Although interventions on the skin of children and adolescents often heal better than in adults, inappropriate interventions on nails can lead to avoidable trauma and irreparable damage to fingers and toes.When are interventions on nails indicated in children? What age-related characteristics are important?With reference to the literature and experience from own clinical cases, the most commonly occurring constellations in children are discussed and approaches to protective treatment are demonstrated.Ingrown toenails are one of the most common reasons for presentation due to nail problems in childhood. Conservative measures or protective interventions on the nail matrix avoid unnecessary trauma caused by currently obsolete techniques. Additional nail problems in children which could be treated operatively included nail pigmentation, exostosis and onychodystrophy.A thorough evaluation of the indications and cautious implementation allows a targeted nail surgery or its avoidance even in childhood.