If your child has a sore, swollen toe and even putting on a shoe hurts, you may be wondering if it's an ingrown toenail and whether it's time to see a podiatrist. You may also be worried they'll have to miss soccer, dance, or other activities if they need treatment. The good news is that most kids are back to their normal routine in just a few days. In fact, once the ingrown portion of the nail is removed, many children feel dramatic relief almost immediately.
Signs and Symptoms of An Ingrown Toenail in Children
An ingrown toenail occurs when the edge of the nail grows into the surrounding skin instead of straight out. In kids, it usually shows up as:
- Redness and swelling along the side of the nail
- The toe feeling warm or tender to the touch
- Sometimes drainage, or a bit of pus, if it's gotten infected
And here's something a lot of parents don't expect — even babies and toddlers can get ingrown toenails. Their nails are still soft, which makes it easier for the edge to dig into the skin.
The main thing to watch for is the difference between a toe that's just tender and one that's starting to show real signs of infection—redness that's spreading, warmth, swelling, or drainage.
Once bacteria get trapped under the edge of the nail, the infection usually doesn't clear up on its own. In fact, it often becomes more painful every day and can spread into the surrounding skin. That's why it's important not to wait too long to have it evaluated.
If you notice those signs, that's your cue to get it looked at.
5 Causes of Ingrown Toenails in Kids
Parents almost always assume it's something they did wrong with trimming — and I want to take that worry off the table right now. Here are 5 things that can cause ingrown toenails in kids.
- Genetics - this is the biggest factor —the natural shape and curve of your child's nail. Some kids are simply more prone to ingrown toenails than others.
- Wearing Too Short or Too Narrow Shoes - Kids' feet grow incredibly fast, and when shoes become too short or too narrow, they put extra pressure on the sides of the toenails.
- Active Kids Who Wear Snug Athletic Footwear - active kids who wear cleats, dance shoes, or other snug athletic footwear.
- Stubbed Toe - a stubbed toe or other injury
- Overpronation or Collapsing Arch - this can lead to excessive pressure on the great toe and an ingrown toenail. If this is the case for your child, learn more about how we treat flat feet in kids.
How to Treat Your Child's Ingrown Toenail At Home
Before you get in to see the podiatrist, here's what actually helps:
- Warm water soaks with Epsom salt, about 10 to 15 minutes, a couple times a day
- An antibacterial ointment and a bandage to protect the area
- Roomier shoes and socks to take pressure off the toe
I know it's tempting to try to dig out the corner at home, but unfortunately that usually pushes the nail in deeper and makes it harder to treat. I call that "bathroom surgery," and it almost always makes things worse — especially on a child who's already uncomfortable and squirming. And there's no store-bought product that actually fixes this.
How We Make Ingrown Toenail Treatment Comfortable for Children
Don't Wait To Bring Your Child In
The biggest mistake I see is parents waiting because they're worried treatment will hurt. The truth is, the longer you wait, the more uncomfortable the toe becomes. The earlier we see your child, the easier the treatment usually is—for both you and your child. If the toe is staying red, painful, or starting to drain, it's time to come in.
Treatment is the part parents worry about most, so let's go through it clearly.
3 Comfort Measures We Use With Children
First—comfort is the priority.
To decrease any pain from the numbing injection, we do three things.
- TENS Unit - a TENS unit sends a gentle electrical pulse to help minimize pain before and during the procedure.
- Numbing Cold Spray
- Explaining Every Step to Your Child - we take the time to explain everything to your child in a way they understand, so they know what's happening and stay as calm as possible. A scared, tense kid makes everything harder — so slowing down and building trust matters just as much as the technique itself.
Parents are often surprised at how well children do. Once the toe is numb, they usually tell me, "That wasn't nearly as bad as I expected."
Ingrown Toenail Procedure For Children
Here's what the actual procedure looks like. If the toe is infected, we start with something called a nail avulsion — we numb the toe, then remove the ingrown portion of the nail. It's done right here in the office, it only takes a few minutes, and it's well tolerated even by young patients.
For a child, we simply take it slower and use the TENS unit to keep things as comfortable as possible.
That first visit relieves the pain and clears up the infection, usually within about a week. Once your child has healed, we do a second procedure called a matricectomy. This treats the root cells under that edge of the nail so that piece doesn't grow back — which prevents the ingrown toenail from returning.
If there's no infection to begin with, we can sometimes do both steps in a single visit.
Most children walk out of the office on their own and are much more comfortable than when they came in. Often they are back to their normal activities almost right away.
Post Op Treatment for Ingrown Toenail Surgery
Once the procedure is done, we'll walk you through two simple options for caring for your child's toe at home.
- Amerigel Wound Care Kit - it's an advanced ointment that's antibacterial and helps the area heal faster we provide at our office. If your child had the permanent procedure, it also helps neutralize the solution used for that.
- Antibiotic Ointment with an Epsom Salt Soak - which you can pick up at the pharmacy.
We'll send you home with clear written instructions, and we'll walk you through exactly which option makes the most sense for your child's procedure.
How to Prevent Your Child From Getting Another Ingrown Toenail
Once your child's toe has healed, there are a few simple things you can do to help prevent another ingrown toenail.
- Trim Toenails Straight Across - trim toenails straight across rather than rounding the corners. It may not look quite as neat, but it helps keep the nail from growing into the skin.
- Buy Shoes That Fit Properly -this is one of the biggest things parents can do to prevent ingrown toenails. Kids' feet grow quickly, and shoes that are too short or too narrow put extra pressure on the sides of the toenails. Be sure to measure your child's feet. Look for about a thumb's width of space between the longest toe and the end of the shoe, and if one foot is larger than the other, always fit the larger foot. The shoes should feel comfortable right away—don't count on a "breaking-in" period.
- Bring Them In Early With Symptoms - notice redness, swelling, or tenderness starting to come back, don't wait. The earlier we see your child, the easier the problem is to treat.
In conclusion, if your child has an ingrown toenail, please don't wait, and please don't worry. We see this every day, we treat it gently, and most children are seen quickly. If your child has had a painful experience somewhere else, I understand your concern. One of the things we hear most often from parents is how much easier and more comfortable the experience was at our office than they expected.
