How to Heal Cracked Toenails

Handle the remaining toenail carefully. In some cases, a small crack leaves most of the nail intact, while in others, the entire nail may detach. After the injury, proper care of the remaining nail is essential for healing. Leave any remaining nail undisturbed. If a portion of the nail is loose, gently use clean nail clippers to trim it as close to the cuticle or remaining nail as possible. Cut along the crack.

• Smooth any remaining nail edges with a file. This prevents the nail from snagging on socks or bedding.
• Ask a friend or family member for assistance if you're cautious or struggling. Children may require adult help for cracked nail care.
• If you wear a toe ring, remove it before treating the cracked nail. Use soap and water for lubrication if needed, or seek medical help if it cannot be removed.

Stop the bleeding (if any). Apply a clean cloth or gauze directly to the bleeding area. Apply pressure for about 10 minutes or until the bleeding stops. Lying down and placing a pillow under your leg to elevate it can also help slow the bleeding.

• If the bleeding does not slow after 15 minutes of pressure, seek medical attention.

Thoroughly clean the wound. Wash the toenail with warm soapy water and a cloth. If the area around the wound is dirty, gently scrub away the dirt. Remove any dried blood or debris left after the injury. Don’t hesitate to ask a friend or family member for help. Clean the wound as thoroughly as possible to prevent infection.

• Gently pat the wound dry with a clean towel. Avoid rubbing to prevent further bleeding.

Apply antibiotic ointment. Once the nail is clean and dry, apply an antibiotic ointment such as Neosporin, Polysporin, or any "triple antibiotic" ointment (containing bacitracin, neomycin, and polymyxin B) to the wound. These ointments are available at most pharmacies without a prescription.

• Antibiotics also come in cream form. Ensure you purchase the correct ointment to prevent the bandage from sticking to the wound.
• If the skin is intact and there are no cuts or abrasions, you can apply a small amount of moisturizing wax instead of antibiotic ointment.

Wrap the toenail. Purchase sterile gauze or non-stick bandages and medical tape. Place the gauze or bandage over the injured toenail (trim it to fit if necessary) and wrap it around a few times to secure it. Leave a small portion of the bandage at the tip of the nail to fold over, creating a "cap" for easy removal later. Wrap the top of the nail twice in a crisscross pattern (like an "X"). Use two pieces of medical tape to secure the bandage in place.

• You can buy non-stick bandages or ensure you apply antibiotic ointment or moisturizing wax before wrapping the toenail. Be careful when removing the bandage to avoid pulling off the nail or reopening the wound. If the bandage sticks to the nail, soak it in warm water for a few minutes to loosen it.
• Do not wrap too tightly, as this may cause the toenail to turn red, purple, or lose sensation. The bandage should be secure and snug but not uncomfortably tight.

Change the bandage daily. Each day, gently remove the bandage and wash the toe with warm soapy water. Reapply the antibiotic ointment and wrap a fresh bandage. Repeat this process for 7-10 days until the nail bed (the soft, sensitive tissue under the nail) hardens.

• It’s best to apply a new bandage around the toenail every night before bed. This will protect the injured nail from snagging on bedding or bumping into anything while you sleep.

Apply ice frequently on the first day. On the initial day following the injury, it's advisable to ice the area in 20-minute intervals, every 2 hours to reduce swelling and alleviate pain. Place ice cubes in a plastic bag and wrap it in a towel before applying it to the toenail to avoid excessive cold.

• After the first day, you can apply ice for 20 minutes, 3-4 times daily.

Elevate the foot. If the toenail is throbbing with pain, lie down and place a pillow underneath to raise the foot above heart level. This method significantly reduces swelling. Apply this technique within the first 48 hours post-injury.

Take over-the-counter pain relievers. Medications like Ibuprofen and Naproxen can help reduce swelling and pain. Acetaminophen, while not effective for swelling, can alleviate pain. These medications are available at pharmacies without a prescription. Always follow the dosage instructions on the packaging.

• If you have heart disease, kidney issues, high blood pressure, or a history of stomach ulcers, consult your doctor before using these medications.

Wear open-toed or wide shoes for several weeks. Tight shoes can exert uncomfortable pressure on the injured toenail. Opt for open-toed or wide shoes to lessen pressure and speed up recovery. Continue this practice as long as necessary for comfort.

Seek medical care if the toenail shows signs of infection. No matter how well you care for the injury, infections can still occur. If the toenail is infected, you may notice red streaks extending from the toenail, foot, or leg. A fever of 38°C or higher may also develop. Pus (thick, white, or discolored fluid draining from the nail) is another sign of infection. Visit a doctor if any of these symptoms appear, as infections can become serious.

• The doctor will prescribe antibiotics if the toenail is infected. Take the medication as directed and continue until the infection clears.

Consult a doctor if pain, redness, and swelling worsen. Medical attention is necessary if the pain is severe enough to disrupt sleep or daily activities, doesn’t improve within 2 hours of taking pain relievers, or intensifies over time. If swelling worsens or doesn’t improve after medication, icing, and elevating the foot, seek professional help.

• Ask the doctor questions like, "My toenail hurts more today, and Tylenol isn’t helping—is this normal?" or "What level of swelling is considered typical?"

Get checked if the toenail turns black or blue. Sometimes, injuries caused by pressure on the toenail (e.g., from a heavy object falling on it) can lead to subungual hematoma or bleeding under the nail. This creates small blood pockets beneath the nail, which can cause discomfort due to pressure. They appear as dark blue, black, or bruised patches under the nail. If the area is smaller than 1/4 of the nail size, it will heal on its own. Otherwise, see a doctor, as draining the fluid may be necessary to relieve pain and prevent further injury. Do not attempt to drain it yourself or ask someone else to help—consult a professional.

• The doctor will drill a tiny hole in the nail to release the blood. This procedure is painless and reduces pressure, alleviating discomfort.

Visit a doctor if there is visible damage around a cracked nail. Whether the nail grows back normally depends on the condition of the nail bed. If you’re concerned about the nail’s appearance as it regrows, discuss minor surgical procedures on the nail bed with your doctor. If there is obvious damage to the surrounding tissue, such as a tear, seek medical attention. If the nail bed or matrix is severely damaged, the nail may not regrow or may look slightly unusual. However, some cases can still be corrected.

• It may take 6-12 months for the toenail to fully regrow.

Seek assistance if you cannot clean the wound properly. If scrubbing the wound for more than 15 minutes doesn’t remove all dirt and debris, it’s time to seek medical help. Thoroughly cleaning the wound is crucial to prevent infection, so don’t hesitate to ask for assistance if you’re unable to do it yourself.

• Depending on the severity of the toenail injury, you may also need a tetanus shot or a booster. If the crack is dirty and it’s been over 5 years since your last tetanus shot, or if the crack is clean but it’s been over 10 years since your last booster, you’ll need a tetanus vaccination.

Get an X-ray if the toe cannot move or looks abnormal. Many injuries that cause a toenail to detach can also result in a broken bone. Check the injured toenail to see if the bone can bend and stretch fully. If not, or if the bone protrudes at an unusual angle, it may be fractured. Seek emergency care for an X-ray and proper treatment.

• In severe injuries, the toenail may completely detach within 1-2 weeks. This is normal. Allow the nail to fall off naturally rather than trying to remove it yourself.