A broken toenail occurs when the nail plate is damaged, often appearing as a crack, chip, or partial detachment. This common injury often results from direct trauma, such as stubbing a toe or dropping a heavy object. Ill-fitting shoes causing repetitive friction can also lead to damage. While often minor, proper care is important to prevent complications like infection or permanent nail deformity.
Immediate Steps After Injury
After a broken toenail, first clean the injured area gently with mild soap and water to minimize infection risk. If bleeding occurs, apply direct, gentle pressure with a clean cloth or gauze for about 10 minutes, or until it stops. Elevating the injured foot above heart level can also help reduce bleeding.
For pain relief, apply a cold compress or ice pack wrapped in a thin towel to the affected toe for up to 20 minutes at a time, every 3 to 6 hours. Over-the-counter pain relievers, such as ibuprofen or naproxen, can help manage discomfort and reduce swelling. To protect the nail from further injury and keep the wound clean, cover the area with a sterile, non-stick dressing or bandage, changing it daily and whenever it gets wet. If any part of the nail is loose, carefully trim it with clean clippers to prevent catching, smoothing jagged edges with a nail file.
Ongoing Care for Healing
Continued care is important as the toenail heals, a process that can take weeks to months. Maintain a clean and dry environment for the injured toe; gently wash the area with clean water twice a day after the first 24 to 48 hours, avoiding scrubbing or soaking. Applying a thin layer of petroleum jelly and covering with a non-stick bandage can help protect the exposed nail bed and promote healing, changing as needed.
Protecting the nail from further injury is important during recovery. Wear appropriate footwear, such as open-toed or loose shoes, to prevent pressure on the affected toe. Avoid tight shoes. As the new nail grows, trim it carefully, cutting straight across and avoiding cutting too short or curving the edges. Toenails grow slowly, with a new toenail taking 12 to 18 months to fully grow back. Monitor the area for signs of improvement or issues.
When Professional Medical Help is Needed
Specific situations warrant professional medical evaluation for a broken toenail. Signs of infection, such as increased redness, swelling, pus, increased pain, or fever, indicate medical attention is needed. Severe pain that persists or worsens despite home care, or significant throbbing, also suggests a medical consultation.
A large subungual hematoma (blood pooling under the nail), especially if it covers more than a quarter of the nail plate or causes intense pain, should be evaluated by a doctor. A doctor may need to drain the blood to relieve pressure and prevent complications. Complete nail avulsion (where the entire nail is detached), or suspicion of an underlying bone fracture or deep laceration, requires prompt medical attention. A toe that appears crooked or deformed after the injury may indicate a fracture.