Bruised Toenail: When to See a Doctor for Treatment?

Q: Bruised Toenail: When to See a Doctor for Treatment?

Hello： If you are experiencing a foul odor and are concerned about a possible infection, you can visit a major hospital's dermatology or general surgery outpatient clinic to assess whether nail removal and medication treatment are necessary. <br>Thank you!

Subungual hematoma, elevated?

Hello, doctor.
My husband injured his big toe over a month ago when a heavy object fell on it.
There was no open wound, but he has had severe bruising that hasn't gone away, and the toenail is lifting and looks like it might fall off soon.
Additionally, there is a foul odor coming from it! Should we go to a major hospital for treatment, or is a general clinic sufficient? Which specialist should we see, dermatology or surgery? Thank you!

Sharon, 30~39 year old female. Ask Date: 2015/09/23

Dr. Li Yufen reply Dermatology

Hello: If you are experiencing a foul odor and are concerned about a possible infection, you can visit a major hospital's dermatology or general surgery outpatient clinic to assess whether nail removal and medication treatment are necessary.
Thank you!

Reply Date: 2015/09/23

More Info

When dealing with a bruised toenail, especially one that has been subjected to significant trauma, it is crucial to monitor the situation closely. In your husband's case, the fact that the toenail has been bruised for over a month, is lifting, and is emitting an odor indicates that it may require medical attention. Here’s a detailed breakdown of the situation and recommendations for seeking treatment.

Understanding Bruised Toenails
A bruised toenail, medically known as a subungual hematoma, occurs when blood collects under the nail due to trauma. While minor cases may heal on their own, more severe cases can lead to complications, especially if the nail is lifting and there is a foul smell, which could indicate an infection.

When to See a Doctor
1. Persistent Symptoms: If the bruising has not improved after a month, it is advisable to seek medical attention. The prolonged presence of bruising suggests that the underlying issue may not be resolving on its own.

2. Nail Separation: The fact that the toenail is lifting is concerning. This can lead to further complications, including the risk of infection or permanent nail deformity.

3. Odor: The presence of a foul smell is a significant red flag. This could indicate an infection, which requires prompt medical evaluation and treatment.

4. Pain and Discomfort: Although you mentioned that there is no pain, any sudden changes in sensation or the development of pain should prompt immediate medical attention.

Where to Seek Treatment
Given the symptoms described, it would be best to visit a healthcare facility that can provide a thorough evaluation. Here are your options:
- General Practitioner or Family Doctor: If you prefer a more accessible option, starting with a general practitioner may be sufficient. They can assess the situation and refer you to a specialist if necessary.

- Podiatrist: A podiatrist specializes in foot and ankle conditions and would be well-equipped to handle issues related to toenails, including trauma and infections.

- Dermatologist: If the primary concern is the skin and nail condition, a dermatologist can provide specialized care for nail disorders.

- Emergency Room: If the situation worsens or if there are signs of severe infection (such as increased redness, swelling, or pus), visiting an emergency room may be warranted.

Treatment Options
Upon evaluation, the doctor may recommend several treatment options based on the severity of the condition:
1. Drainage: If there is a significant accumulation of blood under the nail, the doctor may need to drain it to relieve pressure and reduce the risk of further complications.

2. Antibiotics: If an infection is suspected or confirmed, antibiotics may be prescribed to treat the infection.

3. Nail Care: Depending on the condition of the nail, the doctor may recommend protective measures or even removal of the nail if it is severely damaged.

4. Follow-Up Care: Regular follow-up appointments may be necessary to monitor healing and ensure that no further complications arise.

Conclusion
In summary, given the symptoms your husband is experiencing—persistent bruising, lifting of the toenail, and an unpleasant odor—it is advisable to seek medical attention promptly. A visit to a podiatrist or a general practitioner would be appropriate, and they can guide you on the next steps for treatment. Early intervention can prevent complications and promote better healing outcomes.

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