Gentle Care for Pediatric Ingrown Toenails

by | Jul 12, 2018

One of the basic facts of ingrown toenails is this – anyone who has toenails can potentially develop the condition.

So, whereas it would be rather unusual to treat a five-year old for osteoarthritis or gout—medical issues that normally develop over time—we do provide care on a frequent basis for children who are suffering from the pain and discomfort ingrown toenails can bring.

As with any medical issue, it’s always best to identify the problem at the earliest possible opportunity. In doing so, you can ensure the condition doesn’t worsen and become severe.

Of course, more than that, the sooner you have the problem addressed, the sooner your child won’t be in pain!

Now, every child is (naturally) quite different. Some kids won’t hesitate to say something when there’s a problem. Others tend to be more reserved and reluctant to speak up.

If your son or daughter lets you know a toe hurts—and you cannot think of any reason why this would be the case—there’s a chance he or she has a toenail that’s become ingrown. A little detective work on your end can usually confirm or deny this pretty quickly.

Basically, you need to look at the corner of the nail on the affected toe and see if it’s started to grow into the soft flesh flanking it.

Most cases involve the big toe. The small toe is the next-most-likely to have an ingrown nail. If your child has pain in either area, it’s a distinct possibility that this condition is the source.

An overwhelming majority of pediatric ingrown toenail cases—while still being a source of discomfort or pain—don’t qualify as medical emergencies.

This is certainly good news. After all, the less “medical emergencies” for young ones, the better!


With that being said, it’s important to know when an ingrown toenail is more problematic. To this end, you should seek immediate care—whether at our office or potentially the ER—if you have a child who exhibits any of the following signs or symptoms:

  • Severe pain that has not improved within two hours after antibiotic ointment and pain medication has been administered
  • There is a red area or streak that is spreading and very large and/or accompanied by a fever
  • Your child looks or acts very sick

At other times, the problem may still be urgent, but your child will be fine if you call us within 24 hours. This includes times when:

  • The entire toe has become red and swollen.
  • There is a red area or streak starting to spread, but without fever
  • A pocket of pus (green or yell) can be seen in the skin around or under the nail (and needs to be drained at our office)

For other cases, contact us during normal office hours and we can work together to find time for an appointment that will work with your schedule.

With regards to the treatment and care we will provide your child, we are generally talking about soaking the foot, gently lifting the ingrown corner out, taking measures to keep the nail elevated above the skin, and then using antibiotic ointment to reduce any potential risk of infection.

To manage painful symptoms, we may prescribe an acetaminophen or ibuprofen medication.

We have good news – there are a couple of ingrown toenail prevention measures you can use to reduce the risk of your child suffering from this problem, including:

Provide children with shoes that fit well.

You would quickly amass a small fortune if you had a dollar for every lower limb problem—including ingrown toenails—stemming from footwear that is either too small or tight. The problem with small footwear is that it squashes the toes together in the front, which can then lead to nails growing into the flesh surrounding them.

Part of the reason this potential cause of pediatric ingrown nails comes down to the simple fact that young feet are growing at an incredible rate – which they need to in order to support a growing body!

That means children can outgrow shoes much sooner than you might realize. Here are some general guidelines to keep in mind:

  • Until around 15 months, feet grow by about half a size every two months.
  • Between 15 months and 2 years, feet grow by about half a size every two to three months.
  • Between 2 and 3 years, feet grow by about half a size every three to four months.
  • Between 3 and 5 years, feet grow by about half a size every four months.

It’s important to emphasize the point that these are only general guidelines. Every situation is unique, and this means there is no need to worry if your son or daughter seems to be growing at either a slower or faster rate.

Furthermore, toddlers the same age might wear shoes that are a couple sizes apart – only to end up wearing the exact same size a couple years down the road.

Bring children with you when buying shoes.

The best way to ensure proper fit isn’t to rely on sizes printed on the shoes. Rather, you should have your child try on shoes and make sure they aren’t too small (or too big).

The rationale behind this is the fact that not all manufacturer’s sizes are equal. What could be a “3” for one brand might be a “3 ½” or “4” in another.

Also, it’s important that your child’s shoes fit correctly in the store. Do not plan on “they’ll stretch” (which is a common mistake).

Trim their toenails correctly.

Too many cases of ingrown toenails—for patients of all ages—are caused by improper nail trimming practices. In what can likely be attributed to how we clip our fingernails, some people round off the toenails when they clip them. A better practice, however, is to cut them straight across.

In addition to not rounding the nails off, you should make sure they aren’t cut too short as well. A good guideline in this regard to is to keep them roughly even with the edge of the corresponding toes.

Unfortunately, not all cases of ingrown toenails are avoidable. Sometimes, the problem develops in response to physical trauma. So if your child accidentally drops something on his or her foot, a nail might become ingrown and need to be treated.

At other times, the root cause is simply an inherited nail structure. There is really no way to prevent this from happening and, in all likelihood, the condition will continually reoccur.

For adolescents and adults, the solution might be to permanently remove the nail. In the case of pediatric ingrown toenails, we may need to monitor the situation—actually see if it does, in fact, return—and then determine an appropriate course of action that’s best for your child.

If your child is pain from an ingrown toenail—or any other possible foot or ankle problem—we would love the opportunity to provide treatment so he or she can find relief. When we do, you can trust that our team at Heartland Foot and Ankle Associates will use only the gentlest possible methods!

For more information on the child foot care services we offer or to request an appointment for your son or daughter, simply give our Bloomington, IL office a call at (309) 661-9975 or contact us online and we’ll be in touch with you at the earliest possible opportunity!

10 Heartland Drive Suite B
Bloomington, IL 61704

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