Ingrown Toenails in Children

By Emily White|2024-05-15T01:46:29+00:00May 27th, 2022|

Children's ingrown toenails Melbourne podiatrist

Recently we have been seeing quite a few children walk through our doors with ingrown toenails. An ingrown toenail is where one or both edges of a toenail grow into the surrounding skin creating pain and often infection. In some cases a small splinter of nail can separate from the main part of the nail and imbed itself in the skin. Ingrown toenails most commonly affect the big toes but can also affect the lesser toes too.

Causes of ingrown toenails in children

Ingrown toenails can occur in children as young as a few weeks old but more commonly it is seen in adolescents. There are various causes of ingrown toenails, including:

Genetics, which can affect either the width of the nail or the curvature of the nail. Some children have a nail plate that is simply too wide for the toe. In this case the nail has little room, placing pressure on surrounding tissues, increasing the risk of an ingrown nail. Other children may have an excessive curvature of the nail on each side that can also cause an impact on the surrounding skin.

Nail pickers or even nail biters (yes some kids chew their toenails!). This can lead to too much nail being removed, leaving behind sharp edges and corners, particularly down the sides of the nail. When the nail grows back, it is more likely to grow into the skin causing irritation and pain.

Cutting down the sides of the nail or cutting the corners of the nails out. This may give some instant relief in the case of an ingrown toenail, however, it can often leave a deeper sharp corner or edge, increasing the risk of an ingrown nail. Quite often as the nail grows back, the sharp edge grows deeper and deeper into the sides of the nail causing a bigger problem.

Poor personal hygiene or extra sweaty feet can also be common culprits of children’s ingrown toenails. Usually another factor will be at play here too, but poor hygiene and excessively sweaty feet can predispose children to infection at the site of the ingrown toenail, causing inflammation, redness, puss, pain and an excess growth of skin that grows up and around the nail. This extra skin is known as hypergranulation tissue and is very painful and easily bleeds if touched or knocked.

Pressure on the sides of the nail. There are various causes of such pressure, which can include trauma, small or tight footwear or gait related issues. Some children’s feet will roll in or excessively pronate, particularly as they go to push off through their big toe. Other children may spend a lot of time walking on their tip toes. Both excess pronation and toe walking places extra pressure on the big toes and in some cases can cause the nail to impact on the adjacent skin.

Our podiatrists treat children’s ingrown nails

At Melbourne Podiatrists and Orthotics, our podiatrists are trained to diagnose and treat ingrown toenails in children. In some cases, treatment will be conservative and may include education on correct nail cutting technique and good foot hygiene. Other conservative treatment will involve altering and deflecting the pressure at the affected toe using toe props or foam packed under the nail to lift it up from the skin and encourage it to grow flatter.

If an ingrown toenail is caused by the way a child walks or their footwear, our podiatrists can conduct a gait analysis and may then use orthotics to help the foot function better.

In more severe or chronic ingrown toenail cases, a permanent solution to stop the ingrown toenail from returning may be required. This involves a small procedure to the affected side or sides of the toenail under a local anaesthetic. This nail surgery procedure is known as a partial nail avulsion (PNA). All of our Melbourne podiatrists are experienced in performing PNA’s in children and will be able to advise if this is a suitable option or if conservative treatment options are the best solution for your child’s ingrown toenail.