Ingrown Toenail Removal

What is an ingrown toenail?

An ingrown toenail happens when the side or corner of a toenail grows into the skin around it. It most often affects the big toe, but it can also affect other toes in some patients. This can cause pain, redness, swelling, thickening, or lifting of the nail.  

Ingrown toenails can run in families. They can also be caused by trauma or injury to the nail. 

Chemotherapy can also cause the nail to stop growing or become loose. The nail or skin around the nail may become red, swollen, thick, or loose. This is sometimes called “chemo toe.” 

Ingrown toenails can be more serious in children with cancer or weakened immune systems. Their bodies may have a harder time fighting infection or healing. 

Even a small break in the skin around the nail can let bacteria enter the body. Infections in children with serious illness can: 

• Develop quickly 
• Become more serious 
• Spread beyond the toe 

If the toenail gets infected or does not improve, a health care provider may need to remove part of the nail edges. In rare cases, the entire nail may need to come off. Do not try to remove the ingrown toenail yourself. Call your care team to schedule a procedure. 

What to expect during ingrown toenail removal

Ingrown toenail removal is a procedure to trim or remove part of the nail. The procedure is simple and usually takes about 20 minutes. During the procedure, the health care provider will: 

• Clean the toe to help prevent infection 
• Numb the toe with medicine (local anesthesia) 
• Place a tight band around the toe for a short time to reduce bleeding 
• Remove the edge of the nail that is growing into the skin. (In rare cases, the entire toenail may need to be removed.) 
• Apply a solution to help keep the nail from growing back along the nail edges. 

What to expect after ingrown toenail removal

After the procedure, your child may have: 

• Pain or soreness 
• Redness or swelling 
• Small amounts of bleeding or fluid draining 
• Skin that becomes tougher where the nail was removed 
• Healing usually takes 2–6 weeks.  

Care at home after ingrown toenail removal

Follow your care team’s instructions for caring for your child’s toe at home. Wash your hands before and after caring for the toe to prevent infection. 

Keep the toe clean and dry. For the first 24 hours, have your child rest and raise their foot as much as possible. This can help reduce swelling.  

You will need to soak the toe each day and dress the toe as indicated below. This should be done for 7 days after the procedure. After 7 days, the toe should not have any ointment or bandage unless directed by the doctor.  

A small amount of blood on the bandage is normal on the day of the procedure. Call your health care provider if you have questions. 

Soak the foot as instructed 

Starting 24 hours after the procedure, follow these general steps to soak the toe daily.   

1. Remove the bandage gently. Warm water can help loosen any material that is stuck to the toe. 
2. Choose a clean bowl or pan that is large enough to hold your child’s foot. Mix 2 teaspoons of Epsom salt with 2 quarts of warm water. You can also use warm water without Epsom salt. 
3. Have your child soak their toe in the water for 15 minutes. 
4. Allow the foot to completely dry or pat it gently with a piece of sterile gauze until dry. 

Apply ointment and toe sock 

1. Apply a small, pea-sized amount of antibiotic ointment as directed. 
2. Place a toe sock over your child’s toe.  
3. Tape the toe sock loosely to your child’s foot. Do not wrap the tape too tightly.  

Depending on the type of procedure done, your care team may give different care instructions.  

Give medicines as instructed 

Your child may need pain medicine or antibiotics after the procedure. Give all medicines exactly as directed. 

If your child takes antibiotics, make sure they finish all the medicine, even if they feel better before it is gone. This helps prevent infection. 

Watch for signs of infection 

Check the toe every day for signs of infection, such as: 

• Increased redness 
• Swelling 
• Pain 
• Warmth 
• Drainage 

Continue home care until your child’s next appointment. Keep all appointments, even if the toe looks better. Your care team needs to make sure your child's foot is healing well.

When to call your care team

Contact your child’s care team if your child has: 

• Pain that makes it hard to walk 
• Redness, swelling, or warmth around the toe 
• Drainage from the wound, especially if it smells bad 
• A toe that looks pale, blue, or black 
• Trouble moving the toe 
• Fever of 100.4°F (38°C) or higher  
• Chills 
• Nausea or vomiting  

Tips to prevent ingrown toenails and infection

• Do not let your child pick at or tear their toenails.
• Keep feet clean and dry.
• Clean under the toenails gently.
• Wash your hands before touching your child’s feet. 
• Check toes regularly for redness, swelling, pain, or signs of injury.

Questions to ask your care team

• What does an ingrown toenail look like? 
• Why does my child need their ingrown toenail removed?  
• Can an ingrown toenail heal on its own? 
• What will my child feel during and after the toenail removal?  
• How should I care for my child’s toe at home while it heals?  
• How long will it take for my child’s toe to heal? 
• Will my child’s toenail grow back? 
• When can my child go back to normal activities? 
• What signs of infection should I watch for? 
• When should I call the care team?  
• What causes ingrown toenails in children? 
• How can I help prevent ingrown toenails? 

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