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What Causes The Sensation Of Heat From A Wound After Being Scratched By A Nail?

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Posted on Fri, 20 Oct 2023
Question: I fell a week ago and scraped my lower leg on a nail. It was just a small cut and didn't even bleed much. I cleaned it with peroxide. About 3 days ago, I kept feeling heat inside my leg around the wound. It's still going on, happening every 5 to 10 minutes. It isn't too hot to the touch but feels hot inside.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (34 minutes later)
Brief Answer:
Questions so that I can advise

Detailed Answer:
Hello and welcome,

I read your history here and have a few questions to try to help sort this out:

1. Did the nail puncture the skin, or was it strictly superficial?
2. Have you had a tetanus booster in the past 10 years.
3. Is there any redness or discharge at the site?
4. Could the nail have left any foreign material in the wound?
5. Do you have any ongoing health problems such as diabetes, thyroid disease, etc?
6. Does the heat inside feel like burning and does it radiate/travel from one place to another?
7. Is there any swelling in the leg, such as above the level of the leg where you were injured?
8. Other than scraping, was there any injury from the fall, such as coming down hard against a surface, etc?

Thanks - I'll write about what might be going on after I hear back from you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (15 minutes later)
1. It punctured the skin but only slightly. It did bleed, but not much. More like a scratch.
2. I don't know when my last tetanus shot was.
3. No redness or discharge.
4. Possibly, but I don't think so.
5. Yes, I have diabetes and hypothyroidism.
6. Burning, in the same area.
7.No.
8. Yes, I hit concrete, my nose, chest, wrist and knees took the brunt of the fall. I have severe arthritis in both knees, so that hurt a lot.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (17 minutes later)
Brief Answer:
Thoughts on this

Detailed Answer:
I'm limited by not being able to do an exam, but when the symptom is burning and there aren't signs of other local trauma it can be that a nerve got hit in the injury. Nerves can cause burning and sometimes traveling sensation along the course of the nerve.

Diabetes and hypothyroidism can sometimes increase the chance of neuropathic symptoms.

Diabetes, if sugars aren't well controlled, can both cause peripheral neuropathies (nerve problems in the extremities) as well as delay healing.

Given the severity of the fall, I am also speculating that there may have been a deeper injury without you realizing it, but usually then there will be some bruising.

As this problem doesn't seem to be subsiding, I think it would be a good idea to go in to have it seen in person. If you go to an urgent care clinic, specifically tell the receptionist that you want to be seen by a doctor and not a PA or NP as this problem is not a garden variety and needs a higher level of expertise.

My thoughts on what might be going on:
1. Trauma to a nerve at the site of injury.
2. Possible foreign material (foreign body) in the tissues.
3. Possible infection.
4. Possible deep vein thrombosis (although typically there is swelling above the level of the injury/clot) so this is lower on my list of possibilities.
5. Possible small fracture (although typically there will be swelling and bruising, so again, lower on my list).

I wish I could tell you specifically what is happening, but this is what I can do remotely. So I do think it should be looked at, particularly given that you have diabetes.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3134 Questions

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What Causes The Sensation Of Heat From A Wound After Being Scratched By A Nail?

Brief Answer: Questions so that I can advise Detailed Answer: Hello and welcome, I read your history here and have a few questions to try to help sort this out: 1. Did the nail puncture the skin, or was it strictly superficial? 2. Have you had a tetanus booster in the past 10 years. 3. Is there any redness or discharge at the site? 4. Could the nail have left any foreign material in the wound? 5. Do you have any ongoing health problems such as diabetes, thyroid disease, etc? 6. Does the heat inside feel like burning and does it radiate/travel from one place to another? 7. Is there any swelling in the leg, such as above the level of the leg where you were injured? 8. Other than scraping, was there any injury from the fall, such as coming down hard against a surface, etc? Thanks - I'll write about what might be going on after I hear back from you.