How to Treat a Smashed Fingernail

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Whether you crush your finger with a hammer or a slammed car door, a smashed fingernail can be a very painful experience. Fortunately, if not too severe, there are some steps you can take to relieve the pain without having to rush to the emergency room. Immediately after the injury, you’ll want to take some precautions to reduce swelling and redness.

Section 1 of 3:

Relieving the Pain Immediately After Injury

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  1. Wrap an ice pack or cold compress in a paper towel and place it on the injured finger. Apply ice for 20 minutes every 2 hours on the day of the injury, and then 3 to 4 times a day following. [1] Ice helps to minimize swelling, bleeding, and pain.
    • Be careful not to apply too much weight or pressure with the ice. Place your finger just on top of the wrapped ice pack or compress.
    • Similarly, you can also place the injured finger in cold water. [2]
    • Do not put ice directly on skin or keep the ice on for longer than 15-minute intervals. This may cause further inflammation or skin damage. [3]
    • If you’re wearing jewelry, remove it upon injury. [4]
  2. Hold your injured finger up in an elevated position above the level of your heart. Diplomate for the American Board of Internal Medicine, David Nazarian, MD, states that “elevating the hand can help” after smashing a fingernail. “What happens is blood flows to the injured area,” so it’s best to elevate the hand and “keep it more upright.”
    • If you keep your hand down at your side, blood rushes to the injury, increasing the swelling and uncomfortable throbbing pain. [5] So, keep it elevated and upright whenever possible.
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  3. To further relieve pain and reduce inflammation, take an oral anti-inflammatory or pain killer such as ibuprofen (Advil), Tylenol, Motrin, or Aspirin. [6]
    • If you’re unsure how much medication to take, talk to your healthcare provider for personalized advice.
  4. If the injury resulted in an open wound, clean it as soon as possible. Clean the wound by rinsing with running tap water and washing around it with a gentle, fragrance-free soap. [7]
    • If there is any dirt or debris in the wound, remove it with sterilized tweezers. [8]
    Tao Le, Physician and Medical Author

    When dealing with a smashed fingernail, respond quickly to minimize pain and infection risk. Start by gently cleaning with mild soap and water. Elevate the hand and use a cold compress to reduce pain and swelling. If the nail is severely damaged, seek medical care.

  5. Apply a thin layer of an antibiotic ointment, such as Polysporin, to the open cut. This helps keep the surface of the cut moist and prevents scarring and infection. [9]
    • Petroleum jelly can also be used on the wound. [10]
  6. 6
    Press a clean cloth to any bleeding areas. If your crushed fingernail is bleeding, gently wrap or apply a clean cloth, paper towel, or gauze to the affected area. [11] Use a gentle hand and avoid applying too much pressure to the wound.
    • Avoid wrapping the area too tightly, as this can cause further swelling and discomfort.
  7. If you’re able to do so, gently move your finger as much as possible without causing further pain. This can help reduce inflammation and prevent stiffness. [12]
    • Stop moving your finger if you feel any pain.
    • If you can’t move your finger or feel it after a few minutes have passed, contact your doctor immediately. [13]
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Section 2 of 3:

What Not to Do

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  1. 1
    Do not splint the finger. Unless told otherwise by your doctor, avoid putting a splint on the injured finger. This can cause the finger to stiffen or heal incorrectly. [14]
    • Similarly, avoid wrapping the smashed fingernail tightly with cloth or gauze, as this can increase swelling.
  2. 2
    Do not drain the blood from the fingernail. Using DIY at-home methods to drain the blood from the injured fingernail (such as using a sterilized paperclip) can cause further injury and should be avoided. Unless otherwise instructed by your doctor, avoid draining the blood at home and seek medical care. [15]
    • Blood can pool under the fingernail after sudden trauma, such as being smashed in a car door.
    • Nail trephination is a common and safe way that doctors drain trapped blood from under the fingernail. A doctor makes a small hole in the nail and allows gravity to pull the blood out from the nail.
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Section 3 of 3:

When to See a Doctor

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  1. Contact a doctor if your symptoms worsen. Smashed fingernails happen and can usually be taken care of at home; however, if the pain or the fingernail gets worse, it’s best to contact a doctor. If you experience any of these symptoms, see a doctor immediately for further care: [16]
    • Redness, pain, or swelling increases
    • Yellow or white fluid drains from the wound
    • Bleeding doesn’t stop
    • Wound has a bad smell [17]
    • Fever
    • Skin is cut or bone is exposed [18]
    • Inability to move or feel your finger

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      Warnings

      • Seek medical help if you can't straighten your finger, it feels numb, it is noticeably bent or crooked, symptoms get worse after 48 hours of home care, or the injury stays swollen for more than 48 hours. [19]
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      Expert Interview

      Thanks for reading our article! If you'd like to learn more about health treatment in the working place, check out our in-depth interview with David Nazarian.

      References

      1. ↑ https://medlineplus.gov/ency/patientinstructions/000800.htm
      2. ↑ https://www.nationwidechildrens.org/conditions/crush-injuries-of-the-fingertip
      3. ↑ https://www.houstonmethodist.org/blog/articles/2020/nov/ice-vs-heat-when-to-use-which-for-aches-pain/
      4. ↑ https://medlineplus.gov/ency/patientinstructions/000800.htm
      5. ↑ https://my.clevelandclinic.org/health/diseases/21794-jammed-finger-sprained-finger
      6. ↑ https://my.clevelandclinic.org/health/treatments/12058-pain-relievers
      7. ↑ https://www.nationwidechildrens.org/conditions/crush-injuries-of-the-fingertip
      8. ↑ https://www.mayoclinic.org/first-aid/first-aid-cuts/basics/art-20056711
      9. ↑ https://www.seattlechildrens.org/conditions/a-z/finger-injury/
      1. ↑ https://www.ucihealth.org/blog/2018/10/wound-care
      2. ↑ https://www.nationwidechildrens.org/conditions/crush-injuries-of-the-fingertip
      3. ↑ https://www.cuh.nhs.uk/patient-information/hand-therapy-active-finger-exercises/
      4. ↑ https://www.mountsinai.org/health-library/injury/smashed-fingers
      5. ↑ https://www.mountsinai.org/health-library/injury/smashed-fingers
      6. ↑ https://my.clevelandclinic.org/health/procedures/nail-trephination
      7. ↑ https://medlineplus.gov/ency/patientinstructions/000800.htm
      8. ↑ https://www.nationwidechildrens.org/conditions/crush-injuries-of-the-fingertip
      9. ↑ http://www.mountsinai.org/health-library/injury/smashed-fingers
      10. ↑ https://my.clevelandclinic.org/health/diseases/21825-mallet-finger

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