Why Do Children and Teenagers Get Ingrown Toenails?
Ingrown toenails are particularly common in teenagers, and there are several reasons for this:
Hormonal changes during puberty increase sweating, which softens the skin around the nails. Growth spurts mean shoes are outgrown quickly — and wearing shoes that have become too small is one of the most common causes.
Sports participation is a major factor. Football, rugby, running, and dance all put significant pressure on the toes. Repetitive impact combined with warm, moist environments inside sports shoes creates ideal conditions.
Nail picking and improper cutting are more common in younger patients. Tearing nails rather than cutting them cleanly can leave sharp edges that grow into the skin.
Fashion footwear — particularly narrow shoes and trainers — also contributes, especially in older teenagers who may prioritise style over fit.
When Is Surgery Appropriate for Young Patients?
Surgery is generally suitable for children from approximately age 12–13 onwards. At this age, the nail and nail bed have developed sufficiently for the procedure to be performed safely and effectively.
For younger children (under 12), conservative management is usually the first approach — careful nail trimming, footwear changes, and salt water soaks.
Surgery is recommended for young patients when the ingrown toenail keeps recurring despite conservative treatment, when there is active infection that has not responded to antibiotics, or when the pain is significantly affecting school, sport, or daily activities.
The decision is always made in consultation with the parent or guardian and the child. Anna will only recommend surgery when it is genuinely the most appropriate course of action.
What the Procedure Involves
The procedure for children and teenagers is identical to the adult procedure — phenol matrixectomy under local anaesthetic.
Young patients are often more anxious about the procedure than adults. Anna has extensive experience treating children and teenagers and takes extra time to explain each step, answer questions, and ensure the young patient feels comfortable and in control.
A parent or guardian is welcome to remain in the room throughout the procedure. Some teenagers prefer their parent to stay; others prefer some independence. Either is fine.
The local anaesthetic injections are the same as for adults — two small injections at the base of the toe. The injections are over in seconds and the toe is numb within 5–10 minutes. The procedure itself is painless, and the whole appointment takes approximately 45 minutes.
Consent for Patients Under 16
For patients under 16, a parent or guardian with parental responsibility must attend the appointment and provide written consent for the procedure. This is a legal requirement in line with HCPC and Royal College of Podiatry guidelines.
The parent or guardian will be given full information about the procedure, risks, aftercare, and expected outcomes before being asked to sign the consent form. The young patient will also be involved in the discussion — it is important that they understand and agree to the treatment.
For patients aged 16–17, they may consent to treatment independently, although parental involvement is still encouraged for significant medical decisions such as surgery.
Recovery for Young Patients
Children and teenagers typically heal faster than adults. Their circulation is usually excellent and their tissue regeneration is rapid.
Returning to school is usually possible within 1–2 days for desk-based learning. PE and sport should be avoided for approximately 2 weeks, and contact sports (football, rugby) for 3–4 weeks. A letter for school can be provided if needed.
The main challenge with younger patients is compliance with aftercare — particularly dressing changes. Parents should supervise the daily dressing change routine for the first week to ensure it is done properly.
Supporting Your Child Through the Process
If your child is anxious about the procedure, the following may help:
Be honest about what to expect. Children cope better when they know what is going to happen. Explain that there will be two small injections (a sharp scratch for a few seconds) and then the toe will be numb.
Acknowledge their feelings. Being nervous is completely normal. Validating their anxiety is more helpful than dismissing it.
Let them ask questions. Encourage your child to write down any questions before the appointment. Anna is happy to answer everything directly.
Plan something positive for afterwards. Having something to look forward to — a film, a favourite meal, a day off school — helps frame the experience positively.