Nail this down

My child came home from a school field trip complaining of pain in his big toe. I looked at it, and it was very swollen and red. He wore shoes all day, so I am wondering what caused the swelling and how to treat it and prevent it from recurring.

It is likely that your child has onychocryptosis. While that sounds obscure, it is the medical term for what would otherwise be referred to as an ingrown toenail, which is quite common among older children and teens.

The big toe is most likely to develop the condition, although any toe can be affected.

Ingrown toenails usually develop when people wear tight-fitting shoes or trim their toenails too close to the skin. In both of these situations, pressure is put on the toenail, which, as you know, is always growing.

As a result, the toenail grows under the nail fold instead of growing outwards. In addition to tight shoes and nails cut too short, excessive sweating can also contribute towards the formation of ingrown toenails because it softens the skin surrounding the nails, making it easier for the nail to inflame or puncture the skin.

The symptoms are fairly clear and include pain, swelling, erythema (redness) and sometimes even drainage of pus.

To treat the condition, you can give your child pain relievers such as acetaminophen or ibuprofen to offset the pain.

As for dealing with the toenail itself, soaking the affected toe in warm water for 10 to 20 minutes, twice a day, should help the toe grow out properly.

You can also try placing a bit of cotton or dental floss under the edge of the toenail to encourage it to grow properly.

If none of these treatments seem to work, your child’s pediatrician or podiatrist can perform a partial lateral nail avulsion, if necessary.

This is a surgical procedure that removes part of the ingrown toenail.

In some cases, the ingrown toenail may become infected, and this will require antibiotics to prevent the spread of infection to other parts of the body.

To prevent ingrown toenails from forming and coming back, cut your child’s nails straight across and be sure not to cut them too short. Following these steps and checking to see that your child’s shoes fit properly (neither too loose nor too tight), will make ingrown toenails old news.

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