Toenails help protect the sensitive tissues in our toes, but can cause severe pain if they cut into the toes. The feet endure a lot of stresses and strains walking, running, wearing shoes, working and playing sport. Occasionally, the whole nail or just a portion of it will grow into the skin and penetrate the skin’s surface. This problem usually occurs on the big toe however smaller toes can be affected.

What Causes an Ingrown Toenail?

There are a range of factors that can cause ingrown toenails. Below are a few common causes that can predispose you to ingrown toenails.

  • Improper Nail Cutting Technique

Nails should be cut along the contour of the toe or straight across. It’s important not to cut down the sides of the toenails but the file the corners instead. Picking at the toenails can lead to the nail breaking off and leaving sharp edges for the nail to penetrate the nail bed

  • Poor Fitting Footwear       

Tight (width) or short shoes (length) can restrict room for nail growth with resultant pressure on the nails which can lead to ingrown nails. Ensuring the length of the shoe is at least a thumb-width from the longest toe to the tip of the shoe is imperative in ensuring the toenails are damaged while in footwear.

  • Trauma to the Toe

An acute injury near the nail or anything that causes the nail to be damaged repetitively can predispose you to an ingrown nail.  A few example of trauma to the toe can  include direct blunt trauma to to toe such as dropping a heavy object to the toe, micro trauma from activities such as running, and or wearing narrow or shallow footwear

  • Anatomy of the Toe

People can inherit the shape of our toes from our parents which can predispose you to ingrown toenails. A common presentation is ‘chubby toes’ whereby the skin around the nail folds are thick and raised. As a result the skin at the side of the toe is more likely to be traumatised or pierced by the nail as it grows straight out. Another presentation is a wide nail plate in proportion to the toe causing the distal edges of the nails to pierce the skin.

  • Incurvated/Involuted toenails             

The nail shape can curve/curl into the skin alongside the nail plate. This can be due to either trauma, a bony abnormality under the nail plate or from an inherited nail condition

  •  Flat Feet

Flat feet or over pronation cause the feet to turn outwards when walking and as a result a high amount of pressure is placed on the inner nail fold causing the nail edge to add pressure to the toe. Hard skin or callus can develop as a result of the toe compression and then an ingrown nail edge can occur.

Simple tips to manage and prevent ingrown toenails

1) To keep the pain and swelling down, soak your foot in lukewarm water for 15 minutes a day. Be sure to dry your foot completely

2) Apply a topical antibiotic ointment on your toenail. This will help to prevent an infection from occurring.

3) Bandage your toe with a Band-Aid to give it some cushion and protect it from touching against anything.

4) Make sure that you always wear shoes that fit you properly. Wearing shoes that are too tight or too high will force your toes into positions that can put pressure on your toenails. Wide-toed shoes are always a good idea, as are shoes with open toe

5) Avoid trying to cut the nail edge back as you may cause the nail edge to break off and pierce the nail fold. Trim your toenails to be even with the end of your toe. Cutting your toenails too short may make it easy for the pressure from your shoes to force the nail into the surrounding skin.

6) If you have diabetes, it is important to check your feet every day for signs of ingrown toenails.

7) Protect your feet if you regularly subject them to risks of injury. By taking great care of your feet, you can prevent ingrown toenails from occurring.


A Podiatrist can assess the cause of the ingrown toenail and will be able  to remove the ingrown nail edge to provide relief. If the ingrown toenail is a chronic recurrence then your Podiatrist can recommend a more permanent solution to remove the ingrown nail edge under local anaesthetic to correct the nail shape. Check out some information on Nail Surgery

Call us today on (08) 8450 2830 and the Podiatrists at Foot & Sole Podiatry can help assess your feet and determine the best treatment modality to manage your foot problem.

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