Nail Care

Because an infant’s fingernails grow quickly and may accidentally scratch the face, they should be gently trimmed once or twice a week using infant nail clippers. Toenails, (which do not grow as quickly and can’t cause any injury) need only be trimmed once or twice a month.

The hands of a young child are constantly exploring the world around him, and thus both fingers and fingernails are at risk for a variety of injuries. If a child is barefoot much of the time, toenails could occasionally be injured as well. If a nail becomes cracked without roughness, no special care is needed. If a nail is nearly torn however, use clippers or scissors cleansed with rub alcohol to cut off the loose fragment. Each day, soak hand or foot for twenty minutes in a solution of salt water (1 tsp salt in 2 cups water), then apply biotic ointment and a small adhesive bandage and in about a week, the raw nail bed will be covered with new skin, and this routine can be stopped. A new one will eventually grow out.

Occasionally a crush injury (as occurs when a finger is in the path of a in a closing door) will cause bleeding under the nail. This will be manifested by a deep blue discoloration of the nail and a great deal of pain. This in turn should be seen by the child’s physician, who may use a special tool to poke a hole in the nail to release the blood and relieve pain immediately. If the nail bed is cut as the result of a crush injury, it may need to be treated under local anesthesia.

Nail biting is a commonly self-comforting, bad habit among children. Attempts to stop it through ridicule or punishment will cause more harm than good. A child who wants to break the habit can beat it in a variety of ways:

Offer a reward for a certain number of days or weeks of “biteless” nails.

Devise a simple, nonjudgmental signal (such as saying the child’s name in a friendly tone and pointing to your hand) you can use when you see him biting his nails.

Sour-tasting solutions painted on the nails may serve as a reminder to keep fingers out of the mouth.

An infection of the soft tissue at the junction of the fingernail is called a paronychia. This usually involves common staphylococcal or streptococcal bacteria. The infection arises from a break in the skin resulting from thumb-sucking, chewing, or pulling on the cuticle. Occasionally, pus will drain from the breakage which also has a tendency to become red and irritated. If a pus pocket is clearly visible, your child’s doctor might lance it, which will relieve pressure and reduce pain. The doctor might recommend 10 or 15 minute soaks in a solution of a little antibacterial soap in 6 to 8 ounces of warm water, along with the application of an antibiotic ointment. In more severe cases, oral antibiotics might be prescribed.

Ingrown toenails are caused by improper cutting of the toenails and/or wearing tight shoes, and the nail becomes embedded in the flesh. Always cut a toenail straight across rather than curve it down on the sides. If an ingrown nail develops, soak the foot daily in a solution of soap and water as just described. Massage the swollen part of the toe away from the nail. Frequently, ingrown toenails (especially on the big toe) become infected, causing pain, redness, and swelling where the nail joins the infected skin. While gentle cleansing and warm soaks may help to some extent, your child’s doctor might recommend antibiotics and/or removal of the segment of nail that has become embedded in the skin. (A local anesthetic is given to numb the toe before this is done.)