Noah Sinclair
Bending your fingernail backwards can cause a nail injury, which occurs when any part of your nail becomes injured, including the nail, nail bed, cuticle, and the skin around the sides of the nail. This can be extremely painful as our hands and fingertips have a very high density of touch and pain receptors. The injury can cause the nail to lift from its bed and may require medical attention.
| Characteristics | Values |
|---|---|
| Pain | Severe or throbbing |
| Nail discolouration | Black-and-blue, black-and-purple, red or purple, dark brown or black |
| Nail sensitivity | Very tender to the touch |
| Nail bed separation | Pressure from pooling blood may cause the hard part of the nail to lift up from the tissue underneath |
| Treatment | Drainage of blood trapped under the nail, antibiotics to prevent infection, stitches, special glue or a special type of material to reattach the nail |
| Healing time | 7-10 days for the nail bed to heal, 4-6 months for a new fingernail to grow, 12 months for a toenail to grow back |
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What You'll Learn
Bruising and bleeding under the nail
A subungual hematoma is the medical term for a bruise or bleeding under the nail. It occurs when blood collects under the nail plate, causing pain and swelling. This is usually the result of some kind of injury to the blood vessels under the nail bed, such as a heavy object crushing the finger or a door slamming on it. It can also be caused by repeatedly jamming the toes into a too-tight shoe. The first symptom of a subungual hematoma is throbbing pain in the nail area, followed by discoloration of the nail. The colour may initially look red or purple, but it will gradually turn dark brown or black as the blood clots.
If you have a bruised or bleeding nail, you should seek medical care if you have intense pain, a deep cut, uncontrollable bleeding, or a suspected broken bone. Your doctor will examine your nail and may perform an X-ray to check for a fracture or other injuries. For a large bruise, your doctor may create a small hole in the nail to drain the blood and relieve the pressure and pain. If the bone is broken or the bruise is very large, the nail may need to be removed and the nail bed repaired with stitches. The nail will then be reattached with special glue or more stitches.
In most cases, bruised fingernails and toenails heal without any complications and usually take six to nine months to grow out completely. However, the discolouration may still be visible for many weeks. To care for a bruised or bleeding nail at home, keep the area clean and dry, and elevate the affected finger or toe. You can also take over-the-counter anti-inflammatories to manage minor pain.
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Treatment for nail injuries
For more serious nail injuries, you should go to an urgent care center or the emergency room. They will stop the bleeding and clean the wound. Usually, the nail and finger or toe will be numbed with medicine before it is treated. For a larger bruise, your provider will create a small hole in the nail to allow blood and fluid to drain out and relieve the pressure and pain. If the bone is broken or the bruise is very large, the nail may need to be removed and the nail bed repaired. Part or all of the nail may be removed. Cuts in the nail bed will be closed with stitches. The nail will be reattached with a special glue or stitches. If the nail cannot be reattached, your provider may replace it with a special type of material. This will remain on the nail bed as it heals. Your provider may prescribe antibiotics to prevent infection. If you have a broken bone, your provider may need to place a wire in your finger to keep the bone in place.
To prevent another nail injury, keep your nails short so they do not bend or catch on objects. Make sure your shoes fit well and have a wide toe box to prevent rubbing, and wear the proper gear to protect your nails while playing sports.
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Nail fungus and infection
When a fingernail bends back, it can cause a lot of pain and discomfort. The nail bed is full of nerve endings, and any pressure or injury to the nail can cause these nerves to send pain signals to the brain. In some cases, the nail may even be torn away from the skin, leading to bleeding and potential infection.
Fungal nail infections, or onychomycosis, are a common occurrence, often developing slowly over time. They are characterised by discolouration, thickening, and distortion of the nail, which can become yellow, brittle, and crumbly. Toenails are more frequently affected than fingernails due to the warm, dark, and moist environment that fungi prefer.
Fungal nail infections can be spread in places like communal showers, locker rooms, and gyms, and they can also be transmitted from person to person. The fungi that cause athlete's foot are a common source of nail fungus. While fungal nail infections are usually not serious, they can be challenging to treat and may cause pain or discomfort, particularly when using or putting pressure on the affected toe or finger.
Treatment for fungal nail infections depends on the severity of the injury. Mild cases may not require any treatment, while more severe or painful infections may necessitate medical intervention. Oral antifungal medications are often the first line of treatment, and in some cases, nail removal may be recommended if other treatments have been ineffective. Laser treatment is another potential option, although it is not currently available on the NHS due to insufficient evidence supporting its routine use.
To prevent fungal nail infections, it is important to maintain good nail hygiene and avoid walking barefoot in places where fungal infections can easily spread. Keeping your nails clean, dry, and trimmed can help reduce the risk of infection. Additionally, treating any underlying conditions, such as athlete's foot, can lower the chances of developing a fungal nail infection.
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Permanent cosmetic changes to the nail
A nail injury can cause permanent cosmetic changes to the nail. For example, if the base of the nail or the nail bed is crushed, it may result in a permanent deformity. Additionally, if there is a broken bone or a large bruise, the nail may need to be removed and the nail bed repaired. This can result in the new nail having grooves or ridges and being somewhat misshapen, which may be permanent.
Nail abnormalities can also occur due to various conditions and medical issues. For example, koilonychia, also known as "spoon nails," is a condition where the nails are thin, curved inward, and have raised ridges, resembling spoons. This disorder is often associated with iron deficiency anaemia. Leukonychia refers to white streaks or spots on the nails, which can be caused by drugs or disease. Pitting, or small depressions on the nail surface, can be associated with psoriasis and alopecia areata. Ridges are tiny, raised lines that develop across or up and down the nail and can be caused by chronic picking or rubbing of the skin behind the nail, known as median nail dystrophy.
Long-term exposure to moisture or nail polish can cause nails to become brittle and peel. This can be a result of aging or certain medical conditions. Yellow nail syndrome is a condition where the nails thicken and turn yellow to yellow-green, with slower nail growth. It is often associated with lymphoedema and compromised respiration. Curved nails, or clubbing, can be a harmless trait that runs in families, but it can also indicate low oxygen levels in the blood.
In some cases, nail changes can be a sign of more serious medical conditions. Dark streaks on the nails can indicate subungual melanoma, a potentially deadly form of skin cancer. White nail syndrome, or leukonychia, can be a sign of arsenic poisoning. Additionally, certain antibiotics can cause lifting of the nail from the nail bed, and chemotherapy medications can affect nail growth.
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Preventing nail injuries
Nail injuries can occur when any part of the nail, including the nail, nail bed, cuticle, or surrounding skin, is damaged. These injuries can be painful and take several weeks to heal completely. Here are some tips to prevent nail injuries:
Keep Nails Short
One of the best ways to prevent nail injuries is to maintain short nails. Short nails are less likely to bend or catch on objects, reducing the risk of bending or tearing. Short nails are also more hygienic as they harbour less dirt and bacteria, which can lead to infections.
Wear Proper Footwear
Ensure your shoes fit well and have a wide toe box. Ill-fitting shoes can cause rubbing, leading to nail injuries. Proper footwear is especially important when playing sports to protect your nails from potential trauma.
Treat Injuries Promptly
If you do experience a nail injury, it's important to treat it promptly and properly. Minor injuries can often be managed at home with first aid measures such as cleaning the wound, stopping any bleeding, and covering the area with a light dressing. However, for more serious injuries, such as severe bleeding, large bruises, or broken bones, seek medical attention at an urgent care centre or emergency room.
Prevent Infections
Infections can complicate the healing process, so it's important to keep the injured nail clean and protected. Clean the area regularly with an antiseptic solution, such as peroxide, and apply a protective ointment, such as Neosporin, to prevent infection. Change the dressing regularly to keep the area clean and promote healing.
See a Dermatologist
If you have a nail injury that isn't improving or is causing ongoing pain or discomfort, consider seeing a board-certified dermatologist. They can help manage the injury, ensure proper healing, and address any underlying issues that may be contributing to the problem.
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Frequently asked questions
The hands and fingertips have a high density of touch and pain receptors, which is why bending a fingernail backwards can be extremely painful.
If your fingernail is injured, you should seek medical attention. In the meantime, you can apply ice to the affected area to reduce throbbing and keep your hand or foot above the level of your heart.
It takes about 7-10 days for the nail bed to heal, and a new fingernail will take about 4-6 months to grow back.
