Pediatric Ingrown Toenails
Symptoms, Causes and Treatment of Ingrown Toenails in Children
What are Ingrown Toenails in Children?
Ingrown toenails, medically known as Onychocryptosis, occur when the edge of a toenail grows into the surrounding skin, causing pain, swelling, and sometimes infection.
This condition is especially common in children, affecting any toe but most often the big toe.
Factors contributing to ingrown toenails include pressure from tight-fitting shoes, improper toenail trimming, stubbing the toe, and certain foot or toe deformities.
Ingrown toenails are one of the most common reasons kids and teens visit a pediatric podiatrist — in fact, our doctors at Pediatric Foot & Ankle (Gilbert and Chandler) see several cases every single day. While they can look and feel alarming, especially when infection sets in, ingrown toenails are very treatable, and most kids are back to normal activity the next day.
Causes & Symptoms of Ingrown Toe Nails In Children
Recognizing the Symptoms
Parents should be vigilant in spotting the symptoms of ingrown toenails in their children. Common signs include:
- Pain and Tenderness: The affected toe may be painful, especially when touched or squeezed by shoes or socks.
- Redness and Swelling: The skin around the ingrown nail may appear red, swollen, and warm to the touch.
- Infection Signs: If the condition worsens, the area might become infected, showing pus or increased redness and swelling.
- Behavioral Changes: Babies may cry and pull at their toes, while toddlers might limp or grimace when walking.
Common Causes
An ingrown toenail happens when the edge of the nail grows down into the surrounding skin fold rather than straight across. The toe’s skin pushes back against the nail, leading to chronic irritation — and over time, bacteria can work its way underneath the nail, contributing to swelling, redness, and pain. While cutting nails too short can sometimes trigger the issue, it isn’t always the cause; nail shape, growth pattern, and even a history of picking or peeling at the nails when younger can all play a role.
Ingrown toenails can form due to various reasons, such as:
- Tight-Fitting Shoes: Shoes that squeeze the toes together can cause nails to grow into the skin.
- Improper Toenail Trimming: Cutting toenails too short or rounding the edges can encourage the nail to grow into the skin.
- Toe Injuries: Stubbing the toe or repetitive stress from activities like sports can lead to ingrown nails.
- Genetics: Some children inherit a natural tendency for curved toenails, making them more prone to ingrown nails.
Ingrown Toenails in Babies & Toddlers
It may come as a surprise to parents, but babies and toddlers (newborns up to age 4) can experience ingrown toenails, too. While less common than in adults, ingrown toenails in young children do occur and require specialized attention to prevent complications and infection.
At Pediatric Foot & Ankle, Dr. Mikkel Jarman has treated numerous cases of ingrown toenails in infants and toddlers. Through years of experience, he’s identified a concerning pattern: about one in five cases involve MRSA (methicillin-resistant Staphylococcus aureus), an antibiotic-resistant bacteria, making proper treatment critical.
Treatment for babies & Toddlers
Dr. Jarman emphasizes a straightforward and effective approach specifically tailored for young children. Rather than relying solely on antibiotics—which can often be ineffective against resistant infections—he recommends a gentle nail avulsion procedure, providing immediate relief from discomfort and rapidly resolving infections.
Here’s what parents can expect from this safe, quick, and highly effective treatment:
Quick procedure involving numbing and gentle nail removal
Immediate relief of pain and discomfort
Typically no need for oral antibiotics
Rapid return to normal activities by the next day
Easy at-home care lasting about five days
Nails regrow fully and healthily within 3 to 4 months
Treatment Ingrown Toenails in Children
For mild cases of ingrown toenails, several home remedies can alleviate discomfort and prevent further complications:
- Warm Soaks: Soaking the foot in warm, soapy water for 15-20 minutes several times a day can reduce swelling and tenderness.
- Proper Footwear: Ensure your child wears shoes that fit well and provide ample room for the toes to move freely.
- Gentle Lifting of the Nail: Using a clean cotton ball or dental floss, gently lift the edge of the nail away from the skin. This should be done with care to avoid further injury.
- Antibiotic Ointment: Applying an over-the-counter antibiotic ointment can help prevent infection.
If the ingrown nail doesn’t heal or continues to come back then a part of the toenail and any excess skin can be removed without pain. The doctor will use a local anesthetic to make the procedure painless and comfortable.
In-Office Ingrown Toenail Treatment
In this video, you’ll hear directly from the family and watch the in-office procedure that helped remove years of pain caused by embedded nail growth and chronic toe inflammation.
You’ll learn:
✅ What causes recurring ingrown toenails in active kids
✅ Why regular clinics often can’t fully resolve the issue
✅ How a small sliver of nail can lead to years of pain
✅ What the actual in-office procedure looks like (it’s quick and surprisingly painless)
✅ Why kids feel instant relief—and how recovery is easier than most parents expect
Mild Cases vs Infected Cases
Not all ingrown toenails are the same, and the right treatment depends on how irritated or infected the toe has become.
Mild to moderate cases
When a toe is chronically irritated but not significantly infected, a permanent partial nail removal procedure is often recommended. A small sliver of the nail along the problem edge is removed, and a chemical (phenol) is applied to prevent that sliver from growing back. This is a well-established, reliable procedure with a high success rate — roughly 95% of the time, the nail does not regrow in that area.
Significantly infected cases
When a toe is more severely infected — meaning bacteria has settled in underneath the nail itself, not just in the surrounding skin — the chemical procedure is not recommended right away. The chemical tends not to take well in actively infected tissue, and can sometimes make the outcome worse. In these cases, the better approach is to remove the nail entirely (a nail avulsion), allowing a healthy new nail to grow in over the following couple of months. Because the infection is being harbored underneath the nail itself, removing the nail typically resolves the infection on its own — antibiotics generally aren’t necessary, since the source of the problem has been addressed directly.
What to Expect during the Procedure
Numbing the toe is usually the part kids worry about most, but it's quick.
A cold spray is applied first, followed by a brief injection that feels like a firm pinch for about five seconds. Within about eight minutes, the toe is completely numb, and the procedure itself causes no pain. For kids who feel anxious, nitrous oxide (laughing gas) is available in the office, and in select cases, additional anxiety-reducing medication can be discussed with your podiatrist. For children who are unable to tolerate an in-office procedure — due to severe anxiety, autism, or other factors — the procedure can be performed at a surgical center under sedation instead.
Recovery & Aftercare
Recovery is simple, with no real activity restrictions. Aftercare typically involves:
- Applying a Band-Aid and betadine (iodine) gel for about five days
- Normal showering and bathing — no special soaking or cleaning routine needed
- Returning to regular activities right away, with no restrictions the next day
- A follow-up visit isn’t always necessary — your podiatrist will let you know if one is recommended based on how the toe heals
If the nail grows back
Occasionally, after a nail removal for an infected toe, the nail may grow back in a way that continues to cause irritation. If that happens, a permanent partial removal procedure (phenol) can be performed to fully stop that section of nail root from growing. This is a quick and very effective fix: the toe is numbed, the small spicule of the nail is removed, and the phenol is reapplied. Because there’s no active infection involved, this follow-up procedure tends to be highly successful.
When to See a Podiatrist
If your child has a toe that’s red, swollen, painful to the touch, or draining fluid, it’s worth having it evaluated promptly — especially if the discomfort is affecting their ability to walk, play, or wear shoes comfortably. Catching an ingrown toenail before it becomes significantly infected often means simpler, more predictable treatment.
Pediatric Foot & Ankle has convenient locations in Gilbert and Chandler. If your child is dealing with a painful or ingrown toenail, schedule an appointment with one of our pediatric podiatrists today.
Preventing Ingrown Toenails
Helping Stop Them Before They Start
Prevention is key to avoiding the discomfort and complications of ingrown toenails. Parents can take the following steps to reduce the risk:
- Proper Toenail Trimming: Always cut toenails straight across and avoid rounding the edges.
- Appropriate Footwear: Ensure your child wears shoes that fit well and provide enough room for their toes.
- Regular Foot Inspections: Check your child’s feet regularly for signs of ingrown nails, especially if they are active in sports or other activities.
Success stories
Click Any Card To See The Full Story & Video
Meet Carter - Ingrown Toenail Treatment - No More Pain!
Ingrown Toenail - Alina's Story by Pediatric Foot and Ankle
Pediatric Ingrown Toenails FAQ's
Ingrown toenails in children are primarily caused by improper toenail trimming, tight-fitting shoes, toe injuries, and sometimes genetic factors. Nails cut too short or rounded at the edges can grow into the surrounding skin, leading to ingrown toenails.
Proper Toe nail trimming, appropriate footwear that fit well and regular foot inspections are ways to prevent ingrown toe nails in your child.
Common symptoms include pain and tenderness around the toenail, redness, swelling, and sometimes signs of infection such as pus or increased redness. Your child may also show signs of discomfort, like crying or limping.
In some cases, mild ingrown toenails may heal on their own with proper care, such as warm soaks and wearing comfortable shoes. However, persistent or severe cases often require professional treatment to prevent complications.
You should seek professional treatment if your child’s ingrown toenail does not improve with home remedies, shows signs of infection (pus, increased redness, swelling), or if the condition is causing significant pain and discomfort.
Pediatric foot & ankle specialists treat ingrown toenails by first numbing the toe with a local anesthetic. Then carefully remove the ingrown portion of the nail and may apply a chemical agent to prevent recurrence. The procedure is quick and painless, and detailed post-procedure care instructions are provided.
No, the procedure is not painful. Dr. Jarman uses a local anesthetic to numb the toe, ensuring the child feels no pain during the removal. Most children find the experience comfortable and are relieved from the discomfort of the ingrown toenail.
Recovery time is generally short. Most children can return to their normal activities within a few days. Post-procedure care includes keeping the area clean and applying antibiotic ointment. Dr. Jarman provides follow-up instructions to ensure proper healing.
Your Child’s Feet Are Built for Life. We Help Keep Them That Way.
