What is a nail injury?
A nail 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.
An injury occurs when the nail is cut, torn, smashed, or bruised, or the nail is torn away from the skin.
How common is a nail injury?
A nail injury is extremely common. It can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.
What are the symptoms of a nail injury?
There are five categories of injury that can occur to the nail. Often, a combination of these injuries occurs in the same nail.
- A subungual hematoma (nail bruise) is a collection of blood under the nail. It is usually a red or purple color, which fades to blue over a few weeks. The entire finger or toe throbs and is painful to touch or even move through the air. A nail bruise may occur by itself, or it can be seen in combination with other nail injuries.
- A nail laceration can refer to a cut through the nail, to the nail bed, to the cuticle or lateral nail folds, or any combination of these. There is always blood visible on the skin. The nail can appear quite mangled depending on the type of injury.
- A fingertip amputation means that a portion of the fingertip, including part or all of the nail, has been removed from the rest of the finger. Bone may or may not be visible.
- A nail avulsion occurs when a portion of the nail is lifted off the nail bed or is sticking out of the skin at the base of the nail (the cuticle). There is usually blood visible. This is often associated with a laceration.
- A fracture of the bone under the nail can also be associated with injuries to the nail, particularly with crushing injuries. This is called a distal tuft fracture. Unless there is an obvious bend (deformity) in the end of the finger, an x-ray will be needed to make this diagnosis.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
Also, you will help from a doctor if:
- Redness, pain, or swelling increases
- Pus (yellow or white fluid) drains from the wound
- You have a fever
- You have bleeding that does not stop
What causes a nail injury?
Most injuries to the nail arise from one of these three mechanisms:
- Crushing forces, such as hammers, doors slamming on fingers, human bites, or machinery
- Slicing or cutting, such as knives, box cutters, or machinery
- Tearing or ripping, such as stubbing a toe or catching a fingernail on an object
What increases my risk for a nail injury?
Please discuss with your doctor for further information.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is a nail injury diagnosed?
The doctor will make a detailed examination of the hand or foot and the injured nail and decide the extent of treatment and repair necessary by performing the following procedures.
- The doctor will want to know exactly how the injury occurred to determine possible injuries and if the wound is contaminated (especially if it is from a bite).
- The doctor will ask about other medical problems, medications, allergies, and the date of your most recent tetanus shot.
- Your pulse and blood pressure will be checked.
- Possibly, an x-ray of the hand or foot will be taken.
- Blood tests are not usually required.
How is a nail injury treated?
Mild cases of nail injuries
You may be able to care for a nail injury at home if you can stop the bleeding quickly and:
- The nail is not cut or torn and is still attached to the nail bed
- You have a nail bruise that is less than one fourth the size of your nail
- Your finger or toe is not bent or misshapen
To care for your nail injury:
- Remove all jewelry from your hand. Apply soap, if needed, to help rings slip off your fingers. If you cannot remove a ring because your finger is swollen, call your health care provider.
- Gently wash any minor cuts or scrapes.
- Apply a bandage if needed.
Server cases of 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.
Nail bed injuries:
- For a larger bruise, your provider will create a small hole in the nail.
- This will allow 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.
Nail lacerations or avulsions:
- 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.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage a nail injury?
The following lifestyles and home remedies might help you cope with a nail injury:
- Apply ice for 20 minutes every 2 hours on the first day, then 3 to 4 times a day after that.
- To reduce the throbbing, keep your hand or foot above the level of your heart.
- Take prescription pain relievers as directed. Or you can use ibuprofen or naproxen to reduce pain and swelling. Acetaminophen helps with pain, but not swelling. You can buy these pain medicines without a prescription.
- Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past.
- DO NOT take more than the amount recommended on the bottle or by your provider.
- Follow your provider’s recommendations to care for your wound.
- If you have an artificial nail, it should stay in place until your nail bed heals.
- If your provider recommends it, change the dressing every day.
- If your provider says it is OK, you can apply a small amount of antibiotic ointment to keep the dressing from sticking.
- You may be given a splint or special shoe to help protect your nail and finger or toe as they heal.
- Often, a new nail will grow in and replace the old nail, pushing it off as it grows.
Getting active again
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 to replace the lost nail. Toenails take about 12 months to grow back.
The new nail will probably have grooves or ridges and be somewhat misshapen. This may be permanent.
If you broke a bone in your finger or toe along with the nail injury, it will take about 4 weeks to heal.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Nail injuries https://medlineplus.gov/ency/patientinstructions/000800.htm Accessed October 27, 2017
Nail Injuries https://www.emedicinehealth.com/nail_injuries/page5_em.htm#what_are_the_home_remedies_for_nail_injuries Accessed October 27, 2017
Review Date: October 27, 2017 | Last Modified: October 30, 2017