Isla Bennett
Nail bed injuries are common and can occur when a heavy object crushes or hits the fingers or toes, or when a sharp object cuts them. The nail matrix, which consists of the germinal matrix and the sterile matrix, is the part of the body responsible for creating new nails. Certain injuries and illnesses can damage the nail matrix and affect how your nails look or grow. However, with proper treatment, healthy nails can usually grow back.
| Characteristics | Values |
|---|---|
| Treatment | Bandages, ice packs, antibiotics, stitches, synthetic nails, X-rays, trephination, antifungal pills, injections, topical treatments |
| Healing Time | 2 weeks to 9 months |
| Prevention | Wear properly sized shoes, keep nails trimmed |
| Complications | Infection, bone fracture, tissue tear, permanent cosmetic changes |
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What You'll Learn
Home treatment for nail bed injuries
A nail bed injury occurs when any part of your nail becomes injured. This includes the nail, nail bed (skin underneath the nail), cuticle (base of the nail), and the skin around the sides of the nail. It is usually caused by a heavy object falling on your finger, getting your finger caught in a doorway, or cutting it with a sharp object.
- Apply ice packs to help reduce pain and swelling.
- Bandage the injured nail to keep it protected and in place.
- Soak your finger or toe in cold water for 20 minutes after trimming the nail.
- Apply a thin layer of petroleum jelly, such as Vaseline, to keep the area moisturized and protected.
- Keep the nail bed dry, clean, and covered with a bandage until the nail has grown back.
- File any sharp edges of the nail to prevent further injury.
- Trim off any detached parts of the nail, being careful not to cut the healthy parts of the nail or the surrounding skin.
- Watch for signs of infection such as increasing heat, redness, pain, tenderness, swelling, or pus.
It is important to note that if there is a large amount of bleeding, the injury is severe, or there is a potential bone fracture, you should seek medical attention immediately. A doctor may treat the injury by draining blood from under the nail (a procedure called trephination), removing the nail, repairing the nail bed, providing stitches, or prescribing antibiotics.
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Medical treatment for nail bed injuries
A damaged nail bed can often grow back, but it may take anywhere from six to eighteen months for the nail to fully regrow, and the nail may still have ridges or bumps. The first step in treating a nail bed injury is to determine whether it requires medical attention or can be treated at home. Many nail bed injuries are minor and can be treated at home with remedies such as bandages and ice packs. However, some injuries require prompt medical attention to ensure that the nail bed heals smoothly and the nail grows back properly.
If you are uncertain whether your nail bed injury requires treatment, it is recommended that you speak to a doctor. Doctors can provide antibiotics to prevent infection and will check on the status of your tetanus injections. They may also request an X-ray to check for any bone fractures. In the case of severe subungual hematomas (bruising under the nail), doctors may treat the injury by making a small hole in the nail and draining the pooled blood, a procedure known as trephination. However, this method is not used if the nail is damaged. If the blood covers more than half of the nail bed, the doctor may remove the nail and repair the nail bed.
In some cases, the nail may be too badly damaged to be reattached. In these instances, the doctor may attach a synthetic nail, which will gradually be pushed forward as the new nail grows. If you lose your nail, it will take about seven to ten days for the nail bed to heal, and a new fingernail will typically take four to six months to grow back, while a toenail can take up to eighteen months. During this time, it is important to keep the area dry and clean to prevent infection. You can also apply petroleum jelly and cover the area with a bandage until the nail has grown back.
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Nail matrix damage
The nail matrix is the "factory" where your body makes new fingernails and toenails. It is located at the base of the nail and is responsible for producing the cells that form your nail. The nail matrix has two parts: the germinal matrix and the sterile matrix. The germinal matrix is responsible for about 90% of nail production, giving a natural curvature to the nail. The remaining 10% of cells that make up your nails come from the sterile matrix, which is more important for keeping your nail attached to the underlying skin.
Injuries and certain health conditions can damage your nail matrix and affect how your nails look or grow. Trauma to the nail can cause nail cell production to stop for up to three weeks, and severe trauma, such as crushing injuries or deep cuts, may result in long-term or permanent damage if the nail matrix is significantly injured. If the nail matrix is damaged, it may lead to visible changes in the nail as it grows out, including thickening, ridging, discoloration, or a rough texture. In rare cases, severe damage to the nail matrix can result in complete and permanent nail loss.
However, it is rare for the nail matrix to be permanently damaged, and with proper medical care, healthy nails will often grow back. Treatment for nail matrix damage depends on the cause and may include medication, relieving nail injuries, or surgical procedures in severe cases. After an injury, it is common for nails to show temporary changes as they heal, such as bruising, ridges, or a rough surface. These typically resolve over time as the damaged nail grows and new, healthy cells replace the affected area.
If you notice any changes to your nails, it is important to seek medical advice to determine the underlying cause and receive appropriate treatment.
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Subungual haematoma
A subungual haematoma is a type of nail bed injury in which bleeding occurs under the nail, causing pain and discolouration. It is usually caused by a direct blow or crush injury to the distal phalanx, such as getting a finger pinched in a doorway or a heavy object falling on the fingers or toes. The blood pools under the nail, creating painful pressure on the nail bed. This pressure can be relieved through a procedure called trephination, which involves making a small hole in the nail to drain the blood. This can be done with a hot metal implement, a heated wire (electrocautery device), a carbon laser, or a large needle. If the nail is severely damaged, it may need to be removed and the nail bed surgically repaired.
Trephination is not always necessary, as some small subungual haematomas can be treated at home with ice and over-the-counter anti-inflammatories. However, if there is a fracture or serious damage to the nail bed or surrounding tissues, medical attention should be sought immediately. It is also important to rule out other possible causes of discolouration if there has been no injury.
The nail matrix is the part of the nail where new nails are produced. While it is rare for the nail matrix to be permanently damaged, certain injuries or conditions can affect how the nails grow or look. With proper treatment, healthy nails can usually grow back, although this may take up to 6-9 months for fingernails and up to 18 months for toenails. In some cases, the new nail may grow back with small ridges or bumps.
To ensure proper healing and smooth nail growth, professional treatment is recommended. Doctors may attach a synthetic nail to protect the nail bed as the new nail grows. Antibiotics may also be prescribed to prevent infection.
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Toenail vs fingernail recovery time
Toenails and fingernails can be damaged in a variety of ways, including through crushing or cutting injuries, or by being torn or detached from the nail bed. Nails grow at a rate of about one-tenth of an inch per month, but the speed of recovery from an injury will depend on the severity of the damage.
If a nail separates from the nail bed, it will not reattach, and a new nail will have to grow back in its place. Fingernails typically take between four and six months to grow back, while toenails can take up to 12 to 18 months to fully regrow. Nails that have sustained injuries affecting the nail bed and matrix will grow more slowly for about three months.
The nail matrix is the "factory" where new nails are made. Most nail injuries affect the nail bed, nail plate, or nail folds, but not the nail matrix. In many cases, the nail matrix will heal with proper care, and healthy nails will grow again. However, if the nail matrix is damaged, the growing nail plate will contain a defect. Minor damage will produce minor defects, while more significant damage can result in a permanently deformed nail.
To treat a nail injury, you should apply ice wrapped in a cloth for 20 minutes every two hours on the first day, then three to four times a day after that. You can also take prescription pain relievers or over-the-counter medication such as ibuprofen or naproxen to reduce pain and swelling. If you have a bruise under your nail, a doctor may perform a procedure called trephination to drain the trapped blood, providing pain relief and helping the new nail to grow in correctly. Antibiotics may also be necessary to prevent infection.
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Frequently asked questions
A nail bed injury occurs when a heavy object crushes or hits the fingers or toes or when a sharp object cuts them.
Depending on the severity of the injury, you can treat it at home or seek professional medical attention. Home treatment may involve bandages, ice packs, and trimming off any detached nails. Doctors may treat more severe injuries with antibiotics, stitches, and in some cases, surgery.
In most cases, a new nail will slowly grow back, but it may take up to 6-9 months for fingernails and up to 18 months for toenails. Proper treatment can help ensure that the nail bed heals appropriately and the new nail grows back smoothly.
