Toenail - Ingrown
Is this your child's symptom?
- The corner of the toenail grows into the skin around it
- Almost always involves the big toe (great toe)
Symptoms of an Ingrown Toenail
- 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 an ingrown toenail can barely walk.
Cause of an Ingrown Toenail
- 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.
When to Call for Toenail - Ingrown
Call 911 Now
- You think your child has a life-threatening emergency
Call Doctor or Seek Care Now
- Spreading red area or streak with fever
- Spreading red area or streak that's very large
- Severe pain not improved 2 hours after pain medicine and antibiotic ointment
- Your child looks or acts very sick
- You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
- Spreading red area or streak, but no fever
- Entire toe is red and swollen
- Pus pocket (yellow or green) seen in skin around toenail or under toenail. Reason: needs to be drained.
- You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
- Can't locate and free up corner of toenail
- After using Care Advice more than 2 days, pus discharge not gone
- After using Care Advice more than 3 days, still hard to walk
- After using Care Advice more than 7 days, not improved
- After using Care Advice more than 14 days, not gone
- Ingrown toenails are a frequent problem
- You have other questions or concerns
Self Care at Home
- Minor ingrown toenail
Care Advice for Ingrown Toenail
- What You Should Know About Ingrown Toenails:
- 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.
- Warm Soaks:
- 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.
- 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.
- 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.
- Take a small wedge of cotton from a cotton ball. Try to place the wedge under the nail corner to keep it elevated. (Sometimes this step is impossible).
- Elevate the corner away from the cuticle with every soak.
- Antibiotic Ointment:
- After each soak, use an antibiotic ointment (such as Polysporin). Put it on the swollen part of the toe.
- You can buy this ointment without a prescription.
- Taking Pressure Off Toenail With a 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:
- Inner Edge of Toe. If the inner edge of the big toe is involved, try this technique. Tape a cotton ball or foam pad between the lower part of the first and second toes. This will keep the upper toes from touching.
- Outer Edge of Toe. If the outer edge is involved, use a cotton ball. Tape it to the outside of the lower toe.
- This will keep the toenail from touching the side of the shoe.
- Never wear tight, narrow, or pointed shoes.
- Pain Medicine:
- To help with the pain, give an acetaminophen product (such as Tylenol).
- Another choice is an ibuprofen product (such as Advil).
- Use as needed.
- 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.
- 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.
- Call Your Doctor If:
- Spreading redness or fever occur
- Pus pocket occurs
- Not improved after 7 days
- You think your child needs to be seen
- Your child becomes worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Last Reviewed: 05/23/2019
Last Revised: 03/14/2019
Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.