Specialist practice in Berlin · Orthopaedics & Trauma Surgery

Ingrown toenail: Causes, symptoms and treatment in Berlin

An ingrown toenail is painful and often gets worse without treatment. Here you can find out how to recognise it, what you can do yourself and when treatment is necessary. At the practice of Dr. Univ.-PD Amro Homssi, we treat ingrown toenails gently with laser, as an outpatient procedure under local anaesthetic.

Medically reviewed by Dr. Univ.-PD Amro Homssi, Specialist in Orthopaedics and Trauma Surgery · Last updated: October 2026

Book a consultation appointment What helps?

Consultation appointment usually within 24 h
Outpatient, under local anaesthetic
Over 4,000 patients treated

Handpiece and articulated arm of the CO2 laser at Dr. Homssi's practice in Berlin

At a glance

Ingrown toenail (Unguis incarnatus)

Usually affects the big toe, often at the side edge of the nail
Common causes: nails cut too short or rounded, tight shoes, predisposition
Typical signs are pain on pressure, redness and swelling, later pus or proud flesh
See a doctor if there is pus, if you have diabetes or if symptoms keep coming back
To stop it growing in again: ablation of the lateral nail growth zone, by laser at our practice

What is an ingrown toenail?

With an ingrown toenail (medical terms: Unguis incarnatus or onychocryptosis), the side edge of the nail presses into the surrounding nail fold and grows into the skin. This causes pain, redness and swelling, especially when walking and in closed shoes. If the irritation persists, the area can become inflamed and form pus or proud flesh.

Medical term	Unguis incarnatus, onychocryptosis (ICD-10: L60.0)
Most common site	big toe, side edge of the nail, often on both the inner and outer side
Who is affected?	all age groups, particularly common in adolescents and young adults
Main causes	nails cut too short or rounded, tight shoes, sweating, curved nails
To stop it growing in again	ablation of the lateral nail growth zone, by laser at our practice

The 3 stages of an ingrown toenail

Doctors usually divide ingrown toenails into three stages. The stage determines which treatment is appropriate.

Stage	Features	Recommended treatment
Stage 1	redness, slight swelling, pain on pressure at the nail edge, no pus	foot baths, taking the pressure off, tamponade or tape, nail brace
Stage 2	inflammation with pus, marked swelling, more severe pain	medical treatment; if the inflammation keeps coming back, ablation of the nail growth zone
Stage 3	in addition, proud flesh (in German), i.e. granulation tissue growing over the nail edge; chronic course	surgical treatment, for example laser treatment or the Emmert procedure

Causes of an ingrown toenail

Incorrect cutting: Nails cut too short or with heavily rounded corners increase the risk of the nail growing into the skin.
Unsuitable footwear: Tight or too small shoes, including sports and safety shoes, push the nail edge into the tissue.
Sweating: Softened skin gives way more easily to the nail edge.
Injuries: Knocks or crush injuries to the toe can cause the nail to grow in.
Anatomical predisposition: Strongly curved nails, known as pincer nails, or a particular toe shape make ingrowth more likely.

Is an ingrown toenail dangerous?

In most cases, an ingrown toenail is mainly painful. Left untreated, however, the inflammation can spread. Possible consequences are nail bed inflammation, known as paronychia (in German), an inflammation of the surrounding tissue, known as cellulitis (phlegmon), and, very rarely, an infection of the bone. People with diabetes, circulatory problems or a weakened immune system are particularly at risk.

See a doctor immediately if a red streak runs from the toe up the foot, if you develop a fever, if the swelling increases rapidly or if you have diabetes and the toe is inflamed.

Ingrown toenail: what to do? Immediate measures in 5 steps

At an early stage, i.e. with slight redness and no pus, there is a lot you can do yourself:

Foot bath: twice a day for 15 to 20 minutes in warm water with a mild disinfectant additive or a little soap. This softens the skin and nail and soothes the inflammation.
Take the pressure off: Wear wide or open shoes, and avoid tight sports and safety shoes for a few days.
Do not cut out the nail edge: Do not trim the nail in the corner. An edge cut too short often grows in again, and deeper.
Keep it clean: Dry the foot thoroughly after the foot bath, treat the area with a wound disinfectant and put on fresh socks every day.
Keep an eye on it: If the area does not improve after two to three days, if pus forms or if the pain gets worse, have a doctor look at the toe.

Which home remedies help and which do not?

Useful: warm foot baths, wide shoes, taking the pressure off, wound disinfection, a small piece of tape that pulls the skin away from the nail edge.
Only with guidance: pushing cotton wool or a tamponade under the nail edge. If done incorrectly, this injures the inflamed skin.
Little evidence: tea tree oil, drawing ointment, vinegar or chamomile. They are no substitute for treatment once pus has formed.

More on home remedies and what you can do yourself (in German)

When you should see a doctor

if there is pus, severe swelling or throbbing pain
if proud flesh forms
if the symptoms do not improve after a few days or keep coming back
immediately if you have diabetes, circulatory problems or a weakened immune system

Prevention: how to cut toenails correctly

Cut straight across: Cut the nail straight across and do not round off the corners.
Not too short: The corners should extend slightly beyond the skin.
After a bath: Soft nails are easier to cut cleanly; straight nail clippers are better than curved scissors.
Well-fitting shoes: about a thumb's width of space at the front, including in sports shoes.
Dry feet: breathable socks, and change your socks after sport.

Inflamed toe: what to do? (in German) · Nail bed inflammation (in German)

Which doctor treats an ingrown toenail?

Depending on the stage, different specialists are the right point of contact:

Podiatrist: for mild cases without pus, for example for a tamponade, tape or a nail brace.
GP or dermatologist: for the initial assessment and for treating inflammation in its early stages.
Surgically active specialist: if the nail keeps growing in, or if pus or proud flesh forms. These are specialists in orthopaedics and trauma surgery, such as Dr. Homssi, or surgeons.

Do I need a referral? You do not need a referral for an appointment with us. A referral may only be necessary if your health insurance provides for a GP-centred care model.

All treatments compared

Procedure	Suitable for	Anaesthesia	Healing	Risk of recurrence
Foot bath, tape, tamponade	Stage 1	none	days to weeks	high, the cause remains
Nail brace (in German)	Stage 1, curved nails	none	worn for months	medium
Phenolisation (in German)	Stages 2 and 3	local	2 to 4 weeks, wound weeps	low
Emmert procedure (in German)	Stages 2 and 3	local	usually 2 to 3 weeks, stitches	low to medium
Laser treatment	Stages 2 and 3, recurring	local	often 1 to 2 weeks, no stitches	low

According to a Cochrane review, surgical procedures with ablation of the nail growth zone prevent recurrence better than non-surgical treatments. For mild cases, the nail brace remains a good choice.

Conservative, for mild cases

Nail brace (orthonyxia): lifts the nail edge over weeks to months. More on the nail brace (in German)
Tamponade and tape: relieve pressure on the skin at the nail edge.

Surgical, for inflammation or recurring symptoms

Emmert procedure: the classic procedure, in which a wedge of the nail edge is cut out with a scalpel. Pros and cons of the Emmert procedure (in German)
Phenolisation: The nail edge is removed and the nail growth zone is ablated chemically. Phenolisation and laser compared (in German)
Laser treatment: The nail edge is removed and the nail growth zone is precisely ablated with the laser. This is our main focus. More on laser treatment

Examination and treatment room at Dr. Homssi's practice in Berlin

The method

Modern laser treatment, our surgical focus in Berlin

In laser treatment of an ingrown toenail, the ingrown nail edge is removed in a targeted way and the corresponding section of the nail growth zone is precisely ablated with medical laser energy. The procedure is generally very gentle, with a small wound area and a short healing time.

All about laser treatment

Precise and gentle on tissue
Only the affected part is treated; the healthy nail bed is preserved.
Germ-reducing laser energy
The laser energy reduces germs and stops bleeding, which lowers the risk of infection.
Minimal downtime
Many patients return to their daily routine on the same day; closed shoes are usually possible after around 2 weeks.
Outpatient at the practice
We carry out minor procedures as outpatient procedures at our practice, without a hospital stay.

Laser and the classic method

Why laser treatment is our method of choice

The classic Emmert procedure is an established and proven method, and we also perform it. Which procedure suits you depends on the findings; we discuss this in the consultation.

Why laser treatment is our method of choice: Classic Emmert procedure und Modern laser treatment with Dr. Homssi im Vergleich
Classic Emmert procedure	Our main focusModern laser treatment with Dr. Homssi
Wedge-shaped excision with scalpel and stitches	Precise laser application with little bleeding
More bleeding during the procedure	Immediate control of bleeding through coagulation
Wound healing usually takes 2 to 3 weeks	Wound healing often within 1 to 2 weeks
Depending on the technique, a larger wound and longer aftercare	Laser energy reduces germs
Visible scarring possible	Small wound, discreet result
Proven, especially in advanced cases	Risk of recurrence low

Ingrown toenail surgery: procedure, duration and anaesthesia

This is how laser treatment works at our practice in Berlin-Prenzlauer Berg:

Where	outpatient procedure at the practice, no hospital stay
Anaesthesia	local, as a nerve block at the base of the toe (Oberst block); AR glasses for distraction on request
Duration	procedure about 15 to 25 minutes per toe, about 45 to 60 minutes including the pre-procedure consultation and dressing
Is the whole nail removed?	No, only a narrow strip at the ingrown edge
Stitches	none
Walking	straight after the procedure, in wide shoes
Driving	better not to drive yourself on the day of treatment
Showering	keep the dressing dry for the first 48 hours, then shower as normal
Work	office work often possible as early as the next day; for jobs that involve standing or walking, we discuss the length of time off individually

Healing time and aftercare: what you can do again and when

Period	What applies
Days 0 to 1	keep the dressing dry, wide shoes, everyday activities at home possible
Days 2 to 7	a short foot bath and a fresh plaster every day, office and school usually possible, follow-up check
Weeks 1 to 2	wound usually healed, light sport and walks
Weeks 2 to 3	closed shoes, jogging, football; swimming pool and sauna only once the wound has fully healed
after a few months	the nail has grown back slightly narrower at the treated edge; the aim is that it no longer grows in there

Detailed aftercare guide after toenail surgery (in German)

Special situations

Diabetes and circulatory problems

With diabetes, wounds heal more slowly and inflammation spreads more easily. That is why you should have an ingrown toenail treated early. Laser treatment causes little bleeding and reduces germs, and it is well suited if your metabolic condition is stable. Nail problems in diabetes (in German)

Blood thinners

If you take blood-thinning medication, please let us know in advance. We will discuss with you whether and for how long a medication needs to be paused. Never stop taking it on your own.

Pregnancy

A local anaesthetic is generally also possible during pregnancy. If the procedure is not urgent, we often start with conservative treatment and plan the ablation for after the birth. We decide this together after the examination. More on ingrown toenails during pregnancy (in German)

Children and adolescents

With children, we start with conservative treatment whenever possible. Ingrown toenails in children (in German)

Athletes

Tight sports shoes and knocks during football or running make ingrown toenails more likely. After laser treatment, light sport is usually possible again after 1 to 2 weeks, and intensive sport after 2 to 3 weeks. Tips for football, running and ballet (in German)

What does treatment cost and what does health insurance pay?

Treatment	Statutory health insurance	Private health insurance
Medical consultation at the practice	covered	covered, billed according to the German medical fee schedule (GOÄ)
Nail brace from a podiatrist	since 1 July 2022 as prescribed therapy (Heilmittel) on a doctor's prescription	depending on your policy
Emmert procedure	usually covered if medically necessary	usually covered
Laser treatment	usually a self-pay service	often reimbursed, depending on your policy

Laser treatment costs around €600 to €900 (depending on the extent; exact price after the medical consultation), including local anaesthetic, dressing and a follow-up check; it is billed according to the GOÄ. A nail corner is one side edge of the nail. All prices are listed on the laser treatment page. The video consultation costs €46.93 and is paid directly when booking; private health insurers usually reimburse it on presentation of the invoice.

For anxious patients

Worried about the procedure? Audiovisual sedation with AR glasses.

At Dr. Homssi's practice, we use AR glasses (XREAL) for audiovisual sedation. During the laser treatment, you immerse yourself in a film, music or calming nature scenes and neither hear nor see what is happening.

Audiovisual sedation: The AR glasses take you out of the treatment situation, visually and acoustically.
Low pain and calming: Local anaesthetic and distraction noticeably reduce tension.
For all age groups: Especially popular with patients who are anxious about treatment or have had negative experiences in the past.
Companion welcome: You can bring someone you trust with you.

Book an appointment with AR glasses

Man wearing AR glasses relaxing in a treatment chair, distracted by images and sound during laser treatment

Audiovisual sedation

with AR glasses during laser surgery

Dr. Amro Homssi, specialist in orthopaedics and trauma surgery in Berlin, wearing a navy polo shirt

Your doctor

Dr. Univ.-PD Amro Homssi, Specialist in Orthopaedics and Trauma Surgery in Berlin

My aim is to provide treatment that is tailored to your needs and reflects current medical knowledge. At our practice on Greifswalder Straße, we offer a range of orthopaedic and surgical services with modern equipment, both conservative and surgical.

We carry out minor operations, including laser treatment of ingrown toenails, as outpatient procedures at the practice. Larger procedures take place at the adjacent hospital.

Specialist in Orthopaedics and Trauma Surgery, accident insurance consultant (D-Arzt)
Surgical focus: laser treatment of ingrown toenails
Outpatient procedures at the practice, larger operations in a hospital setting
Languages: German, English, Arabic, French and Italian
Over 4,000 patients treated

More about Dr. Homssi

FAQ

Frequently asked questions about ingrown toenails

What gives quick relief for an ingrown toenail?

At an early stage, warm foot baths with a mild disinfectant additive, wide shoes and taking the pressure off the toe can help. If pus or proud flesh forms or the pain gets worse, you should have a doctor look at the toe.

Can I cut out the ingrown nail myself?

We advise against this. Cutting it out can easily cause small injuries, and an edge cut too short often grows in again, and deeper. Cut your toenails straight across and have an ingrown edge treated professionally.

Which doctor is responsible for an ingrown toenail?

In mild cases, podiatrists, GPs or dermatologists can help. In the case of inflammation or recurring symptoms, a surgically active specialist is the right choice, such as a Specialist in Orthopaedics and Trauma Surgery.

Can an ingrown toenail heal on its own?

At an early stage, the symptoms sometimes subside with foot baths, taking the pressure off and cutting the nail correctly. However, if the nail keeps growing in or pus and proud flesh form, it usually does not heal without treatment.

Does a nail brace help with an ingrown toenail?

In mild cases, a nail brace can lift the nail edge over weeks to months and stop it from growing in. In the case of severe inflammation or recurring symptoms, it is often not enough. More on the nail brace (in German)

What is the best treatment for an ingrown toenail?

That depends on the findings: in mild cases, foot baths, taking the pressure off or a nail brace are sufficient. In the case of inflammation or recurrent ingrowth, ablation of the lateral nail growth is advisable. For this, we recommend laser treatment.

Which symptoms indicate that an ingrown toenail needs treatment?

Typical signs of unguis incarnatus are persistent pain on pressure at the lateral nail fold, redness, swelling, proud flesh (caro luxurians) and purulent discharge. At the latest when inflammation recurs or conservative measures (nail brace, tamponade) have failed, surgical treatment with laser matrix cauterisation is indicated.

Does health insurance cover laser treatment in Berlin?

Medically necessary surgical treatment of an ingrown toenail is generally covered by statutory health insurance. In Berlin, the laser method is mostly a self-pay or private service, as it goes beyond the standard benefits catalogue. It costs around €600 to €900 (depending on the extent; exact price after the medical consultation), billed according to the GOÄ.

Where is your practice for laser treatment in Berlin?

Our practice is located at Greifswalder Str. 137-138, 10409 Berlin. We are very easy to reach by public transport and treat patients from all over Berlin: from Mitte, Charlottenburg, Prenzlauer Berg and Kreuzberg to Steglitz, Zehlendorf, Pankow and the surrounding Berlin area.

Is an ingrown toenail dangerous?

In most cases, it is mainly painful. Left untreated, however, the inflammation can spread, for example leading to nail bed inflammation or cellulitis (phlegmon). If you have a fever, a red streak on your foot or diabetes, you should seek medical help immediately.

How long does it take for an ingrown toenail to heal?

At an early stage, the symptoms often improve within a few days with foot baths and taking the pressure off. After laser treatment, the wound has often healed within 1 to 2 weeks; after an Emmert procedure, usually within 2 to 3 weeks.

Which home remedies help with an ingrown toenail?

Warm foot baths, wide shoes, wound disinfection and tape that pulls the skin away from the nail edge. If there is pus or proud flesh, home remedies are no longer enough.

Does statutory health insurance pay for a nail brace?

Yes, since 1 July 2022, treatment with a nail brace from a podiatrist can be provided as prescribed therapy (Heilmittel) on a doctor's prescription. The prerequisite is an ingrown toenail that is suitable for this treatment.

How long are you signed off sick after toenail surgery?

That depends on the procedure and on your job. After laser treatment, office work is often possible as early as the next day. After an Emmert procedure, many people expect to be unfit for work for about three weeks, especially in jobs that involve standing or walking.

When can I do sport again after treatment?

After laser treatment, light sport is usually possible after 1 to 2 weeks, and jogging and football in closed shoes after 2 to 3 weeks. Swimming only once the wound has fully healed.

Which is better: laser, phenol or the Emmert procedure?

All three procedures ablate the lateral nail growth zone. Laser treatment is precise, causes little bleeding and requires no stitches. We will discuss which procedure is right for you after the examination.

Can an ingrown toenail be treated during pregnancy?

Yes. Conservative measures are possible at any time, and a local anaesthetic is generally possible too. We often plan non-urgent procedures for after the birth.

Sources and further information

IQWiG, gesundheitsinformation.de: Eingewachsener Zehennagel and Behandlung eines eingewachsenen Zehennagels (German)
Eekhof JAH, Van Wijk B, Knuistingh Neven A, van der Wouden JC: Interventions for ingrowing toenails. Cochrane Database of Systematic Reviews 2012, CD001541 (doi.org/10.1002/14651858.CD001541.pub3)
American Academy of Family Physicians: Ingrown Toenail Management, American Family Physician 2019
Gemeinsamer Bundesausschuss (Federal Joint Committee, G-BA): Heilmittel-Richtlinie (German), podiatric therapy with a nail brace for unguis incarnatus since 1 July 2022
MSD Manual, Consumer Version: Eingewachsener Zehennagel (German)
DEXIMED: Eingewachsener Zehennagel, Patienteninformation (German)

Our practice's experience: since 2019 we have treated more than 4,000 patients in Berlin, around 600 a year. Statements on the risk of recurrence are based on our own evaluation and the medical literature and are not a promise for the individual case. This content does not replace a medical examination.

Medically reviewed by Dr. Univ.-PD Amro Homssi, Specialist in Orthopaedics and Trauma Surgery · Last updated: October 2026

Ingrown toenail: Causes, symptoms and treatment in Berlin

What is an ingrown toenail?

The 3 stages of an ingrown toenail

Causes of an ingrown toenail

Is an ingrown toenail dangerous?

How do I recognise an ingrown toenail?

Ingrown toenail: what to do? Immediate measures in 5 steps

Which home remedies help and which do not?

When you should see a doctor

Prevention: how to cut toenails correctly

Which doctor treats an ingrown toenail?

All treatments compared

Conservative, for mild cases

Surgical, for inflammation or recurring symptoms

Modern laser treatment, our surgical focus in Berlin

Precise and gentle on tissue

Germ-reducing laser energy

Minimal downtime

Outpatient at the practice

Why laser treatment is our method of choice

Ingrown toenail surgery: procedure, duration and anaesthesia

Healing time and aftercare: what you can do again and when

Special situations

Diabetes and circulatory problems

Blood thinners

Pregnancy

Children and adolescents

Athletes

What does treatment cost and what does health insurance pay?

In four steps from appointment to follow-up check

Appointment

Diagnosis

Laser treatment

Aftercare

Worried about the procedure? Audiovisual sedation with AR glasses.

Audiovisual sedation

Dr. Univ.-PD Amro Homssi, Specialist in Orthopaedics and Trauma Surgery in Berlin

Book your consultation appointment

Frequently asked questions about ingrown toenails

More on ingrown toenails

Location

Treatments

Guide

Sources and further information

Consultation appointment usually within 24 hours.