Ingrown toenail treatment: home care, signs of infection and nail surgery

The short answer

A mildly ingrown toenail, red and sore but not infected, often settles with simple care: warm salty soaks, roomy shoes, pain relief if you need it, and leaving the nail alone to grow out. That is the advice on the NHS ingrown toenail page.

If the toe is infected, the GP is the right person, because you may need antibiotics. If the nail keeps ingrowing, the treatment with the strongest evidence is minor nail surgery, usually removing the side of the nail that is digging in, under a local anaesthetic, and applying a chemical called phenol so that part does not grow back. That is done by podiatrists and other qualified health professionals, not by Foot Health Practitioners or nail technicians.

The most useful long term step is the least exciting: cutting your nails the right way and wearing shoes that leave room for your toes. This guide covers what causes ingrown toenails, home care, the warning signs, what the research says about nail surgery, what a Foot Health Practitioner can and cannot do, and how to stop it coming back.

This is general information, not a diagnosis. If you have diabetes, poor circulation, or a toe that is getting worse, speak to a GP, a pharmacist or an NHS podiatrist.

What an ingrown toenail is and why it happens

The NHS says you usually get an ingrown toenail on your big toe, though it can happen on any toe. The toe may be red, painful and swollen, and the nail may curve into the skin at the side. If the skin is broken, it can become infected.

The NHS prevention advice points to the usual triggers, and the Royal College of Podiatry adds detail:

• Cutting too short or down the sides. The Royal College of Podiatry warns that cutting down the sides of your nails can leave a "spike" of nail which could result in an ingrown toenail. Its page on ageing feet says simply that poorly cut nails can become ingrown.
• Tight or badly fitting shoes. The NHS advises against shoes that are too tight or do not fit properly, and against tight, pointy shoes while the toe is sore.
• The shape of the nail. Some nails curve strongly at the sides, so the edge presses into the skin more easily.

You will see other causes listed online, such as sweaty feet or an injury to the toe. The current NHS page does not list them, and we did not find a primary source we were happy with, so we have left them out.

What you can do at home

For a toe that is sore but not infected, the NHS suggests:

1. Soak your foot in warm, salty water to soften the skin around the toe and reduce the chance of infection.
2. Dry it well and keep it dry for the rest of the day.
3. Wear wide, comfortable shoes or sandals so nothing presses on the nail edge.
4. Take paracetamol or ibuprofen to ease the pain, if they are suitable for you.

And not to:

• cut the toenail: the NHS says to leave it to grow out
• pick at your toe or toenail
• wear tight, pointy shoes

The advice not to cut it matters. Digging into the corner with scissors or clippers to "free" the edge can break the skin, which is how infection gets in, and the Royal College of Podiatry warns that cutting down the sides can leave a spike of nail that grows in again. A pharmacist can advise on pain relief and on stopping it getting infected, and can tell you whether you need to see a GP.

Signs of infection, and when it is urgent

The NHS lists two signs that an ingrown toe is infected: pus coming out of it, and feeling hot or shivery. It says to see a GP if:

• treating it at home is not helping
• your toe is painful and swollen with pus coming out of it
• you have a very high temperature, or you feel hot, cold or shivery
• you have diabetes and an ingrown toenail

A GP can check the toe, give you antibiotics if it is infected, and refer you to a podiatrist if the nail is badly ingrown.

When infection is spreading

If redness and swelling start to spread up the toe or foot, that can be cellulitis, an infection of the deeper skin. The NHS cellulitis page says to ask for an urgent GP appointment or get help from NHS 111 if your skin is painful, hot and swollen. It says to call 999 or go to A&E if this comes with a very high temperature or feeling hot, cold or shivery, a fast heartbeat or fast breathing, feeling dizzy or faint, or confusion.

If you have diabetes

Do not try to manage an ingrown toenail yourself. The NHS lists diabetes on its own as a reason to see a GP. The Royal College of Podiatry's diabetes leaflet asks you to contact your foot care team, podiatry department or GP "as soon as possible (within 24 hours)" if you notice a wound or break in the skin on a toe or foot. Our guide to foot care with diabetes has more.

Treatments, from antibiotics to nail surgery

Here is who does what, based on the NHS and the Royal College of Podiatry.

What nail surgery involves

The Royal College of Podiatry describes nail surgery as "a medical operation that removes all or part of a toenail". It is usually done with a local anaesthetic, so you stay awake but should not feel pain in the toe, and "Sometimes a chemical will be used to try and stop the nail from growing back again." It says the procedure is completed by "A podiatrist, podiatric surgeon or other qualified health professional", and that in most cases no other treatment is needed once the wound has healed.

NHS Lanarkshire's nail surgery page gives practical detail:

• The podiatrist numbs the toe with an injection, the numbness lasts about 2 to 3 hours, and you cannot drive for 24 hours after a local anaesthetic.
• Phenol is applied to the area the nail grows from; it "causes a burn and stops the nail from growing back".
• Healing time for a partial removal is 2 to 4 weeks without phenol and 4 to 8 weeks with it.
• There is a small chance the nail grows back.
• You change your own dressings, normally every 2 days, and avoid soaking the foot.

Other NHS services quote slightly different healing times, so go by the leaflet your own podiatrist gives you. The NHS says referral to an NHS podiatrist is not available to everyone and waits can be long, but you may be able to refer yourself, or you can pay to see a podiatrist privately.

What the evidence says about phenol and surgery

The main evidence summary is a 2012 Cochrane review, Interventions for ingrowing toenails, which pooled 24 randomised studies with 2,826 participants. It is the latest version we could find. What it found:

• Surgery prevented recurrence better than non-surgical treatment. Surgery beat gutter treatment and was probably better than nail braces (orthonyxia).
• Phenol probably helps. In 4 of 12 studies comparing surgery with and without a chemical such as phenol, the chemical clearly reduced recurrence. But in most of those the two surgical methods differed in other ways too.
• Only one trial compared like with like. In 117 people having the same partial nail removal, the nail came back in 14% of those who also had phenol and 41% of those who did not.
• Aftercare extras made no clear difference. None of the after-surgery treatments studied, including antibiotics, manuka honey and various dressings, changed infection rates, pain or healing time.

The limits

The review authors note that patients could not be blinded to surgery, outcome assessors were blinded in only 9 of the 24 studies, and many details were poorly reported. None of the studies measured the review's main outcomes, relief of symptoms and regrowth, directly; 16 measured recurrence. The authors say more studies are needed to confirm the phenol result. So the fair summary is: surgery with phenol is the most strongly supported way to stop a nail ingrowing again, but the evidence is moderate, not overwhelming, and it is aimed at nails that keep coming back, not every sore toe.

What a Foot Health Practitioner can and cannot do

This is where people are often unsure, so it is worth being precise.

What a Foot Health Practitioner is not. According to the Health and Care Professions Council (HCPC), "podiatrist" and "chiropodist" are protected titles: you must be on the HCPC register to use them. Foot Health Practitioners are not on that register. The HCPC's page on medicine entitlements explains that registered podiatrists with the right training can be annotated to give certain prescription-only medicines, an annotation that used to be called "local anaesthetics".

So a Foot Health Practitioner does not:

• do nail surgery, partial or total nail removal, or phenol treatment
• give local anaesthetic injections
• prescribe or supply antibiotics
• diagnose an infection or another medical condition

What a Foot Health Practitioner can help with:

• trimming and filing toenails correctly, especially if they are thick, curved or hard to reach
• a nail edge that is just starting to press, with no pus, spreading redness or broken skin
• showing you how to cut your nails and which shoes leave room for your toes
• noticing when a toe needs a GP or podiatrist instead, and telling you so

If a nail is infected, very painful, or has ingrown more than once, the right route is a GP or an HCPC registered podiatrist. Our guide to the difference between a Foot Health Practitioner and a podiatrist explains this in more detail.

Preventing it coming back: cutting and shoes

The NHS gives four prevention steps:

1. Do not cut your toenails too short.
2. Cut straight across the nail, not the edges.
3. Do not wear shoes that are too tight or do not fit properly.
4. Keep your feet clean and dry them thoroughly.

The Royal College of Podiatry puts it slightly differently in different leaflets. Its general foot health advice says to cut "straight across following the natural shape of the nail" and not to cut too short or down the sides. Its diabetes leaflet says to follow the curve of the end of your toe and use a file so there are no sharp edges. The common thread is the same: no cutting down into the corners, no very short nails, and smooth edges.

Putting it together

• Cut regularly, so nails never get long enough to catch, but never very short.
• Smooth any sharp edge with a nail file rather than digging into the corners with clippers.
• Look at your shoes: tight, pointed or badly fitting shoes press the nail edge into the skin.
• Keep your feet clean and dry them well, including between the toes.

Our guide to how to cut toenails goes through this step by step. If you cannot reach your feet or see them well, it is worth having someone cut them for you.

How we checked

We read the NHS ingrown toenail page (last reviewed 30 June 2025), the NHS cellulitis page, the Royal College of Podiatry's leaflets on nail surgery, foot health with arthritis, ageing feet and diabetes (February 2026), NHS Lanarkshire's nail surgery page, and the HCPC's pages on protected titles and medicine entitlements, all checked on 10 November 2026. We read the abstract of the 2012 Cochrane review on ingrowing toenails through Europe PMC and noted its size, its one like for like phenol trial and its stated limits.

We did not use clinic websites or forums as sources. We left out causes we could not trace to a primary source (such as sweaty feet), a commonly quoted regrowth figure for phenol that we could only find in PDF leaflets we did not open, and home remedies such as packing cotton under the nail, which none of the sources we read recommend. This is general information, not medical advice. If you spot a mistake, please tell us through the contact form.

Where Fairy Feet fits

Marianna Tapai FHP is a qualified Level 4 Foot Health Practitioner who has worked with nails and feet since 2006, in her own studio in Doncaster. For a toenail that is starting to dig in but is not infected, or nails that are hard to cut well, a Foot Health Treatment / Medical Pedicure (£39.99) includes a foot and nail check, careful nail trimming and reduction, and advice on cutting and footwear so it is less likely to happen again. A call-out home visit is available if getting to the studio is difficult.

Marianna is a Foot Health Practitioner, not a podiatrist or chiropodist. She does not do nail surgery, give injections, diagnose infections or prescribe antibiotics. If your toe has pus, spreading redness or a fever, see a GP or call NHS 111. If you have diabetes and an ingrown toenail, see a GP first. If the nail keeps ingrowing, ask your GP about an NHS podiatry referral or see an HCPC registered podiatrist about nail surgery. For anything else, get in touch through the contact form; there is no online booking.

Questions people ask

Sources

1. Ingrown toenail. NHS, reviewed 30 June 2025, checked 10 November 2026.
2. Interventions for ingrowing toenails (Eekhof JA, Van Wijk B, Knuistingh Neven A, van der Wouden JC). Cochrane Database of Systematic Reviews, 2012.
3. Toenail surgery for people with a rheumatic condition. Royal College of Podiatry, checked 10 November 2026.
4. Nail surgery. NHS Lanarkshire, checked 10 November 2026.
5. Moderate risk of non-healing wounds and amputation (diabetes leaflet). Royal College of Podiatry, February 2026.
6. General foot health advice for people with a rheumatic condition. Royal College of Podiatry, checked 10 November 2026.
7. Ageing feet. Royal College of Podiatry, checked 10 November 2026.
8. Cellulitis. NHS, reviewed 18 April 2024, checked 10 November 2026.
9. The professions. Health and Care Professions Council, updated 12 May 2025, checked 10 November 2026.
10. Exemptions (medicine entitlements). Health and Care Professions Council, updated 3 March 2025, checked 10 November 2026.