How beautiful are babies’ feet, right?  One can kiss, smell, and eat those pea-looking fingers.  But sometimes, we see crooked nails, redness around the edges, and purulent discharges on the thumbs.  We fell sad if the baby’s eyes fill with tears and start to cry when we touch these infe fctedingers.  What should we do?  How should we protect?  Should we go to the doctor right away?
I am wrote about ingrown nails in babies and children in the Paediatric Surgeon’s Journal.
First, let me tell you what the problem is. 
Let’s not forget that when they are still very young babies, the formation process of nails may not be fully completed.  When we look at the beautiful feet of the baby, we can see spoon-shaped, upwardly directed, opposite positioned nails to the usual image.  Or, again, due to the excessive growth of the congenital side folds, the nail may appear more inward.  The good thing is, these developmental problems I mentioned go away as the nails get longer, harder, as the child starts to press the floor and then the nails starts to take shape.  But sometimes, when the side folds cover the nail before it can grow, the nail can start to grow into the tissue and cause inflammation and infection there.
Sometimes we, as parents, cut the nail from the very bottom, in a round shape with scissors, or we try to dress up the babies with hard shoes before they even step on the ground, or we forget that they grow so fast after they start walking, and we do not increase the shoe size on time.  Especially if the shoes are made of a very hard material that is not soft, and if they wear tight socks inside, an invitation for ingrown nails is prepared.
Whether it is related to the structure of the child or external factors such as shoes, socks, blows, and false nail cutting, if the nail grows into the tissue, first redness and pain begin to occur.  Then if an infection is added, a yellowish liquid (pus) begins to flow.  If it is still not treated, the condition becomes chronic, giant granulation tissues begin to form, and the appearance can be frightening.
Fortunately, our patients are toddlers and children.  Treatment may be easier.  Because nails are softer.  For this reason, the situation can be resolved before it becomes chronic with simple conservative approaches before surgery.  Since most of the structural ones will pass by the time the baby starts walking, it will be enough to show some patience and care if there are nails that have ingrown.
 What can be done if babies and young children have ingrown nails?
Very simple.  You will soften the nails by taking a ten-minute hot water bath two or three times a day.  Sometimes betadine, white vinegar or Epson salts can also be added, but not mandatory.  The goal here is to soften the nail.  On the softened nail edge, you will push the tissues coming towards the nail, preferably with the help of anti-bacterial pomade, to the sides, and you will relax the nail.  If these massages fail to expose the edges of the nail, you will gently help to get rid of the tip by inserting thin cotton or gauze around the edge of the soft nail.
Isn’t it working?  Then it’s our turn.  If we cannot reach a solution with conservative treatments, we may need to remove the tissue that has grown on the nail from the side, or pull the ingrown part of the nail and prevent it from coming out again, or rarely pull the nail completely.  Sometimes, fortunately, things get a lot more complicated.  Of course, we, pediatric surgeons, perform these procedures by putting them to sleep in the operating room (under general anesthesia) so that little children do not suffer from pain and fear.
It is best to use nail clippers or electric baby nail files instead of scissors, do not wear tight shoes or socks, apply the conservative approaches I have described as soon as the problem starts to occur, so there is no need for further surgical treatment.
 We’ve come to the end of another course.
 Click to watch the video on youtube, follow us on Instagram.
 And stay happy.
 Prof.  Dr.  Egemen Eroğlu
 March 2022