Nail and cuticle trauma is a leading cause of misshapen nails or nail loss. Common ways that nails can be damaged include:
- Nail biting or tearing
- Improper trimming
- Wearing ill fitting shoes
- Acute physical trauma, eg. slamming a nail in a door
About nail trauma
Severe sudden trauma can cause the nail to split and eventually fall off. It can also lead to a subungual hematoma. This is where a is a large amount of blood is trapped beneath the nail. This can be very painful.
It is beneficial to understand the different regions of the nail to learn the seriousness of any sort of trauma.
Nail anatomy
Nails consist of:
- Nail bed – This is the soft and fleshy region beneath the nail
- Plate – This is the main body of the nail itself
- Cuticle – This is the connective tissue that shields the nail matrix at the proximal nail fold
- Lunula – The white crescent-shaped area of the nail (matrix)
- Matrix – The germinal cells that produce the nail plate; they are under the proximal nail fold and extend out onto the nail bed as the lunula
Treatment
Options for nail trauma treatment may include:
- Draining blood from subungual hematomas – This is often necessary to relieve the pain that ensues. The haematoma may discolour the nail until it grows out.
- Trimming torn nails – This should be performed carefully, because trimming too deeply or too low may result in an ingrown nail.
- Attaching torn nails – May be attempted if the nail is only partially avulsed. When the nail has come completely off, there is no point attempting reattachment.
- Skin issues – If you stub a toe and pull off the nail, there is a possibility that a large swelling of skin will grow before the nail can return. This is called a granuloma. This may require cauterising. Antibiotics are sometimes also required.
- Infection – Bacterial and fungal infections may compromise a nail. These require the appropriate topical or oral therapies. Sometimes a swab or nail/skin scraping is performed to identify the offending organism.
If you have any questions or concerns about nail trauma or nail diseases, make an appointment to see our dermatologist. Contact us today.