Treatment of Artificial Nail Injuries
For artificial nail injuries, treatment should focus on removing the artificial nail, cleaning the affected area, and addressing any infection or damage to promote healing of the natural nail.
Initial Assessment and Management
- Remove the artificial nail completely to allow proper assessment and treatment of the underlying natural nail 1
- Clean the affected area thoroughly with saline solution without additives 1
- Assess for signs of infection including redness, swelling, discharge, or pain 2
- Obtain bacterial/fungal cultures if infection is suspected 1
Treatment Based on Severity
Mild Injury (without infection)
- Apply antiseptic soaks with dilute povidone-iodine for 10-15 minutes twice daily 2
- Use topical emollients on periungual folds, matrix and nail plate to promote healing 1
- Avoid any damaging or irritant regimens, including manipulation of the cuticles and nail biting 1
- Cut nails regularly until the nail plate grows reattached 1
Moderate to Severe Injury (with signs of infection)
- Begin oral antibiotics with anti-staphylococcus aureus and gram-positive coverage 1, 2
- For painful haematoma or subungual abscess, partial or total nail avulsion may be required 1
- Clean the nail bed and obtain cultures at the time of nail removal 1
- Apply silver nitrate solution for excessive granulation tissue 1, 2
Special Considerations
- Candida species are the most common pathogens in artificial nail-related infections 3
- Infections associated with nail injuries are relatively rare but more common when treatment is delayed 4
- For chronic paronychia, consider high-potency topical corticosteroids alone or combined with topical antibiotics 2
- Reassess after 2 weeks of treatment; if no improvement is seen, consider referral to dermatology 2
Prevention of Recurrence
- Avoid wearing artificial nails, especially for healthcare workers and food industry personnel 3, 5
- Keep natural nails short with smooth, filed edges to prevent trauma 1
- Use protective gloves during activities involving water or chemicals 2
- Apply moisturizers regularly to prevent dryness and cracking 1, 2
Potential Complications
- Artificial nails harbor significantly more bacteria than natural nails, increasing infection risk 1, 5
- Chronic onycholysis may lead to nail bed keratinization and persistent subungual hyperkeratosis 1
- Secondary bacterial or mycological superinfections are present in up to 25% of cases 2
- Crush or avulsion injuries have poorer outcomes compared to simple lacerations 6