Managing a Torn Toenail: Pain Relief and Care Tips

Nail problems

Hello Dr.
Lee, I accidentally hit my big toe against the refrigerator door around 9 PM last night, causing half of the toenail to lift up, exposing the underlying tissue, but there was no bleeding.
The base and the right side of the nail are still attached.
After visiting the emergency room, the doctor determined that nail removal was not necessary, so they applied medication (an anti-inflammatory for wounds) and bandaged it.
I recall you mentioning that wounds should be kept dry, but after applying the medication, I have been experiencing continuous pain throughout the night until now (8 AM the next day), and I'm unsure if this is normal.
Should the wound be kept dry or should I continue to apply medication? Also, how long can I expect the pain to last? Thank you!

Shin, 20~29 year old female. Ask Date: 2021/09/21

Dr. Li Zhonghuai reply Surgery

Hello! Removing the toenail can make it easier to change the dressing, but it is also possible to leave it in place.
However, the recovery time for the old toenail to be pushed out is similar to that of directly removing it.
For dressing changes, use sterile saline solution and antibiotic ointment, and change the dressing daily.
Take care! Changhua Hospital cares about you!

Reply Date: 2021/09/21

More Info

Managing a torn toenail can be a painful experience, and it's important to take the right steps to ensure proper healing while minimizing discomfort. Based on your description, it sounds like you have a partially torn toenail that is still attached at the base and side, which is a common injury. Here are some tips for pain relief and care for your torn toenail.

Immediate Care and Pain Relief
1. Keep the Area Clean: It's crucial to keep the injured area clean to prevent infection. Gently wash the toe with mild soap and water, and pat it dry with a clean towel. Avoid soaking the toe in water, as this can soften the nail and increase the risk of further injury.

2. Apply an Antiseptic: After cleaning, apply an antiseptic ointment to the exposed area to help prevent infection. If your doctor prescribed a specific topical medication, follow their instructions.

3. Dress the Wound: Cover the toenail with a sterile bandage or gauze to protect it from further injury and keep it clean. Change the dressing daily or if it becomes wet or dirty.

4. Pain Management: Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help alleviate pain and reduce inflammation. Be sure to follow the dosage instructions on the package.

Dryness vs. Moisture
You mentioned that you read about keeping the wound dry. In general, keeping the area dry is important, but it should not be completely devoid of moisture. Here’s a balanced approach:
- Keep It Dry but Not Dehydrated: After applying antiseptic, allow it to dry before covering it. If you notice excessive dryness or cracking around the wound, you can apply a thin layer of ointment to keep the skin hydrated.

- Avoid Excessive Moisture: While it's important to keep the area clean, avoid soaking your foot in water (like in a bath or swimming pool) until the nail has healed, as this can lead to maceration of the skin and increase the risk of infection.

Healing Time and Expectations
The duration of pain and healing can vary depending on the severity of the injury. Generally, you can expect:
- Pain Duration: Pain from a torn toenail can last anywhere from a few days to a couple of weeks. If the pain worsens or does not improve after a few days, it may indicate a more serious injury or infection, and you should seek medical attention.

- Healing Time: The toenail itself may take several weeks to months to fully heal, depending on how much of the nail is torn and the overall health of your nail growth. If the nail is still attached and the injury is managed properly, it should heal without complications.

When to Seek Further Medical Attention
If you experience any of the following symptoms, you should contact your healthcare provider:
- Increased redness, swelling, or warmth around the toenail
- Pus or other drainage from the wound
- Severe pain that does not improve with over-the-counter medications
- Signs of infection, such as fever or chills
In conclusion, managing a torn toenail involves keeping the area clean, applying antiseptic, and using pain relief methods. It’s essential to monitor the injury for signs of infection and to follow up with your healthcare provider if symptoms worsen. With proper care, your toenail should heal effectively, and the pain should subside within a reasonable timeframe.

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