A broken nail that bleeds is a common and painful injury that exposes the sensitive tissue beneath the nail plate. This trauma requires immediate and proper care to prevent infection and promote healthy healing. Understanding the correct first aid steps is important for managing the injury effectively, from controlling the initial bleeding to knowing when a doctor’s visit is necessary. This guide offers a practical, step-by-step approach to treating this injury at home.
Immediate Steps to Control Bleeding
The first priority is to stop the flow of blood from the nail bed, which is highly vascular and can bleed profusely. You should immediately apply direct, continuous pressure to the injured area using a clean, non-fluffy cloth or a sterile gauze pad. Sustain this firm pressure for several minutes to allow the natural clotting process to begin.
While maintaining pressure, gently elevate the injured hand or foot above the level of the heart to help reduce blood flow to the extremity and limit initial swelling. Reducing the hydrostatic pressure assists in slowing the bleeding. Make a quick assessment of the break, noting if the nail is cleanly detached or if a partially attached fragment remains.
If the bleeding is minor, it may cease within a few minutes of applying pressure and elevation. If the blood flow soaks through the cloth, do not remove the first layer; instead, place another clean pad on top and continue the sustained pressure. If bleeding persists despite ten minutes of continuous, firm pressure, the injury may be deep enough to require professional medical attention.
Cleaning and Protecting the Injured Area
Once the bleeding is controlled, the next focus is hygiene to reduce the risk of bacterial infection in the exposed nail bed. Carefully wash the injured area with warm water and a mild soap, gently rinsing away any debris or foreign material. The goal is to clean the wound thoroughly without scrubbing the sensitive tissue beneath the nail.
If there are any jagged edges or loose fragments of the remaining nail plate, carefully trim them away using sterile nail scissors or clippers. Removing these pieces prevents them from catching on objects, which could cause additional tearing or trauma to the nail bed.
After cleaning, apply a thin layer of over-the-counter antibiotic ointment or sterile petroleum jelly directly to the exposed nail bed. This application helps keep the wound moist, which is beneficial for healing and prevents the dressing from sticking to the delicate tissue. The injury should then be covered with a non-stick sterile bandage or a specialized finger wrap to provide a protective barrier.
Managing Pain and Swelling
Pain and throbbing often accompany a broken, bleeding nail due to exposed nerve endings and localized inflammation. To manage this discomfort, take over-the-counter pain relievers, such as acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen. NSAIDs also help reduce inflammation and swelling in the surrounding soft tissues.
Applying a cold compress or ice pack, wrapped in a thin towel, to the injured area can help constrict blood vessels and reduce localized swelling. Apply the ice for about 20 minutes at a time, with at least an hour break between applications, to avoid skin damage.
Recognizing When Professional Care Is Needed
While many nail injuries can be managed at home, certain signs indicate the need for prompt medical evaluation. Seek professional care if the bleeding is profuse and does not stop after ten minutes of continuous pressure and elevation. Deep or large lacerations across the nail bed or surrounding skin may require stitches to heal properly.
A large collection of blood under the nail, known as a subungual hematoma, that covers more than a quarter of the nail plate should be examined by a doctor. This blood can cause intense, throbbing pain due to pressure, and a medical professional may need to drain it through a small hole in the nail.
A doctor should also evaluate the injury if the affected finger or toe is visibly deformed or if you are unable to move the joint normally, which could signal a fracture. Watch for signs of developing infection in the days following the injury, such as increased redness spreading away from the wound, warmth, pus drainage, or a fever. A doctor can assess the extent of the damage to the nail matrix and determine if a tetanus booster is necessary based on your vaccination history.