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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Loss Of Nail On The Toe Post An Accident, Intense Pain Due To The Open Wound. No Relief With Antiseptics. Best Remedy?

I lost the cutical and big toe nail in an accident thirty years ago. A black nail existed for twenty eight but over the last two years I have lost that nail and it has been like an open wound on top of the toe. It seems it is in a long term healing process its like all the nerve endings on the top hurting whist a skin layer is growing. It hurts a lot and can wake me at night. I ve trid antisceptic cream can you advize a better solution.
Tue, 26 Jun 2012
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General & Family Physician,  's  Response
Hi,

It is common for a nail to turn black after an injury. The black or purple-black color is caused by blood under the nail and will go away as the injury heals. It is surprising to take so long. The nail should have been protected well with caps to fasten the healing.

Black, brown, or purple discoloration under a nail that has not been injured may be caused by melanoma. it seems the nail bed is also not healed well. We can surgically explore the area and graft to reconstruct the nail bed and restore the blood supply. We also need to checck the blood supply to the nail bed if the graft reconstruction works.

If the nail detaches from the nail bed then it is impossible to restore it. The nail grows from the germinal matrix ( the crescent shaped think from which the nail grows). If that is not damaged we can expect the nail to grow in an year properly attaching to the nail bed.

Consult a Dermatosurgeon in your area.
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Loss Of Nail On The Toe Post An Accident, Intense Pain Due To The Open Wound. No Relief With Antiseptics. Best Remedy?

Hi, It is common for a nail to turn black after an injury. The black or purple-black color is caused by blood under the nail and will go away as the injury heals. It is surprising to take so long. The nail should have been protected well with caps to fasten the healing. Black, brown, or purple discoloration under a nail that has not been injured may be caused by melanoma. it seems the nail bed is also not healed well. We can surgically explore the area and graft to reconstruct the nail bed and restore the blood supply. We also need to checck the blood supply to the nail bed if the graft reconstruction works. If the nail detaches from the nail bed then it is impossible to restore it. The nail grows from the germinal matrix ( the crescent shaped think from which the nail grows). If that is not damaged we can expect the nail to grow in an year properly attaching to the nail bed. Consult a Dermatosurgeon in your area.