From the Research
Treatment for an infected pediatric ingrown toenail typically involves a combination of antibiotics and proper nail care, with partial nail removal being considered for moderate to severe infections or recurrent cases, as recommended by the most recent and highest quality study 1. The goal of treatment is to reduce morbidity, mortality, and improve quality of life. For mild infections, oral antibiotics such as amoxicillin-clavulanate (20-40 mg/kg/day divided every 8 hours) or cephalexin (25-50 mg/kg/day divided every 6-8 hours) for 7-10 days are recommended, as supported by previous studies 2, 3. Some key points to consider in the treatment of infected pediatric ingrown toenails include:
- Warm water soaks for 15-20 minutes 3-4 times daily to reduce inflammation and pain
- Gently lifting the ingrown nail edge with clean cotton or dental floss and applying topical antibiotic ointment like mupirocin or bacitracin
- Pain management with acetaminophen or ibuprofen at age-appropriate doses
- Considering partial nail removal (partial nail avulsion) with or without phenolization for moderate to severe infections or recurrent cases, under local anesthesia by a pediatric specialist, as this procedure prevents regrowth of the problematic nail edge 1, 4
- Ensuring children wear properly fitting shoes and have toenails cut straight across, not rounded at the corners, to prevent recurrence
- Seeking immediate medical attention if the infection worsens, spreads, or if the child develops fever, as these may indicate a more serious infection requiring more aggressive treatment 5, 3.