Dealing with a Bruised Toenail: When to Remove and How Long to Heal

Bruising and shedding of the thumbnail?

Hello Doctor, three months ago I injured my left big toe by wearing shoes that were too small.
When I got home, I noticed that the entire nail had turned black.
After three months, there is still a portion of the nail attached to the nail bed, but it hasn't fallen off yet.
I can see that the new nail has only grown a little from the base (about 0.5 cm in length).
Should I remove the loose part of the nail? How long will it take for the new nail to fully grow out? Thank you, Doctor.

Xiao Xuan, 20~29 year old female. Ask Date: 2015/06/28

Dr. Wu Yuxin reply Dermatology

If there is only a small connection left, it is recommended to remove it.
Full regrowth may take approximately 6 to 12 months.

Reply Date: 2015/06/28

More Info

Dealing with a bruised toenail can be quite uncomfortable, and it's important to approach the situation with care. From your description, it sounds like you have experienced a subungual hematoma, which is a collection of blood under the toenail due to trauma. This can cause the nail to appear black and can be quite painful. Here’s how to handle your situation:

When to Remove the Toenail
1. Assess the Condition of the Nail: If the toenail is partially detached but still attached at the base, it’s generally advisable to leave it in place. The nail bed underneath is sensitive and can be prone to infection if exposed. If the nail is completely detached or if there is significant pain, it may be necessary to remove it.

2. Signs of Infection: If you notice any signs of infection, such as increased redness, swelling, warmth, or discharge, you should seek medical attention. An infected nail bed can lead to more serious complications.

3. Consult a Healthcare Professional: It’s always best to consult with a podiatrist or a healthcare provider before making a decision to remove the nail yourself. They can provide a proper assessment and determine whether removal is necessary.

How to Care for the Bruised Toenail
1. Keep It Clean and Dry: Ensure that the area is kept clean to prevent infection. You can gently wash the toe with soap and water, and then pat it dry.

2. Pain Management: If you are experiencing pain, over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate discomfort.
3. Protect the Nail: If the nail is still partially attached, consider using a bandage to protect it from further injury. Avoid tight shoes that could exacerbate the problem.

Healing Time
1. Nail Growth Rate: Toenails typically grow at a rate of about 1 millimeter per month. Given that your new nail has only grown about 0.5 cm in three months, it may take several more months for the new nail to fully grow out and replace the damaged one. Depending on the extent of the damage, it could take anywhere from 6 months to a year for the toenail to completely grow back.

2. Monitoring Progress: Keep an eye on the growth of the new nail. If it appears healthy and is growing, that’s a good sign. If you notice any abnormalities, such as discoloration or changes in texture, consult a healthcare professional.

Conclusion
In summary, do not rush to remove the toenail unless it is necessary and you have consulted a healthcare professional. Monitor the growth of the new nail and maintain proper hygiene to prevent infection. If you have any concerns about the healing process or if the condition worsens, it’s crucial to seek medical advice. Remember, patience is key when it comes to nail recovery, and taking the right steps can help ensure a smooth healing process.

Similar Q&A

Managing Nail Issues After Trauma: When to Seek Dermatological Help

Hello, Doctor: At the beginning of August, I developed a bruise on the right side of my right big toe due to wearing shoes that were too small and standing for a long time. It is currently not painful but appears as a black bruise. Today, while trimming my nails, I accidentally c...

Dr. Wu Yuxin reply Dermatology
In principle, no treatment is necessary; however, if the separation is too severe and leads to nail loss, regrowth may take approximately 5 to 6 months.

Managing Bruised Toenails: When to Seek Treatment After Injury

About a month ago, my big toe and second toe were injured by a weight. I went to the emergency room for an X-ray, which showed no issues, and the pain has gradually subsided during recovery. However, my big toenail currently has a large bruise covering about two-thirds of it. Sho...

Dr. Wu Yuxin reply Dermatology
Generally speaking, as long as there is no pain and the nail is not unstable or wobbly, there is no need for special treatment; it can be allowed to heal on its own.

Managing Bruised Toenail Pain: Home Remedies and When to Seek Help

Yesterday, my big toe was hit by something, and there is a bruise from the base of the nail to about one-third of the nail. It has been throbbing painfully all night, making it hard to sleep. I looked online and found that the options are either to drain it or to remove the nail....

Dr. Li Zhonghuai reply Surgery
Hello! If the nail is not loose, there is no need for removal. Take pain relievers and avoid contact with tap water for now. Wait for the blood clot to gradually push out with the nail. If you are still concerned, please visit a clinic for medical attention. Take care! Changhua H...

Injury to the Big Toe: Bruising, Pain, and Treatment Options

A few days ago, I accidentally stubbed my toe against a wall while practicing, and my shoes were also ill-fitting. As a result, my big toe is completely bruised, and there are bruises on the skin next to the nail. It hurts from time to time, and it even hurts to walk. Should I go...

Dr. Ke Fangxu reply Surgery
If there is subungual hematoma caused by trauma without pain or swelling, it is acceptable not to remove the toenail. If there is swelling but no infection, simple aspiration and drainage are sufficient. However, if there are signs of infection such as redness, swelling, and heat...