Ava Monroe
Scars are a natural part of the skin's healing process after an injury. While small scars may fade over time, larger or more noticeable scars can be reduced in size or appearance through various treatments. Similarly, scars under nails can be removed or grow out with new nail growth, depending on the type of injury. For instance, white marks on nails, known as leukonychia, are caused by trauma or injury and will grow out once the nail matrix heals. However, more severe nail injuries, such as nail bed lacerations or avulsions, may require medical treatment, including removing the nail to allow for proper healing.
| Characteristics | Values |
|---|---|
| Can scars under nails be removed? | Scars under nails can be removed in some cases. |
| Scar treatment methods | Laser treatment, tissue expansion, cryotherapy, dermabrasion, pulsed dye lasers, carbon dioxide lasers, erbium lasers, non-ablative lasers, liquid nitrogen, steroid injections, surgery, and sunscreen. |
| Nail bed injury types | Nail bed laceration, nail bed avulsion, fingertip fracture, amputation, subungual hematoma, and hook nail. |
| Nail appearance changes requiring medical attention | Melanoma, onycholysis, paronychia, pitted nails, Beau lines, onychomadesis, onychogryphosis, leukonychia, and yellow nail syndrome. |
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Laser treatment
There are two types of lasers used for scar treatment: ablative and non-ablative lasers. Ablative lasers remove the outer layers of scarred skin and encourage the growth of new, healthier skin. This makes the scar look lighter and smoother. Carbon dioxide lasers and erbium lasers are examples of ablative lasers. Carbon dioxide lasers use short, continuous pulses of light to remove layers of skin, while erbium lasers cause less damage to the surrounding tissue. Non-ablative lasers, on the other hand, are less aggressive as they heat the skin without damaging its surface.
During the laser treatment procedure, the doctor moves a laser wand over the skin to remove damaged skin cells and diminish scars. The laser treatment can either remove scar tissue or poke holes in it, depending on the type of laser used. Both methods stimulate collagen production and allow the body to create new, smoother skin. Laser treatment can also target blood vessels in the scar tissue to reduce redness.
It is important to note that laser treatment cannot completely remove scars. Instead, it replaces one scar with another that is less noticeable. Multiple sessions may be required, especially for older and larger scars. The recovery time varies depending on the type of laser treatment, ranging from one week to two weeks.
Before undergoing laser treatment, it is crucial to consult a dermatologist or a doctor. They will consider your skin type, the characteristics of the scar, and your overall health to determine the most suitable treatment option. Sun protection is also essential before and after the procedure to avoid serious burns or skin discolouration.
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Nail bed injuries
Most injuries of the nail bed are due to crushing injuries, such as with a hammer. Twenty-five percent of nail bed injuries involve the finger being crushed in a doorway, most commonly car doors. Crush injuries squeeze the soft tissue of the nail bed between the nail and the distal phalanx. This may result in a simple subungual hematoma or a simple or stellate laceration. Saws, knives, drills, moving belts, and lawnmowers are also common causes of nail bed injuries.
Home remedies and medical treatments can help treat nail bed injuries. Bandages and ice packs can help treat these injuries. Prompt treatment can help the nail bed and underlying structures heal and ensure that the broken nail grows back smoothly. Minor nail bed injuries, including subungual hematomas, often heal on their own, especially when no other injuries are present.
If the subungual hematoma covers more than 25% of the nail bed or is causing pain, the patient should be offered evacuation via trephination or nail removal. Lacerations to the nail bed should be repaired using 6-0 or smaller absorbable sutures. Minimal to no debridement should be performed because aggressive debridement may cause undue tension on the repair and results in scarring. When repairing avulsed nails and nail beds, if the nail is detached proximally, it must be removed to inspect for any damage to the nail bed.
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Cryotherapy
During cryotherapy for skin lesions, a healthcare provider will spray liquid nitrogen on the area being treated to freeze it. The treated area will become red soon after the procedure and may also blister and swell. It is important not to break open any blisters that form, as this can increase pain and prolong healing time. The area will usually heal within 7 to 10 days, and it is unlikely to leave a scar. However, it is common to experience skin discolouration after cryotherapy, which can last for up to a year or even longer in some cases.
Intralesional (IL) cryotherapy is a specific type of cryotherapy used to treat keloid scars. This technique freezes the scar tissue from the inside, using a needle that delivers liquid nitrogen or argon gas. While IL cryotherapy has been shown to reduce scar volume by up to 63%, it has not been proven to completely eradicate scars. Additionally, multiple sessions are often required, and there is a risk of side effects such as hypopigmentation, blistering, delayed healing, and infection.
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Tissue expansion
Scars are a natural part of the skin's healing process following an injury, surgery, or other trauma. They can form anywhere on the body and vary in appearance, feeling itchy or painful. While smaller scars may fade over time, larger or more noticeable scars may require treatment to reduce their size or prominence. It is important to note that no scar can be completely removed or eliminated once it has formed.
In addition to tissue expansion, other scar treatment options include laser treatment, dermabrasion, cryotherapy, and skin grafts or flaps. Laser treatment, such as ablative lasers, removes the outer layers of scarred skin and encourages the growth of new, healthier skin. Dermabrasion also removes the top layers of skin through sanding, promoting the growth of healthier skin. Cryotherapy involves the use of liquid nitrogen to freeze and remove scar tissue, often combined with steroid injections or surgery. Skin grafts and flaps involve taking healthy skin from one part of the body and using it to cover or replace damaged skin in the affected area.
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Wound care
Scars under nails can be caused by injuries to the nail or nail bed. Mild nail injuries can often be treated at home, but more severe cases may require a visit to a dermatologist or emergency medical care.
If any part of your nail is hanging off, gently trim away the part that is not connected to your skin. Then, gently clean the wound using soap and water. If the wound is bleeding, do not put a dry bandage or gauze on top, as this will stick to the wound. Instead, apply petroleum jelly to keep the wound moist, and then cover it with gauze or a bandage. Repeat these steps every day while the wound heals. It is important to keep the wound clean and moist to prevent the formation of a scab, as wounds with scabs take longer to heal and are more likely to scar.
To prevent another nail injury, keep your nails trimmed short so they do not bend or catch on objects. Make sure your shoes fit well and have a wide toe box to prevent rubbing, and always wear the proper gear to protect your nails while playing sports.
While there are treatments to reduce the appearance of scars, such as laser treatment, cryotherapy, tissue expansion, and dermabrasion, it is important to note that no scar can be completely eliminated. Most scars will fade over time, but they will never completely disappear. The effectiveness of scar treatments depends on the size, depth, and location of the scar. For larger, deeper scars that limit movement or cause other problems, surgery may be the best treatment option.
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Frequently asked questions
Yes, it is possible to remove a scar under your nails. However, the treatment depends on the type of injury and scar. For instance, a nail bed laceration may require stitches and the removal of the nail. In contrast, a nail bed avulsion will always require the removal of the nail.
A nail bed laceration is when your nail and the underlying nail bed are cut, usually by a saw or knife, but it can also be caused by a crushing injury.
A nail bed avulsion is when your nail and part of your nail bed are pulled away from the rest of your finger, often caused by your finger getting stuck or jammed.
Other common nail injuries include subungual hematomas, fingertip fractures, and finger amputations.
White marks on the nails, known as leukonychia, are almost always due to trauma or injury. If you have pushed back your cuticles too hard, white marks may appear on the nail plate surface about two months later due to temporary nail matrix damage.
