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Nail Problems and Injuries

Nail Problems and Injuries

Topic Overview

Minor fingernail and toenail problems are common. At one time or another, almost everyone has caught a nail on something, causing it to rip, or has smashed a finger in a door, leaving blood under the nail. These kinds of injuries can be quite painful but are usually not serious. You can often relieve pain and prevent infection of minor nail problems at home.

Normally, fingernails grow about one-tenth of a millimeter each day. Toenails grow at about one-half or one-third the rate of the fingernails. Aging and diseases that decrease blood flow to the hands and feet may slow nail growth.

Common nail changes include:

  • Splitting, peeling, or brittle nails. These are common problems that develop when your hands are frequently exposed to water, strong soaps, and other chemicals. You may be able to prevent some of these problems if you use lotion and avoid repeatedly putting your hands in water.
  • Color changes.
    • Little white marks (leukonychia) often appear after minor injuries. They may last for weeks or months and usually go away on their own.
    • It is common for a nail to turn black after an injury. The black or purple-black color is caused by blood under the nail and will go away as the injury heals.
    • Black, brown, or purple discoloration under a nail that has not been injured may be caused by melanoma .
  • Changes in the shape or texture of nails, which may occur for a variety of reasons. Some nail changes, such as the formation of ridges, are normal with aging. Thick, brittle, or dark nails are more common in older adults who have poor circulation.
  • Ingrown nails , which are often caused by improper trimming, tight shoes, or heredity. Your nails may grow into the surrounding skin, causing pain, swelling, and infection . In rare cases, an abscess may develop under a nail (subungual abscess).
  • Separation from the nail bed. Once your nail separates from its nail bed, for whatever reason, it will not reattach. Nails grow back slowly. It takes about 6 months for fingernails and up to 18 months for toenails to grow back attached to the nail bed.
  • Infection and allergic reactions. These are common problems caused by artificial nails.
  • Fungal nail infections , which can vary in appearance depending on the type of fungus infecting the nail or the location of the infection. It is not unusual for fungal nail infections to follow athlete's foot infections. For more information, see the topic Fungal Nail Infections.

Nail problems can also be caused by:

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

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Home Treatment

Home treatment can help relieve pain, prevent infection, and promote healing. To relieve pain from an injury to the nail, try the following:

Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever pain:

Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips
Be sure to follow these safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

Prevention

To prevent common nail problems:

  • Apply hand cream frequently throughout the day. Be sure to massage the cream into the nail and cuticle.
  • Wear gloves when you are working in your garden or when the weather turns cold.
  • Wear cotton-lined rubber gloves or disposable plastic gloves to protect your hands from overexposure to water, detergents, and other chemicals.
  • Trim your fingernails weekly, after bathing, when they are softer.
    • Do not trim nails too short.
    • Use an emery board and sharp manicure scissors or clippers to trim your fingernails. Nails that are smooth and well-cared for are less likely to become damaged.
  • Trim toenails monthly , after bathing.
    • Cut them straight across and leave the nails a little longer at the corners so that the sharp ends don't cut into your skin.
    • If you have a chronic disease, such as diabetes , peripheral arterial disease , or a disease that causes problems with your immune system , discuss with your doctor the best way to trim your toenails before trimming them yourself.
  • Be especially careful when trimming your baby's nails.
  • Avoid trimming your cuticles. Even a minor cut alongside your nail can cause infection.
  • Do not bite or pick at your nails.

To prevent a fungal nail infection:

  • Keep your feet clean and dry. Dry feet are less likely to become infected. Apply powder to your feet when needed.
  • Wear clean, dry socks. Change your socks once a day or more frequently if they become wet.
  • Wear roomy shoes that allow air to circulate around your feet.
  • Wear shower sandals or shower shoes when you use public pools, spas, and showers.

To prevent problems with artificial nails:

  • Test for a reaction to the artificial nail by having just one nail applied. Wait several days to see whether redness, itching, pain, or rash around or under the nail or separation of the nail from the nail bed develops.
  • Do not apply an artificial nail if the nail or the skin around the nail looks irritated or infected.
  • If an artificial nail does separate from the nail bed, dip your fingertip into rubbing alcohol for 15 seconds before reattaching the artificial nail. This will clean the space between the nails.
  • Do not wear artificial nails for longer than 3 months at a time. Give your natural nails a month to rest before reapplying artificial nails.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • When did your nail problem begin?
  • Was there an injury?
  • Have you had a nail problem like this in the past? If so, how was it treated?
  • Did you try any home treatment? If so, what? Did it help?
  • Has anything improved your nail problem or made it worse?
  • Are you taking any medicines?
  • Do you have any health risks?

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Last Revised October 7, 2012

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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