Have you noticed that one of your baby’s toes appears a little bit red or swollen near the toenail? Is this a sign of infection, or something else?
What you’re seeing may be normal or it might be an ingrown toenail. This is a common occurrence for small babies. And, although it may sound or look painful, it’s usually nothing to worry about as long as you treat it right and watch out for signs of infection.
So for the sake of keeping all the little piggies happy and healthy, we’re here to talk about ingrown toenails in babies. Let’s dive in.
What Are Ingrown Toenails?
Almost everyone will experience an ingrown toenail at least once in their lives, and they’re also fairly common with babies. This occurs as the sides or corners of the nail grow or press into the soft surrounding skin (1).
It’s especially common to see this on the big toe, but any of the other piggies can also fall victim.
Does My Baby Have an Ingrown Toenail?
Babies have somewhat flat and triangular-shaped toenails at birth, some even have nails that curve downward. These things are kind of a setup for the skin around the nail to appear a little higher and fuller than what you would normally expect, making it look like it is swollen. This is sometimes called “pseudo-ingrown toenails of the newborn.” The way you will know that this is what’s going on is that there are no signs of infection, no pain, and baby feels fine!
Ingrown nails can become quite painful, so signs of discomfort may be your first clue. Otherwise, you can quickly spot it by inspecting the top of the nail. During the early stages, the area will likely look a little pink or swollen near the edge of the nail (2).
Some other signs to look out for include:
- Tenderness: Take notice of your baby’s reaction when you gently touch the area. Do they appear to be slightly uncomfortable and pull away? Or do they scream when you touch near their toenail?
- Pulling their toes: If your baby pulls on their toes, this could be another sign of pain and discomfort in the area, but that would probably only be if it were accompanied by crying. Babies pull on their toes for many reasons, sometimes just because they are close and can reach them easily.
- Limp or grimace: Smaller babies might make a grimace whenever in pain. But if your little one is older, they may limp or frown while walking or crawling, if you are putting a sock or shoe on, or washing their baby toes in the bath.
- Change in skin color: the area near the toenail may appear more pink or red than the surrounding skin. This is something that could worsen from day to day, or it might just stay the same.
Ingrown toenails can also become infected. In this case, you should look for signs such as:
- Fluid-filled blisters: These are a telltale sign of an infected ingrown toenail. They’ll usually develop around the red areas where the skin meets the nail.
- Discharge/Pus: A clear fluid can be seen sometimes early in an infection due to the blisters breaking. But pus can then develop from the body’s efforts to fight bacteria. Sometimes you will only see it if you gently press down on the surrounding area, but that will usually hurt if there is an infection there.
- Redness and swelling: As the infection evolves and the swelling puts more pressure on the tissue, the redness and pain will get worse. This is a very important sign of infection when the redness increases from the inflammation, and you will be able to feel the skin getting warmer too.
What Causes Ingrown Nails?
Baby toenails grow unbelievably fast and this is one of the reasons ingrown toenails occur. The toenail basically grows out of proportion. So, if your little one is wearing tight socks or shoes, there’s only one way for the nail to grow — inward.
Some babies simply grow curved toenails due to genetics. These nails will naturally curve down at the tip and cause pressure or grow inward.
Another reason is improper nail cutting. As a mom whose little one has had several ingrown toenails, this was a bit of a shock. I always thought it was solely due to not cutting the nails, when, in fact, I was just doing it wrong.
It turns out that trimming the nails too short and cutting them too close to the skin can also contribute to ingrown toenails. The same goes for cutting them in a curved shape, as opposed to straight across (fingernails should be cut in a curved shape though).
Treatments for Ingrown Toenails
Unless you see signs of an infection, there’s no immediate need to rush to the pediatrician’s office. There are a few simple steps you can try at home first, to ease the uncomfortable symptoms your little one is experiencing.
Doctors recommend that you fill up a small tub with warm water. Add some mild soap and let your baby (or just their feet) soak for 10 minutes. The best reason for soaking with warm water is that it opens up the blood vessels that are kind of squished from the swelling, and allows the body’s natural killer cells to get in there and clean up the bacteria. It will also help to loosen the skin around the ingrown nail and minimize pain and tenderness. Don’t be concerned if it appears redder for a while after the warm soak, that is natural from the increased blood supply.
Next, get them out of the bath and, if it’s not too painful, massage the area gently, to encourage the toenail to pull away. Pat the area dry, before gently applying some over-the-counter antibiotic cream. It’s good to do this whole routine, especially the warm-water soaks, a couple of times a day until the area improves.
One thing you should never try is “bathroom surgery.” Trying to dig out or cut the toenail away can worsen the condition. It may even increase the chance of infection (3).
During this time, help the healing process by having your little one wear loose-fitting socks or shoes when outside. However, when you’re home, let them walk or crawl barefoot as much as possible if the temperature allows for it.
After a few days, you’ll likely see an improvement. However, if it doesn’t start getting better or seems to be getting worse, consult your pediatrician.
How to Prevent Ingrown Toenails
As easy as they are to treat, they’re even easier to prevent. Here are a few steps you can follow to avoid baby ingrown toenails:
- Use a nail clipper: Ditch the scissors and opt for the clipper for the toes (but for fingernails they are fine). Scissors often cut nails in a curved or rounded shape, whereas clippers cut them straight across. The best time to do this is when your baby is sleeping.
- Trim often: The longer the toenails, the higher the chance for an ingrown nail. So remember to trim them regularly: some may need trimming once a week or more.
- Don’t cut too short: On the other hand, avoid cutting the toenails too close to the skin. If they’re still short from a previous trim, just leave them a few more days.
- File the edges: Sharp edges may dig into the soft tissue of the toe. This is a good thing to do if baby is not sleeping and you see an area that needs taking care of right away. Unlike clipping or cutting, it is pretty easy to do while they’re awake.
- Use loose-fitting shoes and socks: Where your little one can’t walk or crawl barefoot, or if the weather is too cold for it, opt for loose footwear. Tight socks and shoes can compress the toes, which could push the nails into the skin. While at home, it’s best to leave them natural and let those little toes breathe as much as possible.
When Should I Contact the Pediatrician?
You should always contact your pediatrician if the toenail doesn’t improve within a couple of days.
Another reason to take your baby to the doctor is if you see signs of infection. If you notice pain, redness increasing and even forming streaks on the toe, or blisters beginning to form, you know it’s time to see the expert.
Your baby’s pediatrician will begin by examining the area and may prescribe either oral or topical antibiotics if the area is actually infected.
In some cases, they may cut the nail away from the skin, or remove some of it. In more severe and recurring cases, they will likely refer your baby to a pediatric podiatrist.
Discovering that your little one is bothered by an ingrown toenail is never on any mom’s wish list. Although it’s not as common for babies as it is for adults, a fair amount do experience them.
It generally occurs due to either improper nail trimming or tight socks and shoes. Sometimes, genetics can play a role by causing the toenails to grow in a curved shape.
Fortunately, this normally subsides without medical intervention, and unless you see signs of infection, you can easily treat it at home.