A bleeding toenail often results from trauma like stubbing a toe or dropping an object. While many toenail injuries can be managed at home, understanding proper first aid and ongoing care is important for healing and preventing complications.
Immediate First Aid
Controlling bleeding is the first priority. Apply gentle, direct pressure to the injured area with a clean cloth or gauze for 10 to 15 minutes, or until bleeding stops. Elevating the injured foot above heart level helps reduce bleeding.
Once bleeding stops, clean the wound with mild soap and water for about five minutes to prevent infection. If any nail is partially detached or jagged, gently trim the disconnected portion with sterile scissors to prevent snagging. Do not pull off any nail still firmly attached.
After cleaning, check for foreign objects. If a subungual hematoma (blood under the nail) covers a quarter or more of the nail, or causes intense throbbing pain, medical attention may be needed to drain it. Apply antibiotic ointment and cover the toe with a sterile, non-adherent bandage.
Ongoing Care and Infection Prevention
After initial first aid, consistent care promotes healing and prevents infection. Change the dressing daily, or more frequently if it becomes wet or soiled. During changes, gently clean the area with mild soap and water, or a warm saltwater soak for 3-5 minutes to cleanse the wound and reduce inflammation. Thoroughly dry the foot before applying fresh antibiotic ointment and a new bandage.
Monitor the injured toe for signs of infection, including:
- Increased pain
- Swelling
- Redness
- Warmth
- Pus or discharge
Foul odor or red streaks also indicate infection. For pain, use over-the-counter pain relievers like acetaminophen or ibuprofen. A cold compress helps reduce swelling and discomfort.
Protect the injured toe during daily activities. Wear open-toed shoes or shoes with a wide toe box to prevent pressure. Avoid activities that might cause further trauma, like strenuous sports, until the injury fully heals, which can take weeks to months.
When to Seek Professional Help
While many toenail injuries are manageable at home, certain symptoms warrant medical attention. Persistent or heavy bleeding that doesn’t stop after 10-15 minutes of direct pressure requires professional evaluation. If pain is severe or throbbing and doesn’t subside, especially with a large subungual hematoma, a doctor can drain the blood to relieve pressure.
Seek medical care for clear signs of infection, such as:
- Worsening redness
- Swelling
- Increased pain
- Warmth
- Pus draining from the wound
A suspected fracture, indicated by a crooked, deformed, or severely painful toe to move or bear weight on, requires assessment. If the entire toenail has come off or is severely loose, or if there’s a deep cut or puncture wound under the nail, seek medical attention.
Individuals with underlying health conditions like diabetes, neuropathy, or compromised immune systems should consult a doctor for any toenail injury due to impaired healing and increased infection risk.