Protect Your Child From Ingrown Toenails

On a regular basis, I see ingrown nails in both adults and children. Although the treatment is quite common, they can become a big problem and often can interfere in even normal activities and normal shoes.

Parents can help prevent this common and painful foot problem in children by following a few simple tips, and with a careful understanding of the common causes.

Ingrown toenails are primarily caused by an inherited tendency for the nails to curve, but may be aggravated by tight shoes, tight socks and incorrect nail trimming (nails should be trimmed straight across as opposed to curved like fingernails). In fact many people without an inherited tendency for nails to curve, will never have ingrowing even with tight shoes, poor nail trimming and other causative actions.

In my experience, many kids hide their painful toenails from their parents, even though the condition can cause significant pain. Over time, the nail may become increasingly red, swollen and painful and may even break the skin and lead to dangerous infections. Over the last year ACFAS (American College of Foot & Ankle Surgeons) has made some recommendations for minimizing this problem. Together with these recommendations, I will provide 10 ways to limit and/or prevent ingrown toenails in your children:

1. Nails should be regularly trimmed straight to minimize trauma to the nail during athletics or simple walking. A cracked or broken nail can often lead to ingrowing of the nail.

2. Rarely do we teach our children how to trim toenails (or fingernails for that matter). ACFAS recommends that parents teach children how to trim their toenails properly. Trim toenails in a fairly straight line, and don't cut them too short. I commonly trim my toenails straight and then remove the corners so there are no sharp edges.

3. Check your children's feet regularly (at least once or twice a week) to ensure they are caring for their nails properly. Don't wait until they are limping or hurting to check their toenails for infection or ingrowth.

4. When fitting your children for shoes, ensure that the fit are measured for both width and length. Regularly we fit shoes based only on length, but shoe width is just as important as length. ACFAS reminds us to make sure that the widest part of the shoe matches the widest part of your child's foot. This may mean that you are unable to pass shoes down from child to child.

5. Ensure children are wearing the proper shoes for the proper activity. Don't wear flip flops or go barefoot for athletic activities as injury to the nail and even the toe can occur.

6. Treat nail injuries aggressively to allow proper healing and limit ingrowth as the nail regrows.

7. If a child develops a painful ingrown toenail, parents can reduce the inflammation by soaking the child's foot in warm water (not hot) with epson salts. While in the water, the parent may also gently massaging the side of the nail fold to help remove any infectious drainage.

8. Antibiotics may often not be necessary if the ingrown nail is treated properly. A majority of the inflammation occurring is due to the nail being treated by the body as a "sliver". Once the nail is removed from the area, the inflammation improves. Soaking as mentioned above will then usually remove any remaining infection.

9. As confirmed by ACFAS, the only proper way to treat a child's ingrown toenail is with a minor surgical procedure at a doctor's office. Parents should never try to dig the nail out or cut it off. These dangerous "bathroom surgeries" carry a high risk for infection.

10. Notice if you see your child limping, the child has a red swollen toe, you see blood or drainage on a sock or you see a child start to cry with a simple "bump" of the toe. With any of these occurrences, you should be thinking ingrown toenail and seek to alleviate the infection and the pain by having it treated correctly.

Until that time, follow the above steps to limit the presentation and recurrence of an ingrown nail. Like you, we want to keep your children active, using these techniques can make it happen. Ingrown toenails although not life threatening can definitely interfere with life.

Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com