Ingrown Fingernail: Symptoms, Causes, and Treatments

What Are Ingrown Fingernails?

Ingrown fingernails occur when the edges or corners of a nail grow into the surrounding skin. This often results in pain, swelling, and sometimes infection.

Nails are composed of a protein called keratin, the same substance that makes up hair and the outer layer of skin. They form as layers of keratinized cells push to the surface of the finger. Normally, nails grow straight out from the nail bed, with ridges on the nails matching the skin ridges below, securing the nails in place.

However, if the shape of your nail changes or if the nail is not trimmed properly, the connecting ridges may weaken. This weakening can cause the nail to grow into the sides or corners of the skin, leading to an ingrown nail. The condition is less common in fingernails than toenails, but it can still cause significant discomfort and complications if not addressed promptly. When a nail grows into the surrounding skin, it creates a wound that can easily become infected. The body responds to this irritation with inflammation, which causes the area to become red, swollen, and painful.

If bacteria enter the wound, an ingrown fingernail infection can develop, leading to more severe symptoms such as pus drainage and increased pain. This scenario often requires medical attention.

Causes of Ingrown Fingernails

• Improper Nail Trimming: Cutting nails too short or not straight across can cause the nail to grow into the skin. Always trim nails straight and avoid rounding the edges.
• Curved or Irregularly Shaped Nails: Some people naturally have nails that are more curved or irregular, which can make them more prone to becoming ingrown.
• Repeated Nail Trauma: Frequent injuries to the nails, such as those caused by sports or heavy manual labor, can lead to changes in nail growth and increase the risk of ingrown nails.
• Nail Biting: Biting nails can damage the skin around them and alter the way nails grow, potentially leading to ingrown fingernails.
• Wearing Ill-Fitting Gloves: Gloves that are too tight can put pressure on the nails, causing them to grow into the surrounding skin.
• Fungal Infection of Nails (Onychomycosis): Fungal infections can thicken and distort the nails, making them more likely to grow into the skin. Proper ingrown fingernail treatment often involves addressing the underlying fungal infection.
• Excessive Nail Growth: Conditions like psoriasis can cause nails to grow excessively, increasing the risk of ingrown nails.
• Slow Nail Growth: Common during old age, slow nail growth can also contribute to the development of ingrown fingernails.
• Chemotherapy Drugs: Certain chemotherapy drugs, such as epidermal growth factor receptor inhibitors, can affect nail growth and lead to ingrown nails.

Symptoms of Ingrown Fingernails

Recognizing the symptoms of ingrown fingernails early can help you seek timely treatment and prevent complications. Common symptoms of an ingrown fingernail include:

• Pain: This is often the first sign of an ingrown nail. You might feel discomfort around the nail, which can increase with pressure.
• Redness: The skin around the ingrown nail may become red and irritated.
• Swelling: Swelling around the nail is common as your body reacts to the nail growing into the skin.
• Tenderness: The area around the ingrown nail is usually tender to the touch.
• Pus or Drainage: If the ingrown nail becomes infected, you might see pus or experience drainage from the affected area.

You can use an online tool Symptom Checker to help identify symptoms but always follow up with a healthcare provider for a definitive diagnosis and treatment plan.

Complications from Ingrown Fingernails

If left untreated, ingrown fingernails can lead to several complications. Understanding these potential issues can help you take preventive measures and seek prompt treatment when needed.

Nail Fold Infection (Paronychia)

An ingrown fingernail can cause a nail fold infection known as paronychia. This condition involves the infection of the tissues surrounding the nail, typically caused by bacteria like Staphylococcus aureus or fungi such as Candida.

According to Medscape, Paronychia accounts for 35% of hand infections, making it the most common hand infection in the United States.

Symptoms of paronychia include pain, redness, and swelling around the nail.

Fungal Infection (Onychomycosis)

Ingrown fingernails can lead to or result from a fungal infection called onychomycosis. Onychomycosis is estimated to affect 10% of the global population and represents up to 50% of all nail diseases, MDPI states. 

This infection can cause the nail to thicken, discolor, and become misshapen. Fungal infections are persistent and can make the nail more prone to becoming ingrown. Proper nail hygiene and treatment of fungal infections are crucial to prevent recurring issues.

Severe Infections and Abscess Formation

If an ingrown fingernail becomes infected and is not treated, the infection can spread, leading to more severe complications such as abscess formation. An abscess is a collection of pus that can develop around the nail and cause significant pain and swelling. In such cases, medical intervention is necessary to drain the abscess and treat the infection.

Chronic Conditions and Permanent Nail Damage

Chronic ingrown fingernails can lead to permanent damage to the nail and surrounding tissue. Repeated infections and inflammation can cause scarring and deformity of the nail. In severe cases, the nail may need to be partially or completely removed to prevent ongoing problems.

Preventive Measures

Proper Nail Trimming Techniques

• Trim Straight Across: Always cut your nails straight across, rather than rounding the edges. This helps prevent the nails from growing into the skin.
• Avoid Cutting Nails Too Short: Leave a small bit of white nail at the tips. Cutting nails too short can cause them to dig into the skin as they grow.
• Use the Right Tools: Use clean, sharp nail clippers. Avoid using tools that can tear or damage the nails.

Tips and Good Hygiene Practices

• Moisturize Regularly: Apply hand lotion or cream to keep your nails and skin hydrated. Dry skin can lead to cracks and increase the risk of ingrown nails.
• Avoid Nail Biting: Biting your nails can damage the nail and the surrounding skin, increasing the risk of ingrown nails.
• Protect Your Nails: Wear gloves when doing activities that could stress your nails, such as gardening or cleaning.
• Be Gentle: Avoid picking or tearing at the nails, which can lead to damage and improper growth.
• Choose the Right Size: Ensure your gloves fit well and are not too tight.

Home Remedies for Ingrown Fingernails

For mild cases of ingrown fingernails, several effective home remedies can help alleviate pain and promote healing. Here are some practical tips you can apply:

Soaking the Affected Finger in Warm Water

Soak your finger in warm, soapy water for 10 to 20 minutes, three to four times a day. This helps reduce swelling and relieves pain. Adding a bit of Epsom salt to the water can also help with inflammation.

Applying Antibiotic or Antifungal Cream

After soaking, apply an antibiotic or antifungal cream to the affected area. This can help prevent infection and promote healing. Make sure to keep the finger clean and dry between treatments.

Gently Lifting the Edge of the Nail

Using a clean piece of dental floss or a sterile cotton swab, gently lift the edge of the ingrown nail. Place a small piece of cotton or dental floss under the nail to encourage it to grow above the skin. Change the cotton or floss daily to keep the area clean.

Using Cotton Wedges to Relieve Pressure

Inserting a small piece of cotton or gauze under the ingrown edge can help relieve pressure and guide the nail to grow correctly. Ensure that you do this gently to avoid causing further pain or damage.

Medical Treatments for Ingrown Fingernails

Cotton Wedge Technique

A healthcare provider may lift the nail and insert a small wedge of medicated cotton under the ingrown edge. This method helps relieve pressure and guides the nail to grow correctly. It is typically combined with advice on proper nail care to prevent recurrence.

Draining Abscesses

If an abscess has formed, your doctor will need to drain it. This procedure involves numbing the area with local anesthesia, making a small incision to drain the pus, and possibly placing a small piece of gauze to keep the incision open for continued drainage. Proper aftercare instructions will be provided to prevent further infection.

Surgical Excision (Nail Avulsion)

In severe or recurrent cases, a portion of the nail may need to be surgically removed. This procedure, known as nail avulsion, involves numbing the area and removing the ingrown portion of the nail. Sometimes, a chemical or laser treatment is used to destroy part of the nail matrix to prevent regrowth in the problematic area.

Prescription Medications

In cases of infection, your doctor may prescribe antibiotics or antifungal medications to treat the underlying cause. These medications can be oral or topical, depending on the severity and type of infection.