Ingrown Toenails in Infants and Children: Developmental Variants and Age‐Specific Management

Infantile ingrown toenails are a common pediatric nail disorder encompassing a spectrum of developmental, anatomical, and mechanical conditions, including congenital malalignment of the great toenail (CMGT), hypertrophy of the lateral nail folds, distal nail embedding, and early inflammatory forms of onychocryptosis. In neonates and young infants, immaturity of the nail plate, soft periungual tissue prominence, and physiological mechanical forces such as the grasp reflex may favor distal embedding of the nail plate, often associated with mild koilonychia or transient periungual inflammation. CMGT represents one of the main predisposing conditions and is characterized by deviation of the nail plate axis in relation to the distal phalanx, usually laterally, which may progressively worsen under repeated microtrauma and lead to nail dystrophy, secondary onychocryptosis, retronychia, or chronic onycholysis. Early recognition of the different clinical patterns of infantile ingrown toenails is essential to guide follow‐up and conservative management, helping to prevent chronic complications and reduce the need for surgical intervention later in childhood.