What is an Ingrown Toenail?
An ingrown toenail, also known as an ingrowing toenail, occurs when the edge of the toenail grows into the surrounding skin, causing discomfort, pain, swelling, and sometimes infection. This condition primarily affects the big toe and is common in children and adolescents.
As the nail grows into the skin, it can lead to increasing irritation, and the skin may overgrow around the nail, making it more difficult to treat. If left untreated, the condition can worsen, leading to recurring infections and more severe discomfort.
The below images show the parts of a normal toe, the formation of a spicule that can cause an ingrown toenail, and an ingrown toenail.
Why Does an Ingrown Toenail Occur in Children?
There are several reasons why a child may develop an ingrown toenail, including:
- Improper nail trimming: Cutting nails too short or peeling the nail instead of using clippers can encourage the nail to grow into the skin.
- Tight footwear or uncomfortable footwear choice: Shoes that pinch the toes can push the nail edges into the skin, leading to ingrowth.
- Injury: A stubbed toe or other injury can change the growth pattern of the nail.
- Growth spurts: Adolescents often experience ingrown toenails during growth spurts, which can affect shoe fit and foot mechanics.
- Foot mechanics and gait: Sometimes, the way a child walks (gait) puts excessive pressure on one side of the toe, pushing the nail into the skin.
Symptoms of Ingrown Toenails in Children
The symptoms of an ingrown toenail are usually:
- Pain and tenderness along one or both sides of the nail.
- Redness and swelling around the nail.
- Overgrowth of skin at the side of the nail.
- Infection, which may cause pus or fluid to ooze from the area.
In more severe cases, children may limp or avoid putting pressure on the affected toe due to pain.
Treating an Ingrown Toenail at Home
In many cases, mild ingrown toenails can be treated at home. It can take a very long time for the ingrown nail to grow out from the skin on the side. During that time, repeated infections can occur.
Soaking the affected foot in warm water several times a day can help cleanse the area and soften the nail and skin. Once the nail is soft, clean and flexible, you may be able to gently lift the nail away from the skin at the side of the toe with a clean cotton wool or gauze can help it grow above the skin.
If it looks like the toe is becoming infected, then apply a small amount of a topical antiseptic after cleansing can help resolve a mild infection before it worsens.
If the infection looks to be worsening or the redness has spread past the toe, please contact your family doctor.
When the toenail is sore and ingrown it is best to avoid tight socks or shoes which may aggravate the toe and push the nail back into the skin.
Following this advice for a few days often resolves the baby’s ingrown toenail.
When Might an Ingrown Toenail Need Surgery?
If the nail becomes repeatedly infected or the skin overgrowth becomes severe, surgery may be necessary. Surgery may involve removing part of the nail or the overgrown skin to allow the nail to grow properly again. This procedure is often recommended when conservative treatments fail or when infections are recurrent.
Find out more on this on our Surgery for Ingrown Toenails page.
Can Ingrown Toenails Be Prevented?
Yes, with proper care, ingrown toenails can often be prevented. Here are some tips to reduce the risk:
- Foot hygiene: Clean and dry feet regularly to prevent bacterial infections.
- Nail care: Always trim nails straight across without rounding the edges. Avoid cutting nails too short. Don’t peel or pick the nails.
- Footwear: Ensure that your child wears properly fitting shoes that provide enough room for the toes. An assessment by a podiatrist may be helpful if fitting shoes is difficult.
- Lifting the nail: Gently lift the nail to prevent it from digging into the skin.
- Gait analysis: Consider having your child’s walking style (gait) analysed by a podiatrist or physiotherapist if they frequently suffer from ingrown toenails. If your child puts a lot of weight on one part of the toe and allowing the nail to dig in, this may be a contributing factor that can be corrected.
When to See a Doctor
If home treatments don’t improve the condition or if you notice signs of infection such as pus, increased redness, or swelling, it’s important to seek medical advice. Your family doctor may recommend more advanced treatment options or refer you to a podiatrist for further care.
If normal medical care and prevention strategies don’t work, then surgery may be required.
For more information on surgical options for ingrown toenails, please visit our Surgery for Ingrown Toenails page.
Image Gallery for Patient Consultations
Our Paediatric Surgeons may use this image set during your consultation to explain conditions and treatments.
We welcome our referrers and other health professionals in the community to use these as well.
