A broken toenail, often caused by trauma like stubbing a toe or dropping a heavy object, can range from a minor crack to a complete separation from the nail bed. Immediate goals are to stabilize the area and prevent contamination. This guidance outlines the process of initial care, ongoing maintenance, and knowing when to seek professional medical attention to ensure a healthy recovery.
Immediate First Aid and Cleaning
Control bleeding by applying gentle, direct pressure with a clean cloth or gauze for several minutes. Elevating the foot above the heart can also slow blood flow and reduce throbbing. Once bleeding stops, thoroughly clean the area to remove any dirt or debris introduced by the trauma.
Gently wash the injured toe using mild soap and lukewarm water to sanitize the wound and surrounding skin. If the nail is partially detached and snagging, carefully trim the unattached portion with sterile nail clippers, cutting along the line of the tear. Leave any part of the nail still firmly connected to the nail bed in place, as it provides a natural protective layer over the sensitive tissue beneath.
Managing the Injury at Home
After cleaning, protect the exposed nail bed with a non-stick dressing to maintain a barrier against bacteria and irritation. Apply a thin layer of antibiotic ointment or petroleum jelly to the wound before covering it with a non-stick pad and securing it with a bandage. Change the dressing daily, or immediately if it becomes wet or soiled, to keep the area clean and dry.
To manage discomfort and swelling, over-the-counter pain relievers like ibuprofen or acetaminophen can be taken as directed. For the first 48 hours, applying an ice pack wrapped in a thin towel for up to 20 minutes every few hours can reduce inflammation. Protect the injured toe from further impact by wearing loose-fitting or open-toed footwear initially.
Soaking the foot in warm water with Epsom salts for 10 to 15 minutes a couple of times a day can help keep the wound clean and temporarily ease pain. This maintains hygiene and softens any crusting. Following a soak, carefully pat the toe completely dry before applying a fresh layer of ointment and a clean, non-stick bandage.
Understanding the Recovery Process
Toenail recovery is a long process because toenails grow slowly, typically taking six months to a full year for complete regrowth. During healing, the sensitive nail bed beneath the lost portion gradually hardens. The remaining attached nail will eventually lift and detach as the new nail grows forward from the cuticle.
The new nail may initially appear thicker, ridged, or slightly deformed due to trauma to the nail matrix, where the nail originates. Monitoring the toe for complications is important. A fungal infection may develop in the separation space, often indicated by a thickened, discolored, or crumbly texture in the new growth.
An ingrown nail is another possible complication, occurring when the new nail edge grows into the surrounding skin, causing redness and pain. Prevent this by maintaining proper trimming technique: cut the nail straight across and avoid rounding the corners as the nail lengthens. The new nail must grow to the very end of the toe before full protection is restored.
When Professional Medical Care is Required
While many broken toenails can be managed at home, certain signs indicate the need for immediate consultation with a doctor or podiatrist. Severe bleeding that does not stop after 10 to 15 minutes of continuous pressure suggests a deeper laceration that may require stitches.
Any sign of a developing infection warrants professional evaluation, including:
- Increasing redness or swelling
- Persistent throbbing pain
- Pus or a foul odor draining from the wound
- Red streaks extending away from the toe
If the nail is broken deep into the cuticle area (the nail matrix) or if the injury prevents bearing weight on the foot, see a physician promptly. A large collection of blood under the nail, known as a subungual hematoma, covering more than a quarter of the surface, may need professional draining to relieve painful pressure. People with conditions affecting circulation or wound healing, such as diabetes, should seek medical advice for any toenail injury.