Request Your Appointment

Pain, redness, and swelling of the skin around the nail of your big toe making every step unbearable? An ingrown toenail may be to blame. Caused by curved nails that grow into the surrounding skin, ingrown toenails are one of the most common conditions we treat at Foot and Ankle Center of Lake City.

While they may seem like a relatively minor issue, they can be extremely painful—and for patients with health problems like diabetes, nerve damage, or poor circulation, they can increase the risk for serious complications. Thankfully, you've come to the right podiatry practice for help.

Comprehensive Ingrown Toenail Care in North Seattle

Dr. Rion Berg treating patient with ingrown toenail in SeattleFoot and Ankle Center of Lake City's expert podiatrist, Dr. Rion Berg, has been in practice for 40 years. During that time, he's helped countless patients overcome stubborn, painful, and unsightly foot and ankle issues. If ingrown toenails are making you miserable or forcing you to give up the activities you enjoy, Dr. Berg can provide the care you need to get back in the game and back to doing what you love.

Ingrown Toenail Causes and Prevention

This painful condition occurs when curved nails grow into the side of the skin, causing irritation, pain, redness, and swelling. In some cases, these ingrown nails can break the skin and allow bacteria to enter the area, resulting in an infection. Though the condition occurs most frequently in big toes, any toenail can become ingrown under the right (or, rather, the wrong) circumstances. Here are some of the most common causes of ingrown toenails, as well as tips to help you prevent them.

Improperly Trimming Toenails

ingrown toenail treatment in North seattleCutting toenails too short or rounding the edges can encourage the skin along the sides of the nail to fold over it. As the nail grows, it can dig and cut into the surrounding skin, inviting bacteria and causing infection. Ingrown toenails start out hard, swollen, and tender, and can ooze pus if infected. Trimming your toenails straight across, with no rounded corners, can help prevent this condition.


Stubbing your toe—or injuring a toe while running or kicking—can also cause ingrown toenails. Talk to us about ways to protect your toes (and toenails) while participating in various sports.

Poorly Fitting Footwear

Shoes that are too tight or too short can cause trauma to toenails that encourage them to become ingrown. Choose shoes that have plenty of room for your toes to move around and allows them to rest flat and straight. We can offer personalized advice for achieving the best fit after evaluating your feet.

fungal toenails in North SeattleToenail Fungus

Fungal infections can cause unusual nail growth which, in turn, can lead to ingrown nails. As these infections can be highly contagious, it's vital to consult with an experienced podiatrist. Tips for avoiding fungal nail infections include washing and thoroughly drying feet daily (taking special care to dry between toes), and wearing moisture-wicking socks and breathable footwear. 

Other Causes

A number of other factors can increase the risk for developing ingrown toenails, including family history, pregnancy (which increases hormone levels and nail growth), and age—as both children and the elderly are more likely to get them.

Treatment for Ingrown Toenails in North Seattle

Most ingrown toenails require treatment from a podiatrist or other medical professional—this is particularly true if there's an infection, or if you have a health condition that makes you more prone to complications. Common treatments include oral antibiotics (for infection, if applicable) and surgery.

Taking a History 

When a patient first comes in with an ingrown toenail, the first step is taking their history to find out how long they've had their symptoms and what's already done at home to treat them. I'll also assess whether the side of the nail that's been painful is red, swollen, or has any drainage or pus.

Once that's done I can decide whether they need a simple course of oral antibiotics, soaks to the toe, a change in shoes, and or a review of how to trim their toenails. I'll also decide whether temporary or permanent removal of the nail is needed.

Trigger Warning: The videos below contain graphic displays of ingrown toenail surgery, although there is minimal bleeding.


Types of Nail Surgery

Performed right in our office, surgical treatments ease the pain and discomfort of the offending nail. Most of our patients experience very little pain after surgery and can start normal activity the next day.

Nail Avulsion

When a patient has a nail with recent drainage, redness, or swelling of the skin on the nail border these are signs of infection. As a result, most of the time our office will do a nail avulsion surgical procedure first. It involves applying a local anesthetic and removing part of the nail's side border. It's done at the office, takes only a few minutes, and is relatively painless.  Afterwards, the inflammation around the toenail border usually resolves within a couple of days. Patients are asked to soak their toe at home to assist in healing the infection. After the toe has healed (usually seven days), a second procedure called a matricectomy is done. 


The second more permanent procedure, called the matricectomy, can only be done after the infection has resolved. It is usually successful in preventing the ingrown toenail from recurring. In this procedure the "root cells" which lie just under the toenail are cauterized with a chemical to prevent reoccurence of the ingrown toenail.

This chemical would be like pouring gasoline on a fire if the toe was still infected. But by the time you heal up from the first procedure, usually within a week, it is safe to do the matricectomy to help prevent reoccurence of the ingrown toenail.  This procedure takes about two weeks to heal and it needs to be checked by a podiatrist to make sure it's healed well.

You might wonder why the matricectomy isn't done first. It can be done first if you had no redness, drainage, and in my evaluation no sign of inflammation in the nail border. It's not uncommon to find no redness but some swelling of the tissue, pain on exam, and drainage during the procedure. That's when I must limit the procedure to the nail avulsion.

If the nail has simply been tender for a long time but doesn't have any of those other indicators of infection then the permanent procedure can be performed at the first visit. Otherwise the safest thing is to do the nail avulsion first and then the matricectomy.

After Surgery

  • Follow the post-op instructions given to you by our office
  • If you've been prescribed oral antibiotics, be sure to take all the medication, even if your symptoms have improved.


You want to do everything you can to prevent yourself from getting another ingrown toenail. Follow these tips to reduce your risk.

  • Trim your toenails straight across and don't round the corners
  • Wear shoes and socks that are not too tight
  • Keep your feet clean at all times.
Dr. Rion Berg
Connect with me
A podiatrist in North Seattle treating families for over 40 years.