How to Prevent and Treat Ingrown Toenails in Children

Ingrown toenails are common in children. Older children and teens often get an ingrown toenail either because they wear tight-fitting shoes that put pressure on their toenail or they trim their toenails too short, especially on the sides. These improperly trimmed toenails can then grow under the nailfold instead of continuing to grow out like they are supposed to.

Symptoms

The most common symptoms of an ingrown toenail include:

• pain
• swelling
• drainage of pus
• erythema (redness)

Complications

Left untreated or undetected, an ingrown toenail can infect the underlying bone and lead to a serious bone infection.

Complications can be especially severe if your child has diabetes, which can cause poor blood flow and damage nerves in your feet. So a minor foot injury — a cut, scrape, corn, callus or ingrown toenail — may not heal properly and become infected. A difficult-to-heal open sore (foot ulcer) may require surgery to prevent the decay and death of tissue (gangrene). Gangrene results from an interruption in blood flow to an area of the body.

Treatment

The treatments for an ingrown toenail can include:

• pain relievers, such as acetaminophen or ibuprofen, in an age-appropriate dose
• soaking the toenail in warm, soapy water for 10 to 20 minutes twice a day, and then applying a topical antibiotic to the area
• taking an oral antibiotic, in addition to soaking the toenail, if the ingrown toenail is infected
• placing a wisp of cotton, dental floss, or a gutter splint, under the edge of the ingrown toenail to help relieve pain until the ingrown toenail grows out again
• partial lateral nail avulsion, in which the part of the ingrown toenail is removed, sometimes with part of the nail bed (matricectomy)

Complications of surgical treatment of an ingrown toenail can include having a toenail that doesn't grow back normally, giving a poor cosmetic result and recurrences. They can also be painful for children. On the other hand, more conservative treatments that don't involve removing the ingrown toenail don't always work.

More serious complications can include the spreading of the infection from the ingrown toenail to other parts of your child's body.

Preparing for Your Appointment

Prepare a list of questions to ask your healthcare provider during your child's appointment. Put the most important questions first in case time runs out. Some basic questions include:

• Is their condition temporary or long-term (chronic)?
• What are your child's treatment options and the pros and cons for each?
• What results can you expect?
• Can you wait to see if the condition goes away on its own?
• What nail care routine is recommended for your child while the toe heals?

Other Things to Know

• The medical term for an ingrown toenail is onychocryptosis.
• The big toenail is the most common toenail to be affected when kids get an ingrown toenail.
• In addition to improper toenail trimming, excessive sweating (hyperhidrosis) is a risk factor for ingrown toenails.
• Although some pediatricians and family practice medical professionals will perform a partial lateral nail avulsion in their office, others refer children and teens to a podiatrist to have the procedure done.
• You can often prevent ingrown toenails from forming or coming back by encouraging your kids to cut their toenails straight across; if your child is too young to cut their own toenails, be sure you also follow this tip and don't cut the toenails too short. Also, make sure your kids wear well-fitting shoes.