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Should I soak my ripped toenail in soapy water?

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Internal Medicine Specialist
Practicing since : 1998
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I ripped most of my nail off of my big toe Friday night. I washed/soaked in soapy water for 20 mins. Since then I've applied Bacitracin and kept it wrapped in sterile gauze. Do I need to soak in soapy water again? Does it need to breathe? Should I wait for the nail to fall off? What's the next step? 31yr male. 6'1", 200 lbs. Very healthy here.
Posted Sat, 5 May 2012 in General Health
 
 
Answered by Dr. Jasvinder Singh 20 minutes later
Hello,

Thanks for posting your query.

First of all, remove the gauze that you have applied. If it sticks to the wound do not pull it off, as this will cause it to bleed. Soak the dressing with hydrogen peroxide and this will separate the dressing from the wound. If the toenail is partially torn off, gently trim off the loose portion without cutting the attached nail or skin.

Then check the nailbed. If it is pale, blue or cool then consult a doctor as it may be subungual hematoma which may have to be drained. Otherwise, clean the toenail with antiseptic or water and Epsom salt and carefully dry the toe with a clean cloth.

Allow it to air dry for 15 minutes and then apply antibiotic cream and gauze it and take care that you use minimal tape to keep the gauze on, as the wound needs to "breathe." Keep the dressing looser now and do the dressing twice a day, until the wound has a scab on it. This can take 5 to 14 days, depending on the severity of the injury.

Do not pull off the scab and allow it to fall off on its own. Complete healing may take 2 to 4 weeks but ensure that you do not wear closed shoes for a long time.

You may need oral anti-inflammatory pain killers during this period like acetaminophen or ibuprofen if you are not allergic to them and these are available by prescription.

Keep an eye out for signs of toenail infection: swelling, excessive redness, severe pain, pus or discharge and if it happens then you may need a course of oral antibiotics.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.
Above answer was peer-reviewed by
 
Follow-up: Should I soak my ripped toenail in soapy water? 51 minutes later
Should I clean with mild soap and water everyday and allow to dry before applying new ointment/bandages? I've heard it should stay dry, which is difficult if I'm washing it. Also I hears hydro peroxide might not do much good as it will kill the white blood cells. I'm mostly confused about whether I should be washing it everyday or keeping it dry.
 
 
Answered by Dr. Jasvinder Singh 40 minutes later
Hello,

Instead of soap and water (as water may introduce infection) and soap may cause irritant contact dermatitis, you can use topical antiseptics like Savlon or Dettol. These can be used instead of hydrogen peroxide also.

Minimize contact with water till thickening of skin occurs as water may cause infection if unsterilized or unclean.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.
Above answer was peer-reviewed by
 
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