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Why do I keep getting ingrown toenails?

Ingrown toenails occur when the edge of the nail grows into the surrounding skin, causing pain, redness and swelling. While anyone can develop an ingrown toenail, some people experience them repeatedly due to factors such as nail shape, genetics, footwear, injury or the way they cut their nails. Understanding the underlying cause is the first step towards preventing them from coming back (NICE CKS, 2023).


What is an ingrown toenail?


An ingrown toenail, also known as onychocryptosis, develops when the side of the nail presses into or penetrates the surrounding skin. This causes inflammation and, if left untreated, can lead to infection.


Although any toenail can become ingrown, the big toe is affected most often.


Early signs include:

  • Tenderness down the side of the nail

  • Redness

  • Swelling

  • Pain when wearing shoes

  • Discomfort when pressure is applied


If left untreated, the area may become infected, resulting in:

  • Increased swelling

  • Pus

  • Bleeding

  • Overgrown tissue (hypergranulation tissue)

  • Difficulty walking


💡 Did You Know? Not all painful toenails are infected. Many ingrown toenails are simply inflamed in the early stages and can often be managed before an infection develops (Rich & Scher, 2003).

Why do I keep getting ingrown toenails?


Recurring ingrown toenails are usually caused by a combination of genetics, nail shape, footwear, injury and nail trimming habits (Park and Singh, 2012; NICE, 2023).


Genetics and nail shape


Some people naturally have more curved (involuted) nails, making the edges more likely to grow into the surrounding skin. Thickened or distorted nails following trauma or fungal infection can also increase the risk (Rich and Scher, 2003).


Cutting nails incorrectly


Cutting nails too short or rounding off the corners can encourage the skin to fold over the nail edge, increasing the chance of the nail becoming ingrown. Nails should be trimmed straight across without digging into the sides (NICE, 2023).


Tight footwear


Shoes that compress the toes—such as narrow-fitting shoes, tight work boots or poorly fitting sports footwear—can force the nail into the surrounding skin and contribute to recurring problems (Park and Singh, 2012).


Toe injuries


A stubbed toe, dropped object or repeated sporting activities can permanently alter the shape of the nail, increasing the likelihood of future ingrown toenails (Rich and Scher, 2003).


Sweaty feet


Excess moisture softens the skin around the nail, making it easier for the nail edge to penetrate the skin and increasing the risk of irritation or infection (Rockwell, 2019).


Why shouldn't ingrown toenails be ignored?


Many ingrown toenails start as mild discomfort but can worsen if left untreated.

As the nail continues to grow into the skin, it creates a break in the skin's protective barrier. This allows bacteria to enter, increasing the risk of infection (NICE CKS, 2023).


Signs of infection include:

  • Increasing pain

  • Swelling

  • Redness spreading beyond the toe

  • Pus or discharge

  • An unpleasant smell

  • Overgrown red tissue around the nail


People with diabetes, poor circulation or a weakened immune system should seek professional advice promptly, as infections may be more difficult to treat and can lead to more serious complications.

When should I seek urgent advice? If you have diabetes, poor circulation, severe pain, spreading redness, significant swelling or pus, you should seek prompt assessment by a healthcare professional.

Self-care and prevention


Mild ingrown toenails can often be managed at home, and adopting good foot care habits may help reduce the risk of them returning (NICE, 2023).


You can help prevent and manage ingrown toenails by:

  • Cutting your toenails straight across and avoiding cutting the corners too short.

  • Wearing properly fitting footwear with enough room for your toes.

  • Keeping your feet clean and dry to reduce skin softening and infection risk.

  • Avoiding picking or digging down the sides of the nail.

  • Protecting your toes from repeated trauma, particularly during sport or work.


If your toenail is painful, swollen, shows signs of infection, or keeps becoming ingrown despite self-care, it's important to seek professional assessment. People with diabetes, poor circulation or reduced sensation should not attempt to treat an ingrown toenail themselves and should seek prompt advice.

Brandon Podiatry Tip Treat an ingrown toenail early. Prompt treatment can often prevent infection and reduce the need for more invasive procedures later.

This combines the practical self-care advice with prevention tips, making the article more concise while maintaining a logical flow.

How can Brandon Podiatry help?


At Brandon Podiatry, we provide evidence-based assessment and treatment for ingrown toenails.


Depending on the severity of your symptoms, treatment may include:

  • Professional nail care

  • Conservative nail management

  • Advice on footwear and nail cutting techniques

  • Managing any associated infection

  • Partial Nail Avulsion (PNA) for persistent or recurring ingrown toenails

  • Total Nail Avulsion (TNA) where clinically appropriate


If nail surgery is recommended, we'll explain the procedure, expected recovery, aftercare and answer any questions so you can make an informed decision.

Brandon Podiatry Tip Recurring ingrown toenails are often caused by the shape of the nail rather than how you're caring for it. If you've had repeated infections or ongoing pain, a professional assessment can help identify the underlying cause and discuss the most appropriate long-term treatment.

❌ Myth vs Fact


❌ Myth: Cutting a "V" in the middle of the nail helps it grow differently.


✅ Fact: There is no scientific evidence that cutting a V-shaped notch changes the direction of nail growth. The nail continues to grow from the nail matrix at the base of the nail, so this common home remedy is ineffective (Rich & Scher, 2003).

What does the evidence say?


Current evidence suggests that recurrent ingrown toenails are most commonly associated with nail shape, external pressure from footwear and improper nail trimming. Conservative management can be effective for mild cases, but for persistent or recurrent ingrown toenails, partial nail avulsion combined with chemical matrix ablation (phenolisation) has been shown to reduce recurrence compared with nail avulsion alone (Eekhof et al., 2012; Cochrane Review).

Frequently Asked Questions


Why does my ingrown toenail keep coming back?


The most common reasons include naturally curved nails, pressure from footwear, previous injury or incomplete resolution of a previous ingrown toenail.


Will antibiotics cure an ingrown toenail?


Antibiotics may help treat a bacterial infection if one is present, but they do not remove the underlying cause of the ingrown toenail. If the nail continues to grow into the skin, further treatment may still be required (NICE CKS, 2023).


Is nail surgery painful?


Nail surgery is carried out under local anaesthetic, so the procedure itself should not be painful. Some discomfort afterwards is normal, but this is usually manageable with appropriate aftercare.


Can children get ingrown toenails?


Yes. Ingrown toenails are common in teenagers and young adults but can occur at any age.

References (Harvard)

Eekhof, J.A.H., Van Wijk, B., Knuistingh Neven, A. and Van Der Wouden, J.C. (2012) 'Interventions for ingrowing toenails', Cochrane Database of Systematic Reviews, (4), CD001541. https://doi.org/10.1002/14651858.CD001541.pub3

National Institute for Health and Care Excellence (NICE) (2023) Ingrowing toenail. Clinical Knowledge Summaries. Available at: https://cks.nice.org.uk/topics/ingrowing-toenail/ (Accessed: 24 July 2026).

Rich, P. and Scher, R.K. (2003) Nails: Diagnosis, Therapy, Surgery. 3rd edn. Elsevier.

Royal College of Podiatry (2021) Nail Surgery: Information for Patients. London: Royal College of Podiatry.



 
 
 

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