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3 Things to Know About Ingrown Nails in Children

Ingrown nails are a very common (and usually very painful) condition for all ages of people.  Approximately three million ingrown nails are treated annually in the US.  This problem is especially common in children between the ages of 9 and 18, and the big toe is by far the most common nail affected.

  1. Causes of ingrown nails:

There can be multiple reasons for this, including: improperly fitted shoes (toes get squished in the toe box), minor trauma, improper cutting, as well as genetic factors, such as the shape of the nail and surrounding skin.  Also, some sports tend to contribute to the development of ingrown nails.  For example, soccer players can be susceptible due to repeated kicking in tight fitting shoes.  Ski boots can also irritate nails due to tight fit.

I recommend that all parents regularly check the fit of their children’s shoes and boots to see if the toes have adequate room, and make sure to replace any shoes that are getting too small.  Children’s feet can grow rather quickly and even newer shoes may not fit properly for long.

  1. Signs and symptoms:

Signs and symptoms of ingrown nails are pain and sensitivity to the nail and toe that may come and go.  If an ingrown nail is getting infected it will usually look red and swollen and may even bleed or drain fluid.  Home treatment for this issue are limited and not always very effective.  Some common home remedies may even make the problem worse.

For example, you should never try to dig or cut out the nail border since the portion of the nail that is getting ingrown is deeper down in the toe than you think.  Never try to place cotton under the nail.  This is ineffective and may worsen the symptoms or infection.  Don’t try and cut a notch in the nail, as this is also ineffective.  There are a variety of over the counter remedies which at best don’t work and at worst may cause more severe infection.

One home remedy worth trying is soaking the foot in water and Epsom salts.  This can help the nail drain and may give some improvement, however this will rarely fix the problem long term.

  1. Solutions:

The best solution is to have the nail evaluated and treated by an experienced podiatrist.  Ingrown nails can be treated quickly and safely in most podiatry offices.  Treatment often involves numbing the toe and removing a small portion of the nail.  If the nail has been ingrown more than once we will usually remove the nail corner and treat it with a chemical to prevent that sliver of the nail from growing back.  This is a common and highly effective procedure with little pain or discomfort involved.  I absolutely do not recommend that you ever dig at it, chop at it, or poke it with sharp objects.  This will only make it worse.

So, if you think your child may have an ingrown nail, don’t wait until it gets infected or more painful.  Make an appointment and nip it in the bud.  The sooner it’s treated the sooner your child can get back to the fun stuff!

ingrown toenails treatment for children's

Children and Plantar Warts

Children and Plantar Warts

Plantar warts (simply: warts on the feet) are a very common issue for people of all ages.  It’s estimated that 7-10% of the US population has some type of wart infection.  It’s especially prevalent in children, with approximately 10-20% of children in the US affected.  These are most common from the ages of 12-16 and girls are affected more frequently than boys.

Although these skin lesions are typically harmless, they can cause pain and discomfort as well as being unsightly.  They’re also highly contagious and can easily be spread to others through both direct and indirect contact.  This means that warts can be spread either by coming in contact with someone’s wart with your bare skin or by having bare skin contact with an object recently touched by someone else’s wart (ie: shower floor, socks, towels, etc.).

Diagnosis is usually done by physical examination.  This typically involves trimming of the wart to remove any hard outer callus and looking for the telltale signs of wart infection.  These symptoms can be subtle, and proper diagnosis should always be done by a qualified specialist.

Here are some common causes and risk factors for plantar warts in children:

  1. Direct Contact: The HPV virus that causes the warts is contagious and spreads through direct contact with an infected person or surface. Children can contract the virus by walking barefoot in damp, warm environments like public swimming pools, locker rooms, or communal showers.
  2. Weakened Immune System: Children that have weaker immune systems typically take immuno suppressive medications, and that is why are more likely to develop warts.
  3. Cuts or Abrasions: The infection often enter the skin through tiny cuts, scrapes, or abrasions on the feet. Children who have minor foot injuries or whose skin is compromised in some way may be at higher risk.
  4. Walking Barefoot: Children who frequently walk barefoot in areas where the virus is present are more likely to come into contact with the HPV strain responsible.
  5. Personal Hygiene: Lack of proper foot hygiene, such as not washing feet regularly, can contribute to the spread of the virus.

It’s essential for parents and caregivers to educate children about the importance of foot hygiene, avoiding walking barefoot in public areas, and wearing flip-flops or other protective footwear in communal spaces to reduce the risk of contracting warts.

Treating Plantar Warts

Once the diagnosis of  has been made, treatment can be started.  Success rates for wart treatments in the adult population are often very low with cure rates for an initial treatment ranging from 5-10%.  Subsequent treatments are typically needed.  Success rates for initial treatments for children are much better, typically in the 50-60% success range.  Various treatment options exist including over the counter topicals, laser therapies, surgical excision, as well as more aggressive topical therapies that are applied under a doctor’s supervision.  The best treatment option can vary from person to person depending on age, severity, and location on the foot.

Regardless of which treatment is used, prevention of spread is always very important to avoid re-infection and to avoid passing it along to someone else.  My recommendations to prevent spreading warts include:

  • Always wear shower shoes in public locker rooms and changing rooms.  This includes anyone with warts but also anyone without them.
  • If your child has warts they should not share socks, shoes, towels, or anything else that may come in contact with their wart with anyone else.
  • Cover all warts with waterproof bandage for any swimming or outdoor barefoot activity.
  • Anyone with warts should avoid touching the warts directly with their hands and then touching anything or anyone else.  Regular hand washing is encouraged to prevent this.

Emotional Impact on Children

Plantar warts can have a notable emotional impact on children. These benign but sometimes painful growths on the soles of their feet can lead to a range of emotions and concerns. Children may feel embarrassed or self-conscious about the appearance of the warts, especially if they are in visible areas. Additionally, the discomfort or pain associated with this foot issue can lead to frustration and anxiety, as it may interfere with their daily activities and play. It’s essential for parents and caregivers to provide emotional support, address any concerns, and seek prompt treatment to alleviate both the physical and emotional distress caused by it in children.

Seeing a Podiatrist at the Right Time

Children with warts should see a podiatrist if the warts cause pain, discomfort, or if there are signs of infection. Additionally, it’s advisable to consult a podiatrist if home treatments, such as over-the-counter wart removers, are ineffective or if the warts persist or multiply. Podiatrists are specialists in diagnosing and treating foot conditions, including plantar warts, and can provide appropriate care and guidance tailored to the child’s specific situation.

In some cases, the issue may resolve on their own without medical intervention. However, seeing a podiatrist can help ensure a correct diagnosis, prevent complications, and provide treatment options to alleviate discomfort or pain, especially in cases where warts become problematic or painful for the child. Early intervention can help manage warts more effectively and minimize their impact on a child’s well-being.

If you suspect that you or your child may have such a foot condition I encourage you to make an appointment with an experienced health professional.  The sooner they get properly diagnosed, the sooner treatment can be started, and the sooner those warts can be HISTORY!  Please feel free to contact my office with any questions or concerns. We have the SWIFT plantar warts treatment system and more information on how it works can be found here.

Does Your Child Have Sever’s Disease?

Sever's Disease Heel Injury In Kids

My oldest son has been dealing with heel pain for the last month.  He is a very active 9-year-old with soccer, basketball, baseball and running.  Currently, he is playing soccer this fall.  He is a classic example of a young boy or girl from 8-14 years old who commonly suffer from Sever’s Disease.  I know the name sounds terrible and is misleading, but Sever’s Disease is simply the name for a heel injury.

Children have growth plates in the heel bone (calcaneous) that allow the bone to grow in length.  Around the ages of 13 to 15 that growth plate closes, but until then can become irritated by repetitive injury or a sudden growth spurt.  The Achilles tendon is the strongest tendon in the body and attaches to the back of the heel.  If a child has a sudden growth spurt it takes time for the tendon to lengthen and can put increase pull on the back of the heel. That increase pull can irritate the growth plate in the back of the heel and cause pain.  In my son’s case, he grew about an inch over a two-month period this summer and subsequently started complaining of heel pain.

If this sounds familiar for your child and you are wondering if they have Sever’s Disease, here are some symptoms to look for:

  • Pain in the back of the heel along the heel bone and Achilles tendon
  • Pain that worsens with squeezing of the heel bone
  • Pain is usually worse after sporting events and gets better with rest and ice
  • There is typically no bruising and there may be mild swelling to the area

Treatment:

The good news is that this condition doesn’t cause any long term damage and is self-limiting. It will typically go away with rest and ice.   The problem is, most children do not want to rest and stop doing what they love. Some tips to help reduce the symptoms and pain include:

  • Calf stretching especially after sports
  • Non-steroidal anti-inflammatory drugs (NSAIDS) like Ibuprofen
  • Ice at the end of the day and after sporting events
  • Orthotics to help control heel motion and wear supportive shoes

I have found orthotics to help immensely with children’s symptoms and keep them doing the things they love. If symptoms fail to resolve or worsen, then immobilization with a cast or removable cast boot to really rest the area is the definitive treatment. Once symptoms resolve, then gradual return to full activity with continued stretching is essential.  If your child is suffering from heel pain too, come see us at Anderson Podiatry Center and we can tailor treatment according to his or her activity level.