Nail & Skin Disorders

Growing Pains

Cutting toenails improperly and wearing ill-fitting shoes may be invitations for an ingrown toenail, but there are other causes nail techs should also know about.

Cutting toenails improperly and wearing ill-fitting shoes may be invitations for an ingrown toenail, but there are other causes nail techs should also know about.

What It Is

An ingrown toenail can be a painful and unattractive annoyance to your clients. It’s not uncommon for a client to come to you for a pedicure and not even know she has an ingrown toenail. Sometimes a pedicure can help alleviate an ingrown nail, but it may often be better to refer your client to a doctor.

An ingrown toenail occurs when the edge of the nail goes underneath the nail fold along the side of the toe. Left untreated it can become infected and swollen. Luckily, it is a problem that can be easily treated.


An ingrown toenail may show itself innocently enough through mild discomfort. If your client notices even slight pain around the toe where the nail meets the nail fold, it is most likely the beginning of an ingrown toenail.

As the problem progresses severe pain and discomfort may occur and it can become more visually obvious, with redness, swelling, and even drainage occurring.


According to Fort Worth, Texas-based Dennis Arnold, D.P.M., ingrown toenails are caused by several different factors. Injury to the toenail can cause an ingrown nail, and some people may get them as a result of genetics. Although these two factors cannot be avoided, two other causes can easily be managed. Improper toenail trimming and wearing shoes that are too tight around the toes are often the culprits of ingrown nails.

How to Treat It

Wearing shoes that are not too tight or that do not have a pointed toe can keep an ingrown toenail from forming.

Properly trimming toenails can also help prevent an ingrown. Dr. Arnold recommends cutting the toenail straight across and smoothing the edges of the nail with a nail file. Cutting a rounded or squared-off nail or cutting straight across and leaving sharp edges should be avoided. It’s also important to avoid cutting too far into the sides of the nail. Dr. Arnold says this can stimulate the growth of the nail, causing more problems.

If the toenail is in the beginning stages of being ingrown it may sometimes be treated by soaking in an Epsom salt solution and taking ibuprofen or aspirin to reduce swelling. However, this can often be temporary relief for a problem that may require more serious, surgical treatment.

There are two types of surgical procedures for an ingrown toenail: traditional and laser. Although laser treatment has been proven effective, Dr. Arnold recommends traditional surgical removal of the ingrown nail.

“Laser surgery is more expensive and it’s pretty much the same as traditional surgery,” he explains.

In traditional surgery, the toe is first numbed with a local anesthetic. The doctor then cuts the portion of the nail away that is growing under the nail fold, usually only removing the nail border. Dr. Arnold says many people are surprised by how large this piece of the nail can be; often the nail under the fold is as wide as a quarter of an inch.

After the nail border has been cut away, a chemical called phenol is applied to the corner of the toe where the nail border originated. This chemical kills the nail root.

Recovery takes between two to four weeks and involves keeping the area clean, soaking the toe, and applying an antibiotic ointment to avoid infection. The use of phenol causes chemical burn so proper care of the toe post-surgery is important.

Considerations for Nail Techs

Although the pain of an ingrown nail may be the reason a client comes in seeking a pedicure, Dr. Arnold says that not all toes are safe to work on.

If the nail is red, inflamed, oozing, or any combination of the three then the nail tech should recommend the client see a doctor. You may not be able to diagnose the problem for the client, but mentioning that it looks like an ingrown toenail and suggesting she see a doctor is the best way to handle the situation.

If the client’s nail is not too badly inflamed and is not oozing then it is possible to perform what Dr. Arnold calls a “partial” pedicure. He recommends that nail techs not work on the problem toe and make sure your client knows she should seek medical treatment for the pain she may be experiencing. For information on how to treat mild cases of ingrown toenails, refer to “Closing in on Ingrown Toenails” in the December 2002 issue of NAILS.

Dr. Arnold suggests establishing a relationship with a local podiatrist and recommending her services to clients with foot problems. As an added bonus, the podiatrist could recommend your salon to her patients who are looking for a little foot pampering after surgery or other foot problems.

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