Ingrown Toenails in Children

Ingrown toenails are a common cause of pain in children and teenagers. They can interfere with walking, school shoes and sport, and may become recurrent if not addressed early.

What is an ingrown toenail?

An ingrown toenail occurs when the edge of the nail presses into, or breaks through, the surrounding skin. This can lead to irritation, inflammation, and sometimes infection.
The condition most commonly affects the big toe.

Why do ingrown toenails happen?

Several factors can contribute:

• nails cut too short or with a deep curve into the corners

• tight, narrow, or poorly fitting footwear

• repeated pressure or trauma (such as stubbing the toe or contact sport)

• picking at the nail or surrounding skin

• naturally curved or involuted nails

• excessive sweating or prolonged moisture (common in adolescents)

Often, more than one factor is involved

Common signs to look for

• redness and swelling along the nail edge

• tenderness when touched or when wearing shoes

• discharge or crusting

• difficulty walking or avoiding activity

Some children develop granulation tissue (“proud flesh” ), which appears as red, swollen tissue that may bleed easily.

What helps in mild cases?

Early or mild ingrown toenails may improve with conservative measures, particularly if addressed promptly. These may include:

• warm salt-water soaks

• avoiding cutting nails too far into the corners

• wearing shoes with a wide, comfortable toe box

• reducing pressure from sport or school shoes

These strategies aim to reduce inflammation and allow the nail edge to grow forward rather than inward.

When professional treatment is needed

Podiatry assessment is advised when pain is significant, infection is present, or the ingrown toenail keeps recurring.

Treatment options may include:

• Conservative podiatry care
  Gentle removal of the irritating nail edge (spicule), along with guidance on nail care and footwear.

• Partial nail removal
  A common procedure where a small portion of the nail edge is removed. This is sometimes performed under local anaesthetic to improve comfort.

• Surgical nail procedures (phenolisation)
  Used in recurrent cases to prevent the problematic section of nail from regrowing. This approach is well established in paediatric podiatry and typically has a short recovery period.

The most appropriate option depends on symptom severity, recurrence, and your child’s tolerance.

When to seek help urgently

Seek prompt assessment if you notice:

• increasing redness, swelling, or discharge

• signs of infection or fever

• severe or worsening pain

• repeated recurrence of the ingrown nail

• difficulty wearing shoes or participating in daily activities

This information is general in nature and is not a substitute for individual assessment, diagnosis, or medical advice from a qualified health professional.

Sources 
The Royal Children’s Hospital Melbourne – Kids Health Info: Ingrown toenails
NHS UK – Ingrown toenail
Australian Podiatry Association – Consumer foot health resources
Cochrane Database of Systematic Reviews – Surgical treatments for ingrown toenails