Toenails In Babies And Children: How To Treat Them?
Fingernails in infants and children are inflammatory disorders of the nail folds of a finger or toe, manifesting as redness, tenderness, and swelling.
Although they occur more frequently in adults, in children and babies they also tend to occur. Therefore, it is necessary to know how to handle them.
What Causes Fingernails in Babies and Children?
Oral trauma in the pediatric population from thumb sucking predisposes this age group to a different set of bacterial pathogens than adults. Contamination of the lesion can progress to infection and abscess generation within the nail fold.
A study published in the American Jounal of Surgery concludes that in the pediatric population, nails are generated in 46% of cases by mixed anaerobic and aerobic agents.
In this sense, newborns with calming finger-sucking behaviors may have a higher risk of developing fingernails.
Signs and Symptoms of Fingernails in Babies and Children
Infant and child fingernails are not a common condition, however they do come for a doctor’s visit within the first few days due to pain. Fingernails or paronychia are an inflammatory process characterized by the following symptoms:
- Reddening.
- Inflammation.
- Increased sensitivity.
- Pain.
Treatment options for fingernails in infants and children
Fingernails usually disappear after a few days. If not, there are different therapeutic options to treat ingrown toenails. In fact, the way to handle it depends on the severity of the condition and the age of the person in question.
Hygienic measures
The initial treatment to establish are warm water and salt baths on the affected fingers. The use of antiseptic solutions (povidone iodine or chlorhexidine) is also recommended.
Continuous brine baths help reduce inflammation and pain in the affected area. The warm baths should last 10 to 15 minutes several times a day. In turn, it is not recommended to cut the nails in a rounded shape, nor to trim the cuticles or skins. In fact, poor nail trimming is one of the most common causes of ingrown toenails.
Oral antibiotic treatment
Treatment with oral medication accompanies hygienic measures. Broad-spectrum antibiotics such as amoxicillin, clavulanic acid, or clindamycin are recommended.
In most cases, oral antibiotics should be prescribed for 7 to 10 days. You should follow the doctor’s instructions and do not stop taking the medication even if the individual reports feeling better. Pain relievers such as acetaminophen or ibuprofen are helpful in relieving pain in the affected area.
Topical medications
Currently, the first-line treatment for fingernails in infants and children is topical corticosteroids. These help relieve pain and decrease inflammation. Topical antibiotics used may be mupirocin, fusidic acid, bacitracin, or a triple antibiotic ointment.
Ideally, place the antibiotic cream 4 to 5 times a day on the affected areas. There are different presentations such as the following:
- Pomade.
- Cream.
- Ointment.
- Gel forms.
Ointments tend to remain for long periods in the area to be treated compared to creams.
Surgical treatment
Although oral hygiene and antibiotics are the initial therapy, incision and drainage in the perinatal setting is a curative adjunct.
If there is an abscess, the nail infection will require drainage. Consequently, the incision and subsequent evacuation of the pus are performed with a scalpel and local anesthesia, which allows complete drainage and comfort.
In addition, the treatment consists of trimming and removing the ingrown spicule to allow normal growth of the nail.
Differential diagnosis
The differential diagnosis of fingernails can cover different pathologies of the skin and soft tissues. Some of them are the following:
- Cellulitis : it is a superficial infection that presents with erythema and inflammation without fluctuation area due to the presence of pus or fluids.
- Herpetic whitlow : it is a viral infection of the distal finger caused by the herpes simplex virus (HSV).
- Onychomycosis : is a fungal infection that causes yellowish-white discoloration.
- Nail psoriasis : thickened nails, with areas of pitting , ridges and irregular contour.
- Squamous cell carcinoma : In most cases it occurs on the skin, but it also occurs on the nail bed.
Fingernails in babies and children
Fingernails in infants and children usually have a good prognosis. In most cases they resolve within a few days and rarely reappear in healthy individuals.
There are countless home remedies that are shared between individuals. However, this type of self-medication is not recommended for fingernails.
