Foot care at home: cut toenails straight, prevent ingrown nails, handle calluses

A safe home pedicure comes down to a few rules: cut toenails straight across and not too short, soften and gently buff calluses instead of cutting them, and wear shoes that fit. For people with diabetes, a small foot wound can become serious, so their feet are better cared for by a doctor or foot specialist than by following this article on their own.

This is general care for feet without wounds, redness or swelling, and without a health condition that affects the feet.

Before you start: who should not do this alone

Guidance from NIDDK, part of the US National Institutes of Health, for people with diabetes differs from general advice in several places, because diabetes can numb the feet so injuries go unnoticed, and wounds heal slowly.

Topic	Most people	People with diabetes (per NIDDK)
Soaking	A short warm soak is fine	Wash in warm water, do not soak, as it dries the skin. Test water with your elbow or a thermometer
Cutting nails	Straight across, after a bath	Straight across. If you cannot see or reach your feet, or nails are thick, yellowed or curve into the skin, have a podiatrist cut them
Calluses and corns	Soak, then pumice	Do not cut. No medicated pads or liquid removers. Pumice only if your doctor says so
Checking feet	When something feels wrong	Every day, including between the toes, plus regular checks by the care team

If you have diabetes, poor circulation or numb feet, ask your doctor before doing anything in this article.

A home pedicure, step by step

1. Wash and soak briefly. Comfortably warm water, not hot. The American Academy of Dermatology (AAD) suggests soaking a callus for about 5–10 minutes or until the skin softens, and says the best time to trim nails is right after a bath or shower, when they are softer.
2. Dry completely, including between the toes. Moisture left there is what germs like.
3. Cut the nails with clean toenail clippers, straight across (see the next section).
4. File the edges smooth, in one direction.
5. Buff calluses, if you have any, with a wet pumice stone, gently.
6. Moisturise the tops and soles of the feet, but not between the toes.
7. Leave the cuticles alone. The AAD advises against cutting or pushing them back, because that lets bacteria in.

Clean your tools after every use: see cleaning and sanitising nail tools.

Cut toenails straight across to prevent ingrown nails

An ingrown toenail is when the edge of the nail grows into the skin beside it, most often on the big toe. It becomes red, painful and swollen, and can get infected. The AAD and the NHS agree:

• Cut straight across. Do not follow the curve down into the corners.
• Do not cut too short. Leave the nail level with, or just shorter than, the tip of the toe, not so deep that you expose the skin under the corners.
• File sharp corners instead of cutting deep into them.
• Wear shoes that fit. Tight or pointed shoes squeeze the toes and push the nail edge into the skin.

Cut straight, not too short, no digging at the corners. That is the best ingrown-nail prevention there is.

Example: one bad cut, how long to wait

A study that measured nail growth in 22 healthy young adults found fingernails grew an average of 3.47 mm a month and toenails 1.62 mm a month (a small sample, so treat these as rough figures).

Say you cut 3 mm deep into the corner of your big toenail.

1. The nail needs to grow 3 mm before the corner clears the skin fold again.
2. 3 ÷ 1.62 ≈ 1.9 months.
3. So for about 8 weeks the corner grows inside the skin groove, and wearing tight shoes during that time raises the chance it digs in.

For a fingernail, 3 mm takes less than a month (3 ÷ 3.47 ≈ 0.9 months). That is why toenails need more care than fingernails.

Calluses and corns: buff, do not cut

Calluses and corns are skin that has thickened from friction or pressure. The AAD’s home-care steps:

• Soak in warm water for 5–10 minutes, or until the skin softens.
• Use a pumice stone dipped in warm water, with gentle circular or side-to-side strokes.
• Do not take off too much skin. That can cause bleeding and infection.
• Moisturise daily. A cream with salicylic acid, ammonium lactate or urea gradually softens thick skin.
• Pad around the spot to reduce rubbing, and wear shoes that fit. Shop for shoes at the end of the day, when feet are slightly larger.
• Keep toenails trimmed. Long toenails push the toes against the shoe, which can cause a corn.

Never use a knife, razor blade or scissors on a callus. A cut is an entry point for infection. If you are unsure what it is, it is very painful, or you have diabetes, the AAD recommends seeing a dermatologist.

When to see a doctor

• An ingrown nail that does not improve with home care, is painful and swollen with pus, or comes with a fever or shivering.
• A cut, blister or bruise that has not started healing after a few days.
• Red, warm or painful skin.
• A callus with dried blood inside it.
• A toenail that is thick, discoloured or changing shape. For other signs, see nail signs that mean you should see a doctor.
• Any foot problem at all if you have diabetes.

With diabetes, even a small foot wound is worth showing a doctor. Do not wait.

Common mistakes

What people do	What happens	Do this instead
Cutting toenails in a curve down to the corners	The corner grows into the skin	Cut straight across, file the corners
Cutting so short the skin shows	Pain, higher ingrown risk	Leave the nail level with the toe tip
Digging out an ingrown corner	Deep wound, infection	Warm salt-water soak, roomy shoes, see a doctor if no better
Shaving a callus with a blade	Bleeding, infection	Soak, then buff gently with pumice
Cutting the cuticles	An opening for germs	Leave them, use oil or cream
Cream packed between the toes	Damp, sweaty skin	Cream on tops and soles, not between toes

Sources

• How to trim your nails — American Academy of Dermatology
• How to treat corns and calluses — American Academy of Dermatology
• Ingrown toenail — NHS
• Diabetes and foot problems — NIDDK
• Diabetes and your feet — CDC
• Growth rate of human fingernails and toenails in healthy American young adults — J Eur Acad Dermatol Venereol, 2010 (Europe PMC)