Noah Sinclair
Nail injuries are common and can usually be remedied at home. However, some require prompt medical attention to ensure the nail grows back smoothly. If you have a broken nail bed, you should not cut it. Instead, if a portion of the nail is still attached to the nail bed, you can leave it intact and gently remove the non-adhering portion with nail clippers. The nail bed should then be cleaned with a soapy washcloth and covered with an appropriate dressing.
| Characteristics | Values |
|---|---|
| Treatment | Bandages and ice packs can help treat these injuries. Antibiotic ointment can be applied to keep the dressing from sticking. |
| Healing Time | It takes about 7 to 10 days for the nail bed to heal. A new fingernail will take about 4 to 6 months to grow back, while toenails can take about 12 months. |
| Prevention | Keep nails short, wear well-fitting shoes, and limit time going barefoot. |
| Home Remedies | Use fingernail glue to reattach the broken part of the nail. Wash the nail with warm water, dry it, and soak it in warm water to soften it before applying glue. |
| Medical Treatment | Minor nail bed injuries often heal on their own. For more severe injuries, a doctor may make a small hole in the nail to drain blood. Stitches and special glue may be used to reattach the nail. Antibiotics may be prescribed to prevent infection. |
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What You'll Learn
Home remedies for nail bed injuries
Many nail bed injuries can be treated at home, but some require prompt medical attention to ensure the nail grows back smoothly. If you cannot bend your finger or toe, if blood covers more than half your nail, if your nail is black or purple, or if your injury is particularly painful, seek medical care.
If you have a mild nail injury, follow these tips from board-certified dermatologists:
- If any part of your nail is hanging off, gently trim away the part not connected to your skin.
- Gently clean the wound using soap and water.
- Apply ice (inside a cloth) for 20 minutes every 2 hours on the first day, then 3 to 4 times a day after that.
- Prop the arm or leg with the injured nail on pillows so the nail is higher than your heart to reduce swelling.
- Take ibuprofen or acetaminophen to relieve pain and reduce swelling.
- Protect your nail with a light dressing, such as an adhesive bandage or a small piece of gauze.
- File down any sharp ends so they do not catch on clothing or socks.
- Cover the nail bed with petroleum jelly or neomycin ointment and dress with a clean bandage.
- Keep your nails short to prevent further injury.
If you lose your nail, it will take about 7 to 10 days for the nail bed to heal. A new fingernail will take about 4 to 6 months to grow back, while toenails can take up to 12 months. The new nail will likely have grooves or ridges and may be misshapen.
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When to seek medical attention
If you have sustained a nail injury, it is important to assess the damage and determine whether medical attention is required. While many nail bed injuries can be treated at home, some may necessitate prompt medical care to ensure proper healing and smooth nail regrowth. Here are some guidelines on when to seek medical attention:
- If there is damage to the nail bed or adjacent tissues, such as the nail matrix or proximal nail fold, that could result in scarring, it is advisable to have a physician assess and repair the injury.
- In cases of severe subungual hematoma, where blood pools between the nail and the nail bed due to crushed or impacted fingers or toes, a doctor may need to drain the accumulated blood by making a small hole in the nail. This procedure is known as trephination.
- If the nail is torn or detached, and there is significant damage to the surrounding areas, a visit to a physician is recommended. Signs of infection, swelling, increasing pain, or pus that develop a few days after the injury indicate the need for immediate medical attention.
- If the nail bed and nail matrix are damaged, the nail may need to be removed and the area repaired by a doctor. Stitches may be used to repair lacerations to the nail bed, and the nail may be reattached if possible.
- When a fracture is suspected, an X-ray examination may be necessary to determine the extent of the injury and guide treatment. Antibiotics may also be prescribed to prevent or treat infections.
- If the nail is completely torn off, crushed, or there is bleeding beneath the nail, seek immediate medical attention to prevent infection and further injury.
- If the injury involves a large part of the nail or affects the nail bed, it is crucial to seek medical attention as soon as possible to prevent total nail loss and complications such as infections or ingrown nails.
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How to prevent nail bed injuries
Nail bed injuries are common and often occur when a heavy object crushes or hits the fingers or toes. Cuts from sharp objects can also cause nail bed injuries. To prevent nail bed injuries, you can take the following precautions:
- Keep your nails short to prevent them from being levered off the nail bed or running into the end of an athletic shoe.
- Wear well-fitting, roomy shoes to reduce damage to your nails.
- Limit the time you spend barefoot to reduce the risk of injury to your toenails.
- Avoid dangerous situations, such as running into furniture, to reduce the risk of crushing or cutting your nails.
- Maintain a well-rounded diet and good general health to help produce strong nails that are more resistant to injury.
If you do experience a nail bed injury, prompt treatment can help the nail bed heal properly and ensure that the broken nail grows back smoothly. Minor nail bed injuries often heal on their own, but more severe injuries may require medical attention. It is important to seek professional advice if you are uncertain about the severity of your injury.
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The healing process and timeline
Initial Care
If you have injured your nail bed, the first step is to provide initial care to the wound. This includes removing any jewellery from your hand or finger, as swelling may occur, which can make removal difficult later. Gently wash any cuts or scrapes with soap and warm water, and apply a bandage if needed. For more serious injuries, such as heavy bleeding or intense pain, seek medical attention immediately.
Managing Pain and Swelling
To manage pain and swelling, apply ice wrapped in a cloth to the affected area for 20 minutes every 2 hours on the first day, then 3 to 4 times a day thereafter. Keep your hand or foot elevated above the level of your heart to reduce throbbing. Over-the-counter pain medications such as acetaminophen, ibuprofen, or naproxen can also be taken to reduce discomfort.
Medical Treatment
If you experience a deep cut or laceration to the nail bed, you may require stitches or special glue to close the wound and reattach the nail. In some cases, the nail may not be able to be reattached, and a special type of material will be placed on the nail bed as it heals. Antibiotics may also be prescribed to prevent infection.
Nail Regrowth
After the initial healing process, which may take around 7 to 10 days, your nail should start to regrow. For fingernails, it typically takes about 4 to 6 months for a new nail to grow and replace the lost nail. Toenails usually take about 12 months to grow back. The new nail may have grooves, ridges, or misshapen areas, which could be permanent.
It is important to note that proper treatment is essential to ensure the nail bed heals correctly and the nail grows back smoothly. Full recovery can take 6 to 9 months, depending on the severity of the injury.
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Long-term effects on nail growth
A broken nail bed can have long-term effects on nail growth, and the severity of these effects depends on the extent of the injury and the treatment received. Here are some key points regarding the long-term impact on nail growth:
Regrowth Process: When a nail bed is damaged, the nail growth process is disrupted. Nails grow back from the nail matrix, the area at the base of the nail responsible for producing new nails. If the nail matrix is not affected by the injury, the nail is typically capable of regrowing. However, this regrowth process can take several months, depending on whether it is a fingernail or toenail.
Rate of Regrowth: The rate of nail regrowth may be impacted in the long term. While fingernails typically regrow in 3-6 months, and toenails in about 12 months, injuries that affect the nail bed can cause a slowdown in nail growth for about the first 3 months. This means that, during the initial stages of recovery, the nail may grow more slowly than it would have before the injury.
Appearance of the New Nail: The new nail that grows back after a nail bed injury may have a different appearance. It is common for the new nail to have grooves, ridges, or bumps, and it may be somewhat misshapen. In some cases, these defects can be permanent, resulting in a nail that looks different from how it did before the injury.
Scarring and Discoloration: Damage and scarring of the nail bed can lead to whitish changes in the appearance of the nail, known as onycholysis. This occurs when the nail plate lifts away from the nail bed. Minor surgical procedures may be able to improve the nail's appearance in these cases.
Nail Bed Repair: In cases where the nail bed is severely damaged, a doctor may need to repair the nail bed to facilitate proper nail regrowth. This can involve stitches, special glue, or synthetic material to protect and support the nail bed as the new nail grows. The type of repair depends on the extent of the injury and whether the nail can be reattached or needs to be replaced.
Prompt treatment and proper care of a broken nail bed injury are crucial for optimizing long-term nail growth and minimizing any permanent defects in the appearance of the nail. While most nails will regrow after an injury, the rate of growth and the appearance of the new nail may be impacted in the long term, depending on the severity of the initial injury.
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