Ingrown Toenail
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Ingrown Toenail vs Infected Toe
An ingrown toenail is a mechanical problem. The corner of the nail presses into the skin beside it, and that one spot goes red, firm and sore. An infected toe is what happens when bacteria get into that broken skin. Now there is pus, the swelling spreads past the nail fold, and the pain jumps within a day. Most infected toes started as ingrown nails, so the two often sit in the same toe at once.
At a glance
| The difference | Ingrown Toenail | Infected toe |
|---|---|---|
| What it is | A nail edge pressing into skin | Bacteria growing in broken skin |
| What it looks like | Red, firm swelling on one side | Pus, shine and spreading redness |
| Does it hurt | Sore, and worse in shoes | Throbs on its own |
| Do you feel unwell | No | Sometimes |
| What it does over time | Worse until the pressure changes | Worse until the pus is released |
Infected toe
Bacteria growing in broken skin Once the nail edge cuts the fold, ordinary skin bacteria get underneath. The body walls them off, and pus collects in that pocket.
Side by side
The differences that matter
What it is
Ingrown Toenail
A nail edge pressing into skin
The corner of the nail is angled down into the soft fold beside it. The skin reacts the way it would to a splinter. Nothing is infected yet.
Infected toe
Bacteria growing in broken skin
Once the nail edge cuts the fold, ordinary skin bacteria get underneath. The body walls them off, and pus collects in that pocket.
What it looks like
Ingrown Toenail
Red, firm swelling on one side
The nail looks normal. The skin at one corner is swollen and slightly shiny, and there may be a bead of clear or yellow fluid.
Infected toe
Pus, shine and spreading redness
The fold looks tight and glossy, a yellow or white pocket often shows through, and the redness reaches beyond the nail fold onto the toe.
Does it hurt
Ingrown Toenail
Sore, and worse in shoes
Tender when the corner is pressed, and uncomfortable in a tight shoe. Bearable when the foot is bare and up.
Infected toe
Throbs on its own
Beats even when nothing is touching it, and a bedsheet can be too much. The lightest pressure over the pus pocket is very tender.
How fast it changes
Ingrown Toenail
Days to weeks
It builds slowly, and there is usually a week of warning before it becomes a real problem.
Infected toe
Hours to a day or two
The jump is noticeable. Yesterday it was sore, today the toe is fat and hot.
Do you feel unwell
Ingrown Toenail
No
It is a local problem. You should not have a fever from an ingrown nail on its own.
Infected toe
Sometimes
A spreading toe infection can come with feeling generally run down, or with red streaking up the foot.
What it does over time
Ingrown Toenail
Worse until the pressure changes
It will not settle while the nail is still buried. Left alone, the skin piles up over the edge and can start to weep.
Infected toe
Worse until the pus is released
Once a pocket has formed, soaking alone rarely finishes it. It settles quickly once the pus is drained.
Treatment
Ingrown Toenail
Take the pressure off the edge
Warm salt-water soaks for ten to fifteen minutes a few times a day, open or roomy shoes, and a clinician lifting or trimming the corner if it does not settle.
Infected toe
Drain it, then deal with the nail
A clinician numbs the toe and releases the pus, which relieves it immediately. Antibiotics are added when the redness is spreading. The nail edge still has to be dealt with.
When it needs a doctor
Ingrown Toenail
If it has not settled in a week
Worth a visit if soaking and roomy shoes have not helped, or if the same toe goes ingrown over and over.
Infected toe
Yes, and reasonably soon
Pus, spreading redness, heat, or lumpy pink tissue growing over the nail edge all mean the toe needs looking at rather than waiting out.
Common questions
Questions Patients Ask
How do I know if my ingrown toenail is infected?
Look for pus, redness spreading past the nail fold, warmth, and pain that throbs when nothing is touching the toe. An uninfected ingrown nail is sore and firm but stays local.
Will antibiotics fix an infected ingrown toenail?
They treat the bacteria but not the cause. If the nail edge is still buried in the skin, the fold gets injured again and the infection returns, so the nail edge has to be dealt with too.
Can I drain it myself?
No. Cutting or digging at the fold usually pushes bacteria deeper and makes the wound bigger. A clinician can numb the toe and release the pus properly in a few minutes.
Do warm soaks actually help?
Yes, early on. Ten to fifteen minutes in warm salt water a few times a day softens the skin fold enough for the nail edge to lift clear. Once pus has collected, soaking alone rarely finishes it.
What is the lumpy pink tissue at the edge?
That is granulation tissue, which the body grows in response to long-standing irritation. It bleeds easily and it means the nail edge has been buried for a while.
Why does the same toe keep going ingrown?
Usually the way the nail is cut. Rounding the corners leaves a spike that the skin grows over. Cutting straight across, level with the tip, prevents most of them.