Infected Ingrown Toenail (Antibiotics, No Excision)
An ingrown toenail occurs when the nail grows sideways into the skin alongside the nail. This can cause pain. It can also lead to an infection with redness, swelling, and sometimes drainage. The big toe is affected most often. But you can get ingrown nails on other toes.
The most common cause of an ingrown toenail is trimming your nails wrong. Try not to trim the nails too close to the skin. And try not to round the nail too tightly around the shape of the toe. When you do this, the nail can grow into the skin of your toe. It's safer to trim the nail ending in a straight line rather than a curve.
Other causes include injury, especially repeated injury to the feet. Or wearing shoes that are too short or tight. This can cause the same problem that happens when trimming your nails. Your genetics (what you inherit from your family) can also make this more likely to happen.
The following are the most common symptoms of an ingrown toenail:
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Pain
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Redness
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Swelling
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Drainage
People with diabetes, peripheral vascular disease, or other circulatory disorders should follow all foot care instructions from their doctor. Treatment suggestions may differ for people with these conditions. These conditions can make you more at risk for complications or infection. Only use treatment methods that are advised by your doctor.
If the infection is mild, you may be able to take care of it at home with the measures listed below.
Home care
Wound care
For the next 1 to 2 weeks, soak and clean your toe in warm water 2 to 3 times a day.
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To clean and soak the toe:
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Soak your foot in a tub of warm water for 10 to 20 minutes. You can use warm, soapy water. Or you can use warm water mixed with 1 to 2 teaspoons of Epsom salts.
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Clean any remaining crust away with soap and water using a cotton swab.
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Put a small amount of antibiotic ointment on the infected area.
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Keep the toe clean. Change the dressing or bandage every time you soak or clean it, or whenever it becomes wet or dirty.
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While your toe is healing, wear loose, comfortable shoes with a lot of toe room. Or wear open-toe sandals.
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Use a small piece of cotton or waxed dental floss to gently lift up the corner of the problem nail. This can take pressure off the toe. Change the cotton or floss often, especially if it gets dirty.
Medicines
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You can take over-the-counter medicine for pain, unless you were given a different pain medicine to use. Talk with your doctor before using these medicines if you have chronic liver or kidney disease. Also talk with your doctor if you've ever had a stomach ulcer or bleeding in your digestive tract, or if you're taking blood-thinner medicines.
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If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics. If after 2 to 3 days of antibiotics the toenail doesn't get better or gets worse, part of the nail may need to be removed to drain the infection. With treatment, it can take 1 to 2 weeks to clear up completely.
Prevention
To prevent ingrown toenails:
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Wear shoes that fit well. Don't wear shoes that pinch the toes together.
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When you trim your toenails, don't cut them too short. Cut straight across at the top and don’t round the edges.
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Don’t use a sharp object to clean under your nail. This might cause an infection.
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If the toenail starts to grow into the skin again, put a small piece of waxed dental floss or cotton under that side of the nail. This is to help it grow out straight.
If you have diabetes or other conditions
People with diabetes, peripheral vascular disease, or other circulatory disorders should follow all foot care instructions from their doctor. These conditions can make you more at risk for complications or infection. Treatment suggestions may differ for people with these conditions. Use only treatment methods that are advised by your doctor.
Follow-up care
Follow up with your doctor, or as directed. If the antibiotic doesn't work, or if the condition happens again, you may need to have part of the nail removed.
When to contact your doctor
If the above methods aren’t working, or if the infection gets worse, you may need further treatment. Contact your doctor right away if:
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You have increasing redness, pain, or swelling of the toe.
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You have red streaks in the skin leading away from the wound.
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You have pus or fluid drainage.
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You have a fever of 100.4°F (38°C) or higher, or as advised by your doctor.