What are ingrown toenails?
Ingrown toenails are one of the most commonly treated conditions seen by podiatrists. Ingrown toenails are particularly common in children and adolescents. Ingrown toenails occur when the edge of the nail begins to grow into the edges rather than growing vertically alongside the skin from the nail bed, or when inflamed skin overlaps the edge of the nail. Ingrown toenails are typically very painful and can be susceptible to infection if not managed carefully.
What causes ingrown toenails in children?
An ingrown toenail can have a number of causes:
Poorly fitted shoes: Shoes that are too narrow through the forefoot can cause an increased amount of pressure on the corners of toes. With quickly growing feet and changing nail structures, it is crucial to regularly check the fit of your child’s shoes.
Over-trimming of the nails: Nails do need to be cut, but issues can arise if nails are trimmed too far into the corners, cut too short or picked and peeled at. If you are ever unsure of correct nail cutting techniques, please see a podiatrist for a tutorial to hopefully avoid any complications.
Trauma: Trauma to nail plates that causes the nail edges to press into the nail edges can cause irritation of the skin. Accidental trauma to nails is sometimes inevitable, so it is important to carefully monitor any signs of inflammation and irritation.
Genetics: It is possible to inherit ingrown toenails from family members. This is in relation to the underlying nail structure that causes more involution (turning into the corners).
What are the signs and symptoms of ingrown toenails?
Ingrown toenails commonly affect the big toe, but it is possible for it to affect any of the toes.
Common symptoms of an underlying ingrown toenail include:
Localised redness, swelling and inflammation, particularly in the corners overlying the nail edge
Pain when pressure is applied on the toe
Additional skin begins to grow over the nail edge that can be very sensitive
Discharge from the nail edge including pus and blood.
Deep throbbing of the toe
How are ingrown toenails treated in children?
The best management for ingrown toenails is early interference. At first appearance of any of the above signs and symptoms, please consider beginning to soak the foot in lukewarm water with a teaspoon of Epsom salt to reduce the likelihood of further irritation followed by a simple dressing of betadine and a sterile dressing.
If you’re unsure on what to do or cannot relieve painful symptoms, an appointment with a podiatrist will be beneficial. The nail may just need to be thoroughly cleansed and rounded off to reduce any sharp nail edges that may be digging into the skin. A thorough assessment of the nail can be made, including any decisions around beginning a course of antibiotics to address infection.
A conservative approach to each ingrown toenail will always be prioritised. In cases of severe ingrown toenails, repetitive flare-ups or failed conservative care, a partial nail-avulsion (PNA) may be appropriate in the management of in-grown toenails. This is a permanent surgical procedure done under local anesthetic that removes the offending nail edge right down to the nail matrix, followed by the application of phenol which stops the nail growing back in the corner. Following this small procedure, your podiatrist will schedule regular appointments to ensure the safe and effective recovery as the wound site heals.
Do you think your child is suffering from this condition?
If your child is complaining of sore legs, feet, or if you have noticed that they are having difficulty walking in any way, we are able to help through an initial assessment. We are currently running FREE kids assessments!
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Through these assessments, our podiatrists have the ability to assess your child’s gait and feet, the biomechanics of their lower limbs and construct a treatment plan to monitor your child’s progression over time!