How to prevent a lost toenail nail-bed infection.

August 1, 2017 2:22 PM

My index toenail separated from nail bed and mostly fell off. How do I keep the toe bed cavity clean and free from infection?

I had a toe blistering problem 2 years ago during a half marathon and lost a couple of toenails. One fell off entirely and grew back fine the other just separated from the nail bed and never really grew back properly. No big deal to me as I am not concerned about beautiful feet and toes. However yesterday the 'weird' toenail detached after another problem with a sub-nail blood blister (I guess my shoes were a bit too loose last run). I trimmed off the loose part of the nail which was about 90% of it and now have a small lip of remaining toenail with a disturbing hollow cavity beneath and beyond it. I'm squicked out by the space that shouldn't be there and seems like the kind of spot where nasties could accumulate.

Any advice on cleaning, bandaging, ointments etc... appreciated.

posted by srboisvert to Health & Fitness (9 answers total)

Good ol' triple antibiotic ointment will probably do.
posted by kindall at 2:41 PM on August 1, 2017

Mine did the same thing. There was a pinky-red cavity under what was left of the nail on my little toe. Neosporin in the morning before putting socks/ shoes/ sandals on, and once again at night before bed did the trick. Once it dries out, you don't have to worry as much about infection.
posted by Everydayville at 2:49 PM on August 1, 2017

Last time this happened to me, I did three things:

1- Washed the area thoroughly with soap and water 2x per day.
2- Made sure the area was completely dry before getting dressed.
3- Went barefoot as much as possible and wore sandals when that wasn't possible. Luckily it was summer!
posted by schroedingersgirl at 5:31 PM on August 1, 2017

I've lost both big toenails every winter the last few years and I feel your pain. Soaks in water with tea tree oil seem to work, and paradoxically last time I went to get a manicure, and got bullied into a pedicure which included the installation of fake toenails on my nubs, which seemed to help them grow out in the correct shape, and although there was a space in which fungus could have grown, regular soaks kept everything copathetic and looking normal! I now have two healthy toenails. Until the next winter.
posted by cakebatter at 6:12 PM on August 1, 2017

This has happened to me several times when running long races. Basically I would wash, and sometimes soak the toe so I could pull the nail free. I would then wash with soap and just apply a clean bandage for a couple of days. No creams or anything. The skin pretty quickly develops an epidermis, and then it's good to go. I wouldn't worry about it at all unless you have another reason to worry (e.g., compromised immunity, DM).
posted by OmieWise at 7:06 PM on August 1, 2017

When I lost a toenail from a hiking accident, in addition to an ointment and clean dry socks, the Podiatrist had me soak my toe in a very dilute solution of bleach twice a day to help prevent fungus from getting a 'toehold' under the new nail. Don't rely on my memory of the dilution being a cap full to a half-gallon of water.
posted by dws at 8:24 PM on August 1, 2017

This happened to me for over eight years of soccer seasons. I didn't think twice if it and nothing bad happened. Just wash your feet.
posted by Marinara at 10:32 PM on August 1, 2017

If you want to get super thorough a simple irrigator syringe like this could help you flush things out. But I wouldn't mess with it all that much, honestly. Nails are very good at growing back.

Can you forgo running and other things that require confining footwear for a little while? Maybe switch to swimming for cardio if you have access to a pool?
posted by Mizu at 1:43 AM on August 2, 2017

I don't think there's much actual risk in this situation. You could soak your feet in warm salt water, though, to discourage incipient skin infections.
posted by adiabatic at 7:42 AM on August 2, 2017