Noah Sinclair
Nail bed injuries are common and can be caused by a variety of factors, including cuts, crush injuries, and heavy impacts. Treatment for nail bed injuries depends on the type and severity of the injury. Minor injuries may be treated at home with first aid, while more severe injuries may require medical attention. Home treatment typically involves cleaning the wound, applying ice, and using pain relievers and antibiotics to manage pain and prevent infection. For severe injuries, a doctor may need to drain blood from beneath the nail, remove the nail, or use stitches or glue to close the wound.
| Characteristics | Values |
|---|---|
| Type of injury | Nail bed laceration, subungual hematoma, nail bed avulsion, finger fracture, amputation |
| Treatment | Depends on the type and seriousness of the injury |
| Treatment location | At home or at a hospital/doctor's office |
| Home treatment | Remove jewellery, wash the area, trim the nail, stop the bleeding, apply ice, elevate the area, apply antibiotic ointment and bandages |
| Hospital treatment | Remove part or entire nail, cut the nail bed and close with stitches, drain blood, reattach nail with glue or stitches, use surgical material if reattachment is not possible, prescribe antibiotics, painkillers, and/or splint |
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What You'll Learn
Treat minor nail bed cuts at home
Minor nail bed injuries can often be treated at home. However, if the injury is serious, you should seek medical attention. If the cut is deep, won't stop bleeding, or your finger is very swollen, painful, or bent, you should see a doctor.
If you are treating a nail bed cut at home, the first step is to gently wash the wound with soap and water. You should then apply pressure with a clean cloth to stop any bleeding. Next, apply ice to the area to reduce swelling and relieve pain. You can also take over-the-counter pain relievers, such as acetaminophen.
If the cut is small, you may not need to bandage it. However, if it is bleeding or at risk of getting dirty, you should apply an antibiotic ointment and cover it with a bandage. Change the dressing daily, if necessary. You should also keep the injured area elevated above the heart to reduce swelling.
It is important to note that if you have an artificial nail, it should be kept in place until the nail bed has healed. A new nail will grow in and replace the old one, pushing it off. This process can take 4 to 6 months for a fingernail and 12 months for a toenail.
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When to see a doctor
It is recommended that you seek medical attention for a cut nail bed in the following scenarios:
- If the cut is deep and won't stop bleeding.
- If the subungual hematoma (bruising under the nail) covers more than 25% of your nail, you should see a doctor for evaluation and possible drainage.
- If your finger is very swollen, painful, or you suspect a fracture, a doctor should evaluate it.
- If you have not had a tetanus shot in over ten years, or if you have diabetes, poor circulation, AIDS, are on chemotherapy, or have another condition that affects healing or increases the risk of infection.
- If there is any sign of infection, redness, or drainage at the site of the injury after two to seven days.
- If there is any bend or deformity in the fingertip, indicating a possible bone fracture.
In most cases, a cut nail bed can be treated at home with proper care. However, if you are uncertain about the severity of your injury or if home treatment is not effective, it is always best to seek professional medical advice.
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Draining blood from under the nail
If you have bleeding under your nail, it is medically known as a subungual hematoma. This is usually caused by a crushing or stubbing injury, and can result in pain, throbbing, and discoloration (black-and-blue or black-and-purple) of the nail. If the injury is severe, there may be broken bones or deep cuts, which will require further treatment and a longer healing time.
To drain blood from under the nail, it is recommended to see a healthcare provider within the first 48 hours of the injury, as the blood will begin to clot after this time, making drainage difficult. A healthcare provider can perform a simple draining procedure to relieve the pressure and provide relief from pain and throbbing. This procedure, called trephination, uses a hot metal wire, an electrocautery device, or a large-bore needle to pierce the nail and allow the blood to drain out. The nail plate lacks nerves, so this process is relatively quick and painless. The hole created should be large enough to let the blood drain, and the area should be covered with sterile gauze. After the procedure, the wound should be kept clean and dry, and bandages should be changed as instructed by the healthcare provider.
In some cases, the nail may need to be removed to surgically repair the underlying tissues, especially if the injury is deep or covers a large area of the nail surface. This can help prevent the nail from falling off and support proper healing. The wound will usually heal within a few weeks, but it may take several months for the nail to grow back, and the new nail may have ridges or other abnormalities.
It is important to note that nail drainage should not be attempted at home, as it may cause infection. If home measures such as elevating the hand or foot, using a cold compress, and applying compression do not provide relief, it is recommended to contact a doctor for further treatment options.
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Reattaching the nail
Before reattachment, the doctor will examine and evaluate the extent of the injury clinically and check the finger bone or toe bone on X-ray reports. If the nail is damaged or torn, the doctor may remove it and repair the nail bed. They may also do so if the finger or toe is fractured.
If the injury is minor, you may be able to treat it at home. To treat a minor nail bed injury at home, gently wash any cuts with soap and water, apply a bandage if needed, and take over-the-counter pain relievers such as acetaminophen to reduce swelling.
If you have a deep cut in your nail bed, you should see a doctor, especially if it doesn’t stop bleeding. If your finger is very swollen or painful, or if you think it’s fractured, you should also see a doctor for an evaluation.
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Preventing infection
Clean the Wound
Wash the injury gently with soap and clean water to remove any dirt, debris, or bacteria that could cause an infection. You can also use a gentle antiseptic solution if available. Ensure that you also clean the area around the wound.
Apply Antibiotic Ointment
After cleaning the wound, apply a small amount of antibiotic ointment to help prevent infection and promote healing. Cover the wound with a sterile dressing or bandage to keep it clean and protected.
Change Dressings Regularly
Follow your healthcare provider's instructions on how often to change the dressing. This is typically done daily or every other day to ensure the wound remains clean and dry. A clean dressing reduces the risk of infection.
Keep the Wound Elevated
Elevate the injured hand or foot above the level of your heart whenever possible, especially during the first 24 to 48 hours after the injury. This will help reduce swelling and pain, and it can also reduce the risk of infection by promoting proper circulation.
Take Prescribed Antibiotics
If your doctor prescribes oral antibiotics, be sure to take them as directed. Antibiotics help fight off any potential infection and ensure that your injury heals properly. Finish the entire course of antibiotics, even if your wound looks healed.
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