Primary Care Management of Ingrowing Toenails

In-growing toe nails can occur when dirt and debris gets down the side of the nail; a piece of nail digs into the skin due to incorrect cutting or ‘picking ‘at the toe nails. It can also occur due to incorrect footwear and can be hereditary. It is mainly the big toe nails that are affected.

Antibiotics are not usually an effective treatment because in-growing toe nails are caused by inflammation and pressure in the nail fold. Effective treatment is described below.

Please note: any patients who have co morbidities such as diabetes or peripheral vascular disease should be referred to a podiatrist.

Minor Ingrowing Toenail

These do not usually require podiatry referral or antibiotics; if the nail is trimmed correctly and the area kept clean they are likely to resolve with self-care. If self-care in not effective make a non-urgent referral to Podiatry.

Patients can self- refer using the following link:

Acute and Chronic Ingrowing Toenails

These do require podiatry referral for assessment. Only prescribe antibiotics if the surrounding tissue is infected/tracking and there is a foul odour present. Follow local guidelines for Antibiotic Prescribing in the Community – skin & soft tissue infections.

Salt water foot baths are effective at preventing infection and reducing inflammation and pain. Add a hand full of salt to a bowl of warm water and soak the foot for 3-5 minutes once a day. Cover with a clean non adherent dressing. Ensure any tape used is not wound around the toe. 

How to Cut Toenails Correctly

If you need any advice regarding ingrowing toenails please contact:

Alternatively please follow the resource link below to the online podiatry referral form.