If your ingrown toenail keeps coming back, it’s usually a sign of a chronic problem—caused by your nail shape, the way you have treated it, or the way your foot moves—that can’t be completely fixed by at-home care.
Your toe only makes up a small fraction of your body, but the pain, discomfort, and inflammation of an ingrown nail can cause unbearable pain and inflammation. If you’ve had an ingrown toenail before, you know the frustration of simply trying to walk, wear shoes, or work out with one.
On this page, our podiatrists teach you:
- Why ingrown toenails turn into a recurring (chronic) issue
- When self-conducted ingrown toenail care at home is okay vs. when you MUST see a podiatrist
- Options that can potentially provide a permanent fix for your recurrent ingrown toenails
Keep reading to learn more!
Key Takeaways: What to Do When an Ingrown Toenail Keeps Coming Back
TL;DR / Quick answer: When a painful, infected, and mobility-restrictive ingrown toenail keeps coming back, a podiatrist can perform a minor in-office procedure that removes and prevents the regrowth of the edge of the nail that’s digging into your toenail skin.
#1 Stop damaging your nail/the surrounding skin of your toes with aggressive DIY clipping. Avoid digging into the sides of the nail or tearing pieces off, as this often makes the shape more likely to grow back misaligned.
#2 Wear wide, comfortable shoes. Avoid footwear with slim toe boxes, tight cleats, or high heels that apply excess pressure on your big toe.
#3: Use short-term home care only. Warm water and Epsom salt soaks, along with gentle cotton packing, can calm mild flares, but they aren’t long-term solutions.
#4: Visit a podiatrist if this is your 2nd or 3rd ingrown toenail. Take recurring pain and infection, or repeated urgent-care visits, as a likely indication that the shape of your toenail is what continues to cause the problem.
#5: Ask about a permanent procedure. Options like partial nail avulsion with matricectomy remove the ingrown edge and cauterise the root so it can’t grow back, significantly reducing recurrence (Source).
What Is a Recurring (Chronic) Ingrown Toenail?
An ingrown toenail develops when you have a toenail growing into the skin of your toe, rather than past the nail plate/bed as usual. You can be certain that you have a recurring or chronic ingrown toenail problem when you get an ingrown toenail over and over on the same toe every time, causing pain and infection, even when you’re consistent with trimming and home care or have had previous medical treatments.
Chronic cases of ingrown toenails are common in:
- Young adults
- Diabetics
- Tight shoe wearers
- Runners, athletes, and dancers
- Frequent high-heel wearers
How Many Times Counts as “Recurring?”
If you get 2–3 back-to-back episodes of an ingrown toenail on the same toe, it’s worth talking to your primary care or an urgent care doctor about referring you to a podiatrist to see about a permanent solution.
Why Your Ingrown Toenail Keeps Coming Back
If your ingrown toenail keeps coming back in the same spot, it is usually a structural issue (related to the shape of your toe bone/toenail) or a behavioral issue (such as improper trimming, wearing ill-fitting shoes, or failing to prevent toe injury when playing sports).
Potential and Common Structural & Behavioral/Lifestyle Causes:
Natural Nail Shape & Genetics
Often, a person’s ingrown toenails keep coming back because of their nail or toe shape. Many patients have chronic ingrown toenails because they have curved or “pincer” shaped nails, which are more likely to grow into the skin.
When the nail or toe shape you were born with is the culprit of your ingrown toenails, it’s not your fault or something you caused; it’s genetic. In other words, ingrown toenail-prone toe and toenail shapes run in families, and you didn’t “cause” it. However, you can control how it’s managed.
How You Trim Your Nails
Believe it or not, improper nail trimming may be the most common cause of ingrown toenails (Source), including recurring ones.
Excessive toenail trimming is so often an ingrown toenail culprit because cutting toenails too short or rounding the corners encourages the skin to fold over the nail, causing the toenail to dig into your tender nail bed. Picking or tearing off your nail also falls into this “improper trimming” category, and it increases the risk of leaving sharp spicules that grow inward.
The proper technique: Cut your toenails straight across, at an even angle parallel to the nail bed, without rounding the corners. To prevent too short a trim, make sure you leave 0.04–0.08 inches of nail growth at the top of the nail, beyond where your toe ends.
Tight Shoes, Cleats, and Heels
Ill-fitting footwear is also a common source of recurring ingrown toenails. More specifically, narrow toe boxes and high-impact sports shoes compress the big toe, pushing the toenail to grow into the skin.
Whether you play soccer or basketball, run track or cross-country, or are a dancer, the fit of your shoes must be snug, but there’s a fine line between too narrow and properly snug for a flawless fit.
When getting fitted for any type of shoe, pay attention to how your big toe feels. If it feels compressed, as if it is being pushed into the side of your shoe or your second toe, you should opt for a wider size.
Repeated Injury/Trauma from Sports and Activity
Suppose you play sports or dance in pointe shoes. In that case, your toes have likely suffered repetitive trauma, such as stubbing the toe, constant impact, kicking, or another toe injury. This repeated trauma irritates the nail and surrounding tissue over and over, eventually altering the toenail’s ability to grow properly.
“Temporary” Treatments
Receiving a “treatment” for an ingrown toenail, such as trims or partial removals, without addressing the nail root fully, can result in the ingrown toenail regrowing with the same problematic shape, leading to recurrence. Urgent cares and ERs typically offer treatment options that provide only temporary relief, rather than permanent correction.
For a more detailed analysis and explanation of ingrown toenail causes, check out our “Why Do I Keep Getting Ingrown Toenails?” blog post.
When Home Care Isn’t Enough
At-home solutions, such as soaking, wider shoes, and gentle padding, are suitable for mild, first-time ingrown toenails. However, when you have recurring ingrown toenails, it’s time to have a professional take care of them.
Mild Symptoms You Can Try to Manage at Home (Short Term)
When you have an ingrown toenail with mild symptoms (tenderness, mild redness, no pus, and still able to wear shoes and walk normally), you can try at-home remedies and adjust certain habits.
Taking a warm water and Epsom salt soak is a common, soothing home remedy for ingrown toenails. Therapeutic habits to implement include wearing loose, open-toe or wide shoes and avoiding digging/cutting corners when trimming the toenails.
Signs You Should See a Podiatrist
It’s time to see a podiatrist if you experience the following with ingrown toenails and toe pain:
- Your toe keeps getting sore in the same spot.
- You’ve had two or more ingrown episodes on the same toe.
- You have swelling, discharge, or recurrent infection.
- Pain stops you from working out, walking, or wearing normal shoes.
- You’ve already visited urgent care or had temporary procedures.
When an Ingrown Toenail Is Urgent
If you have an ingrown toenail and notice the redness spreading and/or experience severe pain, pus, or fever, seek urgent care immediately or consult your doctor.
If you exhibit any of the above symptoms with an ingrown toenail and already have recurring circulation issues or diabetes, your need for medical evaluation will be all the more urgent.
Permanent Solutions for Recurring Ingrown Toenails
When an ingrown toenail is recurrent, the most effective treatment is usually a minor in-office procedure that alters the way the nail grows, preventing it from digging into the skin.
Conservative In-Office Treatments (When They Still Make Sense)
There are some conservative in-office treatments that podiatrists will try with patients while they still make sense, such as professional trimming/debridement, taping, or splinting of the nail edge. Although this method of providing temporary relief is sufficient treatment for some patients, it is not suitable for others, as it doesn’t permanently alter the nail root.
Partial Nail Avulsion (Removing the Problem Edge)
In a partial nail avulsion procedure, the podiatrist removes only the ingrown side of the nail (the nail’s problem edge); the rest of the nail remains in place.
Partial Nail Avulsion + Partial Matricectomy – The “Permanent Fix”
What people usually mean by a “permanent solution” for an ingrown toenail is a combination of two treatments: a nail avulsion procedure followed by a matricectomy.
A matricectomy is an ingrown toenail treatment involving the application of a chemical (phenol, sodium hydroxide, etc.) onto the nail matrix (root) just under the ingrown edge that destroys it, preventing regrowth.
This combination of treatments for recurring ingrown toenails has a very high success rate. After treatment, the nail will be slightly narrower, but it usually looks normal after healing.
What About Removing the Whole Nail?
In some severe or complex recurring ingrown toenail cases, treating the full toenail with nail avulsion and matricectomy may be necessary. This option is usually not the podiatrist’s or patient’s first choice, as it can alter the appearance of your toenails more dramatically and permanently.
Rest assured that most young/healthy patients with recurring ingrown toenails do not need total nail removal.
What to Expect During a Permanent Ingrown Toenail Procedure
Before the Procedure
- Before you know if an ingrown toenail procedure is even on the table, you’ll need to go to a podiatrist for an exam, where they’ll ask questions about symptoms and recurrence.
- When your podiatrist begins to conduct a consultation for an ingrown toenail procedure during your first appointment, they’ll go over the risks and benefits with you.
During the Procedure
- The area is cleaned and numbed with local anesthesia. You will remain awake throughout the entire procedure.
- The ingrown edge or entirety of the nail is carefully removed (nail avulsion).
- The nail root (matrix) under that edge is treated with a chemical or other method to stop regrowth in that segment (nail matricectomy).
- Your podiatrist will dress your toe with a bandage; stitches aren’t usually required.
Does It Hurt?
Patients who undergo permanent ingrown toenail removal procedures will receive an injection of local anesthesia in the problem area of the toe. With this numbing injection, you’ll mostly feel pressure, not pain, during the procedure.
Afterwards, mild soreness will occur, but it will be extremely manageable with OTC pain relief in most cases.
Recovery: How Fast Can You Get Back to Work, Shoes, & the Gym?
Most people walk out the same day as their ingrown toenail procedure; however, healing times vary depending on the procedure and individual activity.
First 24–48 Hours
For the first two days, mild throbbing/soreness is normal. Keep your foot elevated and your bandages fresh, clean, and dry as instructed.
Going Back to Work or School
If you work from home or have a desk job that requires minimal mobility and standing, you can likely return to work the next day or within a couple of days of your procedure, depending on your comfort level.
If you work on your feet, you may need a few more days, as well as roomy shoes or a post-operative sandal.
When You Can Wear Normal Shoes Again
You can often return to wearing your regular closed-toe shoes within several days to 1–2 weeks after your procedure, depending on the severity of swelling and the style of your shoes.
Getting Back to Sports and the Gym
You should be particularly cautious when exercising after your ingrown toenail procedure. Upper body workouts while sitting should be fine within two days. However, before returning to any workouts that require footwork or standing (such as running, jumping, contact sports, or leg lifts), wait until your wound has completely healed and is no longer tender or painful. This typically takes 2–4 weeks post-op.
How to Prevent Ingrown Toenails from Coming Back After Surgery
Even with a partial matricectomy, good habits help the rest of the nail and other toes stay healthy:
- Trim nails straight across, not too short.
- Avoid tearing or “digging” into corners.
- Choose shoes with a roomy toe box, and make sure that they’re an appropriate size, especially for sports (no “too small for performance”).
- Replace worn-out athletic shoes regularly.
- For people with curved nails, we recommend regular podiatry check-ups.
FAQs About Recurring Ingrown Toenails & Permanent Fixes
Can an ingrown toenail be permanently fixed?
Yes, usually with a partial nail avulsion with chemical matricectomy. For more details about what this combined procedure entails, please refer to the sections above.
How many times should an ingrown toenail come back before I consider surgery?
If you experience 2–3 episodes of improper nail growth on the same toe or any recurrence that affects your daily life, it’s time to consider surgery and consult a podiatrist.
Is a permanent ingrown toenail procedure painful?
Not really. You’ll feel the local anesthesia injection, but the procedure itself is usually painless.
Will my nail look weird after a partial matricectomy?
Sometimes, the nail is slightly narrower after a partial matricectomy, but it typically looks normal to most people once healed. The appearance of your toenail is much more likely to look dramatically different if you had to have a full matricectomy, which patients only need in rare cases.
How long does it take to recover from permanent ingrown toenail surgery?
You can usually return to walking the same day, wearing your open-toed shoes in a few days (or sometimes weeks, depending on swelling), and to sports after your wound has completely healed and the skin is no longer tender.
What happens if I ignore a recurring ingrown toenail?
If you ignore a recurring ingrown toenail, you run the risk of repeated pain, infection, and possible deeper, severe infection.
Do antibiotics alone fix a recurring ingrown toenail?
Antibiotics treat infections caused by an ingrown toenail, but not the underlying nail shape that causes your ingrown toenail. So, even with antibiotics, recurrence is highly likely if you aren’t addressing the root cause.
Get Back on Your Feet with Permanent Ingrown Toenail Relief
If your ingrown toenail keeps coming back and you’re ready to talk about a permanent solution, please contact our staff at Foot Specialists of Birmingham today! We’ll gladly help answer your questions and schedule you a new patient appointment with David Linde, D.P.M., our Medical Director and a leading podiatrist.
You can also navigate the buttons below to schedule your appointment online and to learn more about our ingrown toenail removal services and treatments.
