Best Practices for Managing a Fallen Toenail: Expert Advice

Nail loss

Hello, doctor.
My toenail (the little toe) has naturally fallen off, but there is still a layer of nail attached to the skin.
Currently, I am covering it with breathable tape to avoid bumping it, but I am also concerned about the risk of infection.
What would you recommend as the best course of action? Thank you, doctor.

Peggy, 20~29 year old female. Ask Date: 2021/06/17

Dr. Li Zhonghuai reply Surgery

Hello! If you have a bruise from a bump and the nail has naturally fallen off, you can directly expose the new nail bed to tap water if it is dry underneath.
If it is still moist, it indicates that the new nail bed membrane has not fully developed yet.
Wait until it dries out and no longer oozes before exposing it to tap water.
Take care! Changhua Hospital cares about you!

Reply Date: 2021/06/17

More Info

When dealing with a fallen toenail, especially when part of the nail remains attached to the skin, it is important to take appropriate steps to promote healing and prevent infection. Here are some best practices for managing this situation:
1. Keep the Area Clean: The first step is to ensure that the area is clean. Gently wash the toe with mild soap and water. Avoid using harsh chemicals or scrubbing too hard, as this can irritate the skin further.

2. Assess the Condition: Examine the toe for any signs of infection, such as increased redness, swelling, warmth, or discharge. If you notice any of these symptoms, it may be necessary to consult a healthcare professional.

3. Protect the Toenail: Since you are already using breathable tape to protect the area, continue doing so. This will help shield the exposed nail bed from trauma and reduce the risk of infection. Make sure the tape is not too tight, as this can restrict blood flow.

4. Avoid Picking or Pulling: It is crucial not to attempt to pull off the remaining part of the nail. This can cause pain and increase the risk of infection. If the nail is loose, it may eventually fall off on its own.

5. Moisture Control: Keeping the area dry is essential. If you notice excessive moisture, consider using a non-adherent dressing that allows for airflow while keeping the area dry.

6. Pain Management: If you experience pain, over-the-counter pain relievers such as acetaminophen or ibuprofen can help alleviate discomfort. Always follow the recommended dosage on the label.

7. Monitor for Infection: Keep an eye on the toe for any signs of infection. If you notice increased pain, swelling, or discharge, or if you develop a fever, seek medical attention promptly.

8. Consult a Healthcare Professional: If the toenail does not heal properly, or if you have concerns about the healing process, it is advisable to consult a podiatrist or healthcare provider. They can assess the situation and may recommend treatments such as topical antibiotics or, in some cases, nail removal if necessary.

9. Follow-Up Care: Once the toenail has fully healed, consider practicing good foot hygiene to prevent future issues. This includes trimming nails straight across, wearing well-fitting shoes, and keeping feet dry and clean.

10. Consider Underlying Conditions: If you have underlying health conditions such as diabetes or peripheral vascular disease, it is particularly important to monitor foot health closely. These conditions can impede healing and increase the risk of complications.

In summary, managing a fallen toenail requires careful attention to cleanliness, protection of the area, and monitoring for signs of infection. If you have any concerns or if the situation does not improve, do not hesitate to seek professional medical advice. Taking these steps can help ensure a smooth recovery and prevent further complications.

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