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Ingrown toenail almost always affects the great toe. The natural downward curve of the nail becomes exaggerated, and the edge of the nail is pressed into the nail groove, damaging the tissue. Then infection can set in, causing swelling, drainage, the formation of bulky granulation tissue, and intense pain.
Improper trimming of the nail is a prime cause of ingrowing. Trimming too short, or trimming the nail with a rounded shape rather than square across, or tearing the corner off the nail by nervous picking all can cause the nail to dig into the tissue of the nail groove. Ill-fitting shoes - too tight or too short - are another cause of ingrown toenails.
Self-care for mildly ingrown toenails focusses on proper trimming to restore proper square corners to the nail. Soaking the foot in a basin of warm water mixed with a capful or two of household bleach1 Resist the temptation to perform "minor surgery" on your child's ingrown toenail, beyond trimming the nail corners square.
Excessive pain, redness, swelling and drainage from the infected area indicates infection that may require oral antibiotics. Consult your child's physician for evaluation and treatment of suspected infection. The nail may need to be partially or totally removed to cure a badly ingrown nail. Podiatrists and some primary care physicians perform this type of minor surgery, often in the office under local anesthesia.
1. You will read elsewhere to use Epsom salts. This is "tradition." The truth is that magnesium sulfate is a laxative, not a disinfectant. Go figure.