Isla Bennett
Nail bed injuries are very common and can occur due to various reasons, such as crushing from heavy objects, cuts from sharp objects, or tearing/ripping. Treatment for nail bed cuts depends on the type and severity of the injury. Minor cuts can be treated at home by washing the wound with soap and water, applying antibiotic ointment, and bandaging the area. For more severe cuts, it is recommended to seek medical attention. Doctors may use stitches to repair the nail bed and reattach the nail if possible. In some cases, the nail may need to be removed to access the wound.
| Characteristics | Values |
|---|---|
| Treatment | Depends on the type and seriousness of the injury |
| Self-treatment | If it's a minor cut, wash with soap and water, then apply a bandage. For pain, take acetaminophen (Tylenol) or ibuprofen (Advil, Aleve). For swelling, apply ice |
| Medical treatment | If it's a deep cut, go to an urgent care center or the emergency room. The doctor will stop the bleeding, clean the wound, and may use stitches to close the wound. They may also remove the nail to repair the nail bed and reattach the nail with stitches or glue. |
| Healing time | It can take several months for a nail that has separated from the nail bed to grow back. A new fingernail will take about 4 to 6 months to grow back, while toenails can take up to 12 months. |
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What You'll Learn
When to seek medical attention
Most nail bed injuries are minor and can be treated at home. However, some injuries require prompt medical attention to ensure the nail bed heals properly and the nail grows back smoothly. Here are some guidelines on when to seek medical attention for a nail bed cut:
- Deep cuts in the nail bed: If you have a deep cut in your nail bed, it is advisable to seek medical attention, especially if the bleeding doesn't stop. Deep cuts may require stitches to close the wound and ensure proper healing.
- Inability to stop bleeding: If you are unable to stop the bleeding from a nail bed cut, it is important to seek medical help. A medical professional will be able to stop the bleeding and clean the wound properly.
- Large subungual hematoma: A subungual hematoma is when blood collects under the nail bed, causing intense pain and pressure. If the hematoma covers more than a quarter of your nail, it is advisable to seek medical treatment. A doctor may treat this by creating a small hole in the nail to drain the pooled blood, relieving pressure and pain.
- Fractured finger: If you suspect a finger fracture in addition to a nail bed cut, it is important to seek medical evaluation. A fractured finger may require a splint or other medical intervention to ensure proper healing.
- Inability to remove jewellery: If you have a nail bed cut and are unable to remove rings or other jewellery due to swelling, it is important to contact your healthcare provider for guidance.
- Lacerations, avulsions, or deformity: If the nail bed cut is accompanied by lacerations, avulsions (where the nail pulls away from the nail bed), or if your finger or toe is bent or deformed, it is recommended to go to a hospital's emergency department.
- Infection risk: If the nail bed cut is severe or contaminated (such as from a bite), there is a risk of infection. Seek medical attention to ensure proper cleaning and treatment to prevent infection.
- Bone injury: If there is any indication of a broken bone, such as a bend or deformity in the fingertip, seek medical attention. An X-ray may be required to assess the extent of the injury.
- Tetanus immunization: If you are unsure about your tetanus immunization status, it is advisable to seek medical attention after a nail bed cut. A doctor will be able to provide guidance based on your immunization history and the nature of the injury.
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Home remedies
Many nail bed injuries can be treated at home. However, if the injury is serious, you should seek medical attention. If there is a large amount of bleeding, you should go to an urgent care centre or the emergency room.
If the nail is completely torn off or partially cut off, apply direct pressure with a clean cloth. If the nail is torn, use sterile scissors to cut off rough edges to prevent further injury. Clean the wound and nail area with soap and warm water. Apply antibiotic ointment and bandage. For swelling, apply ice to the area and elevate the injured area above the heart. Take over-the-counter pain medication, such as acetaminophen (Tylenol) or ibuprofen (Advil, Aleve), as needed.
If you have a subungual hematoma (nail bruise), you can treat it at home if it occupies less than 25% of the total nail, the finger or toe is not deformed, and there are no lacerations or avulsions of the nail. Keep the hand or foot elevated above the level of the heart to help with throbbing. Use acetaminophen (Tylenol) or ibuprofen (Advil) for pain if you are not allergic to these medications. Wash any cuts or scrapes with soap and water, then apply a bandage.
If you have not had a tetanus booster shot in the last 10 years, or if you experience infection, redness, or drainage at the site of the injury, seek medical attention.
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Draining a subungual hematoma
A subungual hematoma is a type of nail bed injury that occurs when blood gets trapped under your nail bed. It is usually caused by a heavy object crushing or hitting the finger or toe. Symptoms include throbbing pain, and the nail turning black and blue. This often looks like a bruise under the nail.
If the subungual hematoma is small (one-fourth the size of your nail or less), you don't need to see a doctor. However, if it covers more than a quarter of your nail, you will need medical treatment. If the injury is causing you severe pain, this means the blood is causing too much pressure, and the hematoma should be drained.
Trephination is a quick, outpatient procedure that drains blood from a bruised nail (subungual hematoma). It involves making a small hole in the hard part of the nail (nail plate) to release the pressure and relieve pain. This procedure should only be performed by a healthcare provider, as attempting to do it yourself can lead to infection or further damage.
To prepare for trephination, the provider will clean the nail and the surrounding area with soap and water, and apply a wound-cleansing solution, like chlorhexidine. They will then use a needle, an electrocautery device, or a special tool to make a small hole in the nail. You will be able to go home right away, but you may notice drainage through the hole in your nail for the next 24 to 36 hours. This is normal and temporary, but you should follow your provider's instructions for changing bandages and caring for your finger or toe. In general, you should keep the area dry and clean.
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Reattaching the nail
If only a portion of the nail is detached, the loose part should be removed, and any sharp edges should be filed down to prevent further damage. The exposed nail bed should be treated with a thin layer of petroleum jelly and covered with a non-stick bandage. If there are signs of infection, a doctor may prescribe antibiotics.
In some cases, a doctor may be able to reattach the nail using special glue or stitches. This is more likely to be successful if part of the nail is still attached to the nail bed. The reattachment procedure will also depend on the individual's anatomy and genetics.
If the nail cannot be reattached, a doctor may replace it with a special type of material that will remain on the nail bed as it heals. This material will provide protection and support while a new nail grows.
It is important to note that nail injuries can take a long time to heal, and it may take several months for the nail to return to normal. During this time, it is recommended to keep the nail bed clean and dry and perform finger exercises to prevent stiffness.
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Preventing infection
Clean the Wound
Wash your hands thoroughly with soap and water before treating the injury to prevent introducing new bacteria to the wound. If the injury is minor, gently clean the affected area with soap and warm water to remove any dirt, debris, or bacteria. If the injury is more severe, seek medical attention, as a healthcare provider will be able to properly clean and treat the wound to prevent infection.
Apply Antibiotic Ointment
Once the wound is clean, apply a small amount of antibiotic ointment to help prevent bacterial growth and infection. Ensure you follow the instructions provided with the ointment for proper usage.
Bandage the Area
Cover the wound with a sterile bandage to keep it clean and protected. Change the bandage daily, or as instructed by your healthcare provider, to ensure the wound remains clean and to monitor for any signs of infection.
Elevate the Injured Area
If possible, elevate the injured hand or foot above the level of your heart to help reduce swelling and pain. This can also help to prevent excess blood flow to the wound, reducing the risk of infection.
Monitor for Signs of Infection
It is important to regularly check the wound for any signs of infection, including redness, swelling, heat, or pain around the nail or wound site. Other signs of infection include pus, red streaks extending from the wound, or a foul odour. If any of these symptoms develop, contact your healthcare provider immediately for further evaluation and treatment.
Keep Nails Trimmed and Avoid Nail Biting
While the wound heals, maintain proper nail hygiene by keeping your fingernails trimmed and avoiding the temptation to bite your nails or cuticles. This will help prevent further injury and reduce the risk of introducing bacteria to the wound site.
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