Isla Bennett
Nail injuries are common, and they can occur in various ways, including crushing or cutting your fingers or toes, or even shutting them in a door or drawer. These injuries can cause damage to the nail bed and matrix, resulting in nail separation or onycholysis. While some nail injuries can be treated at home, others require medical attention to ensure proper healing and smooth nail regrowth. In severe cases, reconstructive surgery or antibiotics may be necessary. With proper care and treatment, damaged nail beds usually heal, and healthy nails grow back, although this may take several months.
| Characteristics | Values |
|---|---|
| Do damaged nail beds grow back? | In most cases, new nails will slowly regrow. |
| What causes nail bed damage? | Injuries, fungal infections, nail biting, cuticle biting, and ill-fitting shoes. |
| What to do if your nail bed is damaged? | Bandages and ice packs can help treat these injuries. If there are any signs of infection, swelling, increasing pain, or pus, visit a physician. |
| How long does it take for a nail bed to heal? | Fingernails usually regrow completely in about two to six months. Toenails take about four months to regrow. |
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What You'll Learn
Treating nail bed injuries at home
A nail bed injury occurs when any part of your nail becomes injured, including the nail, nail bed (skin underneath the nail), cuticle (base of the nail), and the skin around the sides of the nail. It is usually caused by a heavy object crushing or hitting the fingers or toes or by a sharp object.
Many nail bed injuries are minor and can be treated at home. Here are some ways to treat nail bed injuries at home:
- Bandages and ice packs can be used to treat injuries caused by crushing or hitting.
- If you have a bruise under your nail, a procedure called nail trephination can be performed to drain the trapped blood. This provides pain relief and helps the new nail grow in correctly.
- If the nail is not cut or torn and is still attached to the nail bed, you can try to stop the bleeding quickly at home. Remove all jewellery from your hand. Apply soap, if needed, to help rings slip off your fingers.
- Minor nail bed injuries, including subungual hematomas, often heal on their own, especially when no other injuries are present.
Some nail bed injuries require prompt medical attention to ensure that the area heals and the nail grows back smoothly. Depending on the severity of the injury, the nail may still grow back with small ridges or bumps. It is rare for the nail matrix to be permanently damaged, preventing your nail from growing back. However, if this happens, consult a healthcare provider.
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When to seek medical attention
In most cases, you don't need to visit a physician or go to an emergency room for a damaged nail. However, if you notice any nail changes, such as a small spot of colour, lines, or ridges, it's important to consult a healthcare provider to determine if it's a nail matrix problem or another issue.
If you see signs of an infection, such as swelling, increasing pain, or pus, it is mandatory to seek medical attention. This includes any signs of acute paronychia, an infection caused by bacteria getting underneath the tissue at the side of the nail, resulting in swelling and irritation.
If there is significant damage to the areas around the nail, a visit to a physician is recommended. This includes any trauma to adjacent structures, such as bone fractures or tissue tears, which may require X-rays and antibiotics to prevent infection.
If your nail has been detached or torn, and there is a large amount of bleeding or moderate pain, it is important to seek medical attention. In some cases, the nail may need to be removed, and deep tears may require stitches. Additionally, if the nail bed matrix is damaged, doctors may remove part or all of the nail to repair the nail bed.
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Surgical procedures for nail bed injuries
A damaged nail bed is a common injury, often occurring when a heavy object crushes or hits the fingers or toes, or when a sharp object cuts the nail. While many nail bed injuries can be treated at home, some require prompt medical attention to ensure the nail grows back smoothly.
There are several types of nail bed injuries, including subungual hematoma, laceration, and avulsion. A subungual hematoma forms when blood collects between the nail and the nail bed, usually due to a heavy impact such as a door crush injury or a heavy weight falling on the finger. Doctors can treat this by making a small hole in the nail and draining the pooling blood, a procedure known as trephination.
In the case of a laceration, compression of the nail bed between the distal phalanx and the nail can result in a simple or complex laceration. Sharp objects like knives can penetrate the nail if they land with sufficient force, resulting in a nail bed laceration. Doctors may treat this by repairing any laceration to the nail bed with stitches and reattaching the nail, if possible, to provide protection and support while the new nail grows.
Avulsion injuries commonly occur in the ring finger and are often associated with other injuries, such as distal phalanx fractures and dislocations. In some cases, the nail may be too badly damaged to be reused, and a doctor may attach a synthetic nail that is gradually pushed forward as the new nail grows. When avulsion is more severe, a surgeon may use reconstructive techniques such as grafting.
The management of nail bed injuries depends on the type and extent of the injury. With appropriate treatment, many injuries to the nail bed can make a full recovery. It typically takes a long time for the nail to recover, with a new but abnormal nail forming within three months, and a return to a normal nail within nine months.
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Onycholysis (nail separation)
Onycholysis is a common condition in which the nail separates from the nail bed, or the skin beneath it. It usually occurs after an injury to the nail or the nail matrix (the area where nails start to grow). However, it can also be caused by fungal infections, psoriasis, and reactions to chemicals in nail products. Onycholysis may also be a symptom of an underlying medical condition such as thyroid disease, vitamin deficiency, or a serious yeast infection.
The symptoms of onycholysis include nails that peel away from the nail bed, thick and tough nail beds, an abnormal border between the pink and white areas of the nail, discoloration (grey, green, purple, white, or yellow), dents or pits in the nails, crumbling nails, and hemorrhages underneath the nails. It is important to note that while onycholysis itself is usually not painful, the underlying cause may be irritating or painful.
To treat onycholysis, it is crucial to first identify and address the underlying cause. In some cases, this may involve stopping the use of certain nail products, treating fungal infections with antifungal medications, or addressing skin or medical conditions with prescribed treatments. While waiting for a new nail to grow, it is recommended to keep the nails short and trimmed, avoid activities that may harm the nails, and keep the nail bed dry to prevent bacterial growth.
The recovery time for onycholysis depends on the severity of the condition and the type of nail affected. Fingernails typically take 4 to 6 months to fully regrow, while toenails can take 8 to 12 months. In some cases, the nail may grow back with small ridges or bumps, indicating that the nail bed has healed smoothly.
It is important to seek medical advice if you suspect that your onycholysis is caused by an underlying medical condition or medication. A doctor can help identify and treat the underlying cause, or determine if alternative medication is required.
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Preventing nail trauma
Fingernail and toenail injuries are common and can occur in many ways, such as a blow to the nail, closing a finger or toe in a door or drawer, or a cut from a sharp object. Repeated trauma to toenails, caused by ill-fitting shoes, can also lead to deformities in the nails. To prevent nail trauma, consider the following:
Wear Properly-Sized Shoes
Many people wear shoes that are too small, which can lead to various foot problems, including toenail trauma. Toenails can be injured when toes are subjected to heavy impact or crushed by heavy objects. Wearing properly-sized shoes can help prevent such injuries.
Keep Nails Trimmed and Avoid Nail Biting and Cuticle Biting
Keeping your fingernails trimmed and avoiding biting your nails or cuticles can help prevent nail trauma. Nail biting is a common habit that can cause acute paronychia, a type of infection where bacteria get underneath the tissue at the side of the nail, leading to swelling and irritation.
Protect Nails During Sports
When playing sports, wear the proper gear to protect your nails. This will help shield your nails from potential trauma caused by impact or other injuries.
Seek Medical Attention for Severe Injuries
Some nail injuries may require prompt medical attention to ensure proper healing and smooth nail growth. Doctors can treat severe injuries, such as avulsions, by attaching a synthetic nail or using reconstructive techniques like grafting. Antibiotics may also be prescribed to prevent infection.
Treat Subungual Hematoma
Subungual hematoma is a common condition that occurs when there is blood under the nail, usually due to crushed or impacted fingertips or toes. Treatment involves relieving pressure by draining the trapped blood. For small hematomas, you can heat the end of a needle or paper clip until it is red-hot and gently create a small hole in the nail for drainage.
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Frequently asked questions
A nail bed injury occurs when a heavy object crushes or hits the fingers or toes, resulting in a cut or a blow to the nail. This often leads to blood under the nail, called a subungual hematoma.
Minor nail bed injuries can be treated at home with bandages and ice packs. For more severe injuries, a doctor may recommend a procedure called nail trephination, which involves making a small hole in the nail to drain the blood. Antibiotics may also be prescribed to prevent infection.
In most cases, the nail will slowly regrow after a nail bed injury. However, it may take up to 6-9 months for the nail to fully recover and grow back smoothly. Proper medical care can help ensure that the nail bed heals appropriately and the new nail grows back correctly.
