Springdale Mason Pediatrics

Toenail - Ingrown

Definition

  • The corner of the toenail grows into the skin around it
  • Almost always involves the big toe (great toe)

Call or Return If

  • Spreading redness or fever occur
  • Pus not gone after 48 hours
  • Not improved after 7 days
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • Toe pain from sharp corner of toenail cutting into surrounding skin.
  • Redness and swelling around the corner of the toenail is usually present.
  • The area may drain pus or yellow fluid.
  • The red area is very tender to touch or pressure from a shoe.
  • Some teens with ingrown toenail can barely walk.

Cause

  • The toenail is usually pushed into the skin by wearing tight shoes.
  • The tiny cut made by the nail allows bacteria to enter the skin. The cut then becomes infected.
  • The sharp corner of buried nail keeps growing. The deeper it goes, the more painful it becomes.

After Care Advice

Overview
  • Ingrown toenails are always painful.
  • Pain is caused by the sharp toenail edge cutting into the skin around it.
  • The pain can be stopped. Find the toenail corner and lift it out of the raw tissue.
  • This will allow the area to heal.
  • Most ingrown toenails can be treated at home. Surgery or nail removal is rarely needed.
  • Here is some care advice that should help.
Clean Area:
  • Soak the toe in warm water and soap for 20 minutes twice a day.
  • While soaking, massage the swollen part of the cuticle (skin next to the nail). Massage away from the nail.
  • While soaking, also try to bend the corners of the toenail upward. Use your fingernail to lift it.
  • Dry the toe and foot completely.
Elevate Corner of Toenail with Dental Floss:
  • Goal: To help the toenail corner grow over the cuticle, rather than into it.
  • The area won't heal until you expose the corner.
  • Often you can lift it with your fingernail.
  • If not, take a short strip of dental floss or fishing line. Try to slip it under the corner of the nail. Then, lift the nail upward. Cut off any sharp edge.
  • Elevate the corner away from the cuticle with every soak.
Antibiotic Ointment:
  • After each soak, put an antibiotic ointment on the swollen part of the toe.
  • You can buy this ointment without a prescription.
Taking Pressure Off Toenail With a Foam Pad or Cotton Ball:
  • Until it heals, try to wear sandals or go barefoot.
  • When your child must wear closed shoes protect the ingrown toenail as follows:
  • If the INNER edge of the big toe is involved, try this technique. Tape a foam pad or cotton ball between the lower part of the first and second toes. Your goal is to keep the upper toes from touching.
  • If the OUTER edge is involved, do the same to the outside of the lower toe. Goal: keep the toenail from touching the side of the shoe.
  • Weather-stripping from a hardware store makes the best foam pad. Reason: has adhesive on one side.
  • Never wear tight, narrow, or pointed shoes.
Prevention - Nail Trimming:
  • Cut your child's toenails straight across so you can see the corners. Use a nail clipper.
  • Do not round off corners (keep the corners visible).
  • Do not cut them too short.
  • After baths or showers, the nails are soft. Bend the corners of the toenails upward. Use your fingernail to lift it.
Prevention - Wear Shoes That Fit:
  • Make sure that your child's shoes are not too narrow. Give away any pointed or tight shoes.
  • Tight narrow shoes are the most common cause of ingrown toenails.
  • Shoes should have a wide toe box. The toes should not feel cramped.
What to Expect:
  • With treatment, the pus should be gone in 48 hours.
  • Pain should be gone in 1 week.
  • Area should be healed up in 2 weeks.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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