge will be narrower than before, but most people find this barely noticeable. The nail still grows normally from the remaining root.
How long does it take to heal after the procedure? Typically 3 to 6 weeks for full healing, though you can usually resume normal activities within 1 to 2 days.
Mild cases sometimes resolve with better footwear and nail-cutting technique, but once the nail has penetrated the skin it rarely corrects itself without treatment.
The local anaesthetic injection is the most uncomfortable part. The procedure itself is painless. Most people return to normal activities within a day or two.
The treated edge will be slightly narrower, but most people find this barely noticeable and the nail continues to grow normally from the remaining root.
Full healing typically takes 3 to 6 weeks, though you can usually wear normal shoes and return to work within 1 to 2 days of the procedure.
Partial nail avulsion with phenol matricectomy has a recurrence rate under 5%. This is the lowest recurrence rate of any technique currently available.