minor surgery
Ingrown toenail in children
The edge or corner of the nail grows into the surrounding soft tissue, causing irritation, inflammation and pain.
INGROWN TOENAIL
An ingrown toenail, or onychocryptosis, occurs when the edge or corner of the nail grows into the surrounding soft tissue, causing irritation, inflammation and pain.
It is a common condition, especially affecting the big toe, and can become very uncomfortable if not treated correctly. In the early stages, it may be possible to try conservative treatment, while in more advanced or chronic cases, a surgical procedure may be needed.
Symptoms and signs to look out for
The most common symptoms are:
Causes or associated factors
An ingrown toenail may be favoured by several factors, including:
- incorrect nail trimming, especially when the corners are cut too deeply;preputioplasty, meaning a procedure to widen the foreskin, when indicated;
- tight or compressive footwear;
- repeated trauma;
- sweating or local maceration;
- anatomical predisposition of the nail or surrounding tissue.
Some everyday habits may therefore contribute to the onset or recurrence of the problem.
When to book a consultation
It is useful to request a specialist assessment as soon as possible, especially when pain, discharge, swelling or signs of inflammation appear.
Early treatment may make it possible to try conservative therapy and prevent the problem from becoming chronic.
A consultation is particularly indicated when:
Assessment and diagnosis
Diagnosis is made through a consultation.
The paediatric surgeon assesses the nail, the surrounding tissue, the presence of inflammation, discharge or granuloma and collects information on how long the problem has been present, the symptoms and any treatments already carried out.
Based on the clinical picture, the most appropriate pathway is defined: conservative treatment, dressings, follow-up checks or surgery.
How it is treated
In the early stages, conservative treatment may be attempted, with the aim of reducing inflammation and supporting correct nail growth.
Treatments that may be considered include:
- application of silver nitrate to the granuloma;
- lifting the nail edge;
- lateralisation of the soft tissue;
- local dressings;
- practical guidance on footwear, nail trimming and local hygiene.
It is important to avoid “do-it-yourself” measures, especially when discharge, significant pain or granuloma are present, as incorrect manipulation may worsen the inflammation.
When surgery is needed and what it involves
Surgery may be indicated in chronic, long-standing cases, when there are large granulomas or granulomas resistant to conservative therapy. It may also be considered when a faster recovery is needed.
The procedure may involve:
-
- ● Removal of the granuloma;
● Partial onychectomy, meaning removal of the affected portion of the nail;
● Matricectomy, meaning treatment of the part of the nail matrix responsible for regrowth in that area, to reduce the risk that the removed portion grows back in the same way.
The procedure may be performed as day surgery, but in some cases also as an outpatient procedure. It may be carried out under sedation or under local anaesthesia while the patient is awake, depending on the patient’s age, cooperation and specialist assessment.
Recovery and useful instructions
After the procedure, it is important to follow the instructions received to support proper healing.
In general, Dr Rapuzzi advises:
To reduce the risk of recurrence, it is useful to:
Parents’ most common questions
In the early stages, it may be possible to try conservative treatment. However, if the problem is chronic, recurring or associated with a significant granuloma, surgery may be needed.
It is advisable to book a consultation as soon as possible, especially if pain, discharge, swelling or granuloma appear. Early assessment can help prevent the problem from worsening.
A granuloma is inflammatory tissue that may form near an ingrown toenail. It may be painful, bleed or produce discharge and, if it persists, may require surgical treatment.
The procedure involves removal of the granuloma, removal of the ingrown portion of the nail and, when indicated, matricectomy to prevent that part of the nail from growing back in the same way.
Not always. It may be performed under sedation or under local anaesthesia while the patient is awake, including as an outpatient procedure, depending on age, patient cooperation and the specialist’s assessment.
In general, it is advisable to avoid physical activity and trauma for about 2 weeks. Return to sport takes place when the pain has disappeared and according to specialist advice.
It is useful to avoid tight shoes, trim the nails correctly without cutting too deeply into the corners and take care of foot hygiene. In some cases, the specialist may recommend foot baths with water and salt.
Note: the information on this website is provided for guidance only and does not replace a specialist medical assessment. In case of acute symptoms, significant pain or a worsening general condition, you should contact a doctor or go to the emergency department.
OTHER CONDITIONS
