Treating An Injured Nail: Removal And Recovery

how to remove nail after injury

Nail injuries are common and can occur when a heavy object crushes or hits the fingers or toes. Depending on the severity of the injury, the treatment for nail injuries varies. Some injuries can be treated at home, while others require medical attention. If the nail bed is injured, it can be treated with stitches or glue, and antibiotics may be prescribed to prevent infection. In some cases, a new nail will have to grow back in place of the damaged one, which can take up to 18 months for a toenail.

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Treat a nail injury at home with ice packs and bandages

A nail injury can occur when any part of the nail, nail bed, cuticle, or surrounding skin is damaged. Depending on the severity of the injury, you may be able to treat it at home with ice packs and bandages. Here is a guide on how to do this:

Stop the Bleeding

If your wound is bleeding, gently clean it with soap and water. Do not apply a dry bandage or gauze, as it will stick to the wound. Instead, apply petroleum jelly to keep the wound moist, then cover it with gauze or a non-adhesive bandage. If you have a ring on the injured finger, remove it immediately. If you cannot remove it due to swelling, seek medical attention.

Apply Ice

To reduce pain and throbbing, apply ice wrapped in a cloth to the injury for 20 minutes every 2 hours on the first day. On subsequent days, apply ice 3–4 times daily. Keep the injured area elevated above the level of your heart to further reduce throbbing.

Bandage the Wound

Once the bleeding has stopped, keep a light dressing on the nail to provide padding and protection. Use an adhesive bandage or a small piece of gauze, ensuring that any sticky products are only applied to the skin around the nail, not the injury itself. You can also use an elastic bandage, but do not wrap it too tightly.

Take Pain Medication

Over-the-counter medications such as ibuprofen or naproxen can help reduce pain and swelling. Acetaminophen can also be used for pain relief, but it will not reduce swelling. Always follow the recommended dosage instructions and consult your healthcare provider if you have any pre-existing medical conditions.

It is important to note that while many nail injuries can be treated at home, some require prompt medical attention. If you cannot bend your injured finger or toe, if the injury is very painful, or if your nail becomes black or purple, seek emergency medical care or consult a dermatologist.

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Reattach the nail with glue or stitches

Reattaching a nail with glue or stitches is not medically recommended if the entire nail has detached from the finger or toe. In such cases, the nail cannot be reattached, repaired, or replaced. Instead, the non-adhering portion of the nail should be removed, and the nail bed should be covered with a dressing. A new nail will then grow back in its place.

However, if only a portion of the nail is detached, it may be possible to reattach it using glue. First, trim off the detached part of the nail, ensuring that any remaining sharp ends are filed smoothly. Then, apply a small amount of nail glue to the torn nail and smooth it out with a toothpick or tweezers. Press the nail into place and hold it for at least a minute to allow the glue to dry. Finally, smooth the repaired area with a nail file and apply a top coat.

As an alternative to using glue, some sources suggest using a tea bag or nail silk wrap to patch the broken nail. To do this, cut a small strip of a tea bag or nail silk wrap to the size of the break. Apply nail glue or super glue to the break, stick the tea bag or silk wrap onto the glue, and press it down. Add more glue until the strip is saturated, then wait for it to dry and buff it with a nail file.

It is important to note that reattaching a nail with glue or other adhesive methods may increase the risk of infection, particularly fungal infections. Therefore, it is recommended to sanitise the nail bed and the underside of the nail before attempting to reattach it. Additionally, if there is any damage to the surrounding tissues, nail bed, nail matrix, or proximal nail fold, it is advisable to seek medical advice, as this may result in scarring.

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Treat a fungal nail infection

A fungal nail infection causes the nail to become thick, discoloured, and brittle. It can affect both the toenails and fingernails, and usually starts at the edge of the nail, slowly spreading to the rest. While it is not a serious condition, it can take a long time to treat.

If you suspect a fungal nail infection, it is recommended to visit a pharmacist. They can advise on the best course of treatment, which may include an antifungal nail medicine that is brushed onto the nail. This type of treatment needs to be applied regularly for several months, and should be continued until advised to stop by a healthcare professional.

If over-the-counter treatments are unsuccessful, a GP may prescribe antifungal tablets. Before prescribing treatment, a doctor will take a sample of the nail to test for the type of infection. They may also request a blood test before and during the treatment. One such medication is terbinafine, which is taken daily for 6-12 weeks, depending on whether it is being used to treat the fingers or toes. It is important to note that terbinafine cannot be taken while pregnant or breastfeeding, and can cause side effects such as headaches, rashes, and gastrointestinal issues.

Another prescription medication is itraconazole, which is FDA-approved to treat nail fungus in adults. This medication should also not be taken during pregnancy, as it can harm the baby. Additionally, it is known to interact with other medications, including statins.

It is important to treat athlete's foot as soon as possible to prevent it from spreading to the nails.

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Prevent infection with antibiotics

Preventing infection is crucial after a nail injury, as bacteria can enter through cuts and broken skin around the nail and cuticle, leading to infections such as paronychia. While antibiotics are not recommended for preventing tetanus, they are often used to treat bacterial infections resulting from nail injuries.

Paronychia is a common nail infection that can develop when bacteria or fungi enter broken skin near the cuticle and nail fold. It is characterised by pain, swelling, and tenderness around the nail, with skin that is red and warm to the touch. In some cases, pus may build up under the skin, forming a white to yellow abscess.

To prevent and treat paronychia, it is important to keep the affected area clean and dry. For simple acute paronychia, drainage can be performed by elevating the eponychial fold and using a small blunt instrument to evacuate the pus. After drainage, the wound should be irrigated with a saline solution, and oral antibiotics may be prescribed for 5-7 days to prevent and treat infection.

In more severe cases of paronychia, oral antibiotics with gram-positive coverage against S. aureus, such as amoxicillin or clindamycin, may be administered. These antibiotics are often used in conjunction with warm water soaks to help reduce pain and swelling.

For nail puncture wounds, oral ciprofloxacin has been shown to be effective in treating foot infections, provided that surgery is performed first to drain any pus and address the underlying cause. Patients with recurring or chronic paronychia should be monitored closely to prevent potential superinfections or deep-seated infections.

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Reduce pain and swelling with ibuprofen or acetaminophen

Nail injuries can be extremely painful and may take a while to heal. In the case of a nail injury, it is important to first clean the wound and torn nail area with soap and warm water. Apply an antibiotic ointment and bandage. To reduce pain and swelling, ice the area and keep the injured area above the level of your heart. You can also take over-the-counter pain medication such as ibuprofen or acetaminophen.

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that helps reduce inflammation and acts as an analgesic to reduce pain. It is easily available over the counter and can be taken orally to help reduce pain and swelling in the injured area. Ibuprofen is typically taken every 4 to 6 hours, but it is important to follow the instructions on the packaging and not exceed the recommended dosage.

Acetaminophen, also known as paracetamol, is another effective over-the-counter medication for pain relief. It works by blocking pain signals from reaching the brain and can help manage the pain associated with a nail injury. Acetaminophen can be taken orally every 4 to 6 hours as needed for pain relief. However, unlike ibuprofen, acetaminophen does not help with swelling.

It is important to note that while these medications can help manage pain and swelling, they do not heal the injury itself. For a nail injury, the healing process can take several months, and the new nail may have grooves or ridges. During the healing process, it is important to keep the injured area clean and bandaged, changing the bandage daily. If there are signs of infection, such as pus, redness, or heat around the nail, it is important to seek medical advice promptly.

Frequently asked questions

Depending on the severity of the injury, you can treat a nail injury at home or seek medical attention. Apply ice wrapped in a cloth for 20 minutes every 2 hours on the first day, then 3 to 4 times a day after that. Keep your hand or foot above the level of your heart to reduce throbbing. Take prescription pain relievers or use ibuprofen or naproxen to reduce pain and swelling.

If your nail has sustained a cut or laceration, or if the nail and part of the nail bed have pulled away from the rest of the nail bed, seek medical attention. Your doctor may reattach the nail with special glue or stitches or replace it with a special type of material if it cannot be reattached. Antibiotics may also be prescribed to prevent infection.

It takes about 6 months or longer for a fingernail to grow back and up to 18 months for a toenail. With proper treatment, the rate of nail growth will eventually return to normal.

Nail injuries can occur when a heavy object crushes or hits the fingers or toes, resulting in a cut or piercing of the nail and nail bed. They can also occur due to severe or repetitive stubbing, wearing tight-fitting shoes, or fungal nail infection.

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