How to treat a broken nail?

Management of a Broken Nail

For a broken nail, gentle removal of the damaged portion followed by proper care of the exposed nail bed is recommended to prevent infection and promote healing. 1

Assessment and Initial Management

• Evaluate the extent of the nail damage - whether it's a partial break, complete avulsion, or an ingrown portion 1
• If the nail is partially detached but still connected:
  • Gently clip the broken portion using clean nail clippers to prevent further tearing and trauma 1
  • File any sharp edges with an emery board after softening the nail by soaking in warm water 1

Treatment Algorithm

For a Partially Broken Nail:

1. Clean the affected area:

   • Soak in warm, soapy water for 10-15 minutes 2
   • Apply topical antiseptic such as 2% povidone-iodine to prevent infection 1

2. Protect the nail bed:

   • If the nail is partially detached but still viable, consider taping it gently in place as a biological dressing 1
   • For painful exposed nail bed, apply a protective covering such as a sterile bandage 1

3. Prevent infection:

   • Use daily dilute vinegar soaks (50:50 dilution) to the nail folds twice daily 1
   • Monitor for signs of infection (increased pain, redness, swelling, pus) 1

For a Completely Detached Nail:

1. Clean and protect the nail bed:

   • Gently clean the exposed nail bed with antiseptic solution 1
   • Apply antibiotic ointment if there's risk of infection 1
   • Cover with a non-adherent dressing to protect the sensitive nail bed 1

2. Allow natural regrowth:

   • A new nail will typically grow in over time (3-6 months for fingernails, 6-12 months for toenails) 3
   • Keep the area clean and protected during regrowth 1

Special Considerations

For Painful Broken Nails:

• If edema and pain are present, apply mid to high potency topical steroid ointment to nail folds twice daily 1
• For hangnails (torn skin around the nail), consider using surgical glue to paste them back rather than cutting them off 4

If Infection Develops:

• Culture any purulent discharge 1
• Treat with appropriate antibiotics based on culture results 1
• Stop topical steroids if infection is present 1

Prevention of Future Nail Damage

• Keep nails trimmed straight across to prevent splitting and breaking 1
• Apply moisturizing agents to maintain nail hydration 5, 6
• For brittle nails prone to breaking, consider oral biotin supplementation 5, 6
• Avoid prolonged exposure to water and harsh chemicals 5
• Use protective gloves for wet work or when handling cleaning products 1

Common Pitfalls to Avoid

• Aggressive manipulation of the broken nail which can cause further damage 3
• Using artificial nails over damaged nails, which can trap moisture and lead to infection 1
• Neglecting signs of infection which may require prompt antibiotic treatment 1
• Forceful removal of a partially attached nail that could serve as protection for the nail bed 1

Remember that proper nail care is essential not only for cosmetic reasons but also to maintain the protective function of nails and prevent complications such as infection or permanent nail deformity 1, 3.