Ingrown Toenail Treatment

What Causes An Ingrown Toenail?

An ingrown toenail occurs when the sides/corners of the toenails catch or undermine the skin around the toe. This can create swelling, pain, and redness at the side of the toe. The big toe is the most commonly affected. 





Effective Treatment For Ingrown Toenails

Having an ingrown toenail can significantly hamper quality of life and interfere with physical activity. A nail excision is a quick and effective treatment that provides relief for at least 6-12 months. In many cases, patients go without recurrence for several years after an ingrown toenail treatment.


  • Pressure from tight or poor fitting shoes
  • Abnormal toenail shape
  • Thickened nails, such as from fungal infection
  • Soaking the foot in warm water for 15-20 minutes daily
  • Pulling the skin away from the toenail edge using tape
  • Cotton wicks/balls tucked into the corner of the nail
  • Minor surgical procedures such as a wedge nail excision to remove the section of undermining nail; recurrent toe infections often make this procedure necessary

While antibiotics do work to treat infection around the nail, a common occurrence with ingrown nails, excising the nail will most likely result in clearing of the infection. Antibiotics are not routinely prescribed after the procedure.

Pain and sensitivity can linger for a few days. Patients who work in safety critical positions should avoid work for as long as they experience pain. Sedentary work is agreeable. Over the counter medications often work well for pain relief.

Some patients have thickened and discoloured nails that contributed to their ingrown nail. More than likely, this is on account of fungal infection. At the time of a wedge nail excision, nail samples can be sent for fungal analysis. Patients should be aware that a culture result can take as long as 3-4 weeks to be reported. Culture results can also be falsely negative, meaning that while fungus is present, it is not detected on testing.

Fungal infection can be challenging to treat. Topical antifungal nail lacquers such as efinaconazole are effective for mild to moderate nail fungus. Severe fungal nail infections may require up to 12 weeks of antifungal therapy. It typically takes 12 months from the start of treatment for new normal nail to grow back. Nail fungus treatments can be started immediately after an excision. No fungal treatment is 100% effective and some patients do not respond.

Request A Referral From Your Doctor For Ingrown Toenail Treatment



It is important to wash your affected foot before coming to your ingrown toenail treatment appointment. This lessens the chance of infection.

Local anesthetic is used to freeze the toe during the procedure and this can be quite painful for some patients. To lessen the pain, it is advisable to purchase a topical anesthetic ointment such as Emla® from your local pharmacy. The cost is usually between $10-15. This should be applied to the BASE (area of blue rectangle on diagram below) of the toe for 30 minutes prior to the procedure.

A similar prescription-strength ointment can be applied at our office for a $15 fee. It is important to show up to your appointment 30 minutes early so that the anesthetic can be applied in time to take effect.

It is strongly recommended that children and adolescents as well as those with needle phobia be pre-treated with a topical anesthetic by one of the two options listed above.

You may take ibuprofen (Advil®) or acetaminophen (Tylenol®) for pain relief within 30 minutes of the procedure. This will lessen pain after the procedure.

First an anesthetic is injected in the base of the toe (this is the most uncomfortable part of the procedure)

After the toe is numb/frozen, you should not feel pain. It is normal to feel touch, pressure, and temperature. If you feel pain, let the physician know.

A tourniquet is placed over the toe to squeeze to help lessen the bleeding during the procedure an improve vision of the surgical field.

The toe is cleansed with an iodine-based antiseptic solution called Betadine.

The procedure is performed using a sterile technique. This involves the use of sterile gloves and drapes to reduce the risk of an infection after the surgery.

The toenail causing the issue is then cut and pulled away from underneath the overlying skin.

  • Keep the bandage/dressing on your toe at least until the following morning.
  • Use ibuprofen (Advil®) or acetaminophen (Tylenol®) for pain relief as needed.
  • Keep the toe covered with a small amount of polysporin and a bandage for as long as the toe is sensitive. This will take at least several days. The toe can subsequently be left open to air, though covering the toe during exercise or dirty environments is advised.
  • If you begin to notice increasing pain, swelling, redness, or drainage, please contact our office or your primary care provider. These are signs of infection and require an antibiotic.

A wedge nail excision can be permanently effective for many patients. However, it is not uncommon to encounter recurrences 1-2 years later when the nail regrows.

Taping can be used to prevent ingrowing as the nail grows back. This is by applying the free edge of the tape to the skin adjacent to the nail. The tape is then wrapped around the toe so that mild tension PULLS the skin on the affected side away from the nail.

Cotton balls and wicks can be used to PUSH the skin away from the nail.

Avoid shoes that tightly squeeze the toes. Wearing shoes with a wider ‘toe-box’ is encouraged.

Ask Your Family Doctor For A Referral