Any tips on toenail loss?

[W I S N E R !]

I smashed my left big toe surfing last Friday. The left 2/3 is black/blue and it bled/leaked out today. I've surfed every day since then and it looks like it is now beginning to detach from the nail bed. The right 1/3, however, seems healthy and attached still.

I leave for the Sierra in a little over a week, which has me concerned about what sort of shape it'll be in on the trail. Obviously, bumping it still hurts like $@#!

What do you say?

Leukotape, gauze, and neosporin, washing and changing the dressing as much as I can? Anything I can do to help it along now? Soaking it? Salt? Peroxide?

Thanks.

[Greg Mihalik]

I've lost more toe nails than I care to think about. Once you get past this initial trauma the pain will stop and the nail will eventually come off. Until it does, you should consider taping it lightly to keep from catching it on something and ripping it off. (That would shorten the process but isn't much fun.)

The naked nail bed won't hurt.

The question is whether or not you have damaged the base of the nail bed that generates new nail. Not much you can do about it if you did, but if the new nail looks lumpy and weird that's what's going on.

The other thing to consider is OTC prophylactic fungus cream. Your toe is vulnerable now along the fractured edge. Toenail fungus is no fun and nearly impossible to get rid of.

[Jerry Adams]

Can you cut off the damaged portion of the nail leaving the healthy part of the nail?

[Ken Thompson]

Took 10 months for mine to grow back out after a black toe incident. A little tender at first but no issue really.

[Ian]

It has been a while but the last time I had what you are describing, half the toenail was dead and half not, I just trimmed off the dead part and let the toenail grow out naturally. I'm not above SAK self surgery but with that kind of timeline for a Sierra hike I'd probably swallow my pride and see if the doc in the box could just remove it altogether so it would have a week to heal and harden up.

If memory serves, keeping it dry helped me when it came to trim off the dead part but this was over a decade ago.

[Hoot Filsinger]

I would make my own Leukotape bandages with nonstick gauze, neosporin,and tape to protect toe while hiking and the remove at night and clean with peroxide. Infection could ruin a long trip. They make a product called "Toe Caps" which may help keep your toe clean. Try to avoid scree but you will more than likely be hiking in the pumice dirt trails that penetrate your shoes so an extra pair of liners might be useful.

Safe and Adventurous Trails

[Jennifer Mitol]

Since you've only got a week or so, you have two choices: keep it taped and protected, or snip off the detached part and protect what's left.

If there's no good way to snip off the detached portion and you don't want to have a podiatrist do it (you need to do it ASAP to give it time to heal before your trip), just use a piece of medical tape and just tape it loosely but securely onto your toe. Not sure you need all the neosporin and whatnot unless there is evidence of infection (antibiotic ointments actually slow healing, so if there is no sign of infection, don't use it), but use the tape to just make sure you don't rip the nail off the rest of the way. That will slow you down a bit, and then you WILL have to do some wound care to make sure it doesn't get infected.

I've lost pretty much every single toenail on both feet numerous times during my marathon hey days. Take a nice photo to remember this by (cause you know you'll want to!), pick which of the icky choices above that you least hate, and go for it.

I haven't run a marathon in 3 years, yet both of my big toe nails are still only partially attached. Great fun!!

[peter vacco]

once the swelling goes down, it is as others claim, a remarkable lack of major discomfort.
yours is not the first mammalian toe to get squished, and your body will handle the issue with unexpected grace.
it looks a lot worse than it is.

so : maybe do what you can to reduce the swelling (perhaps regular baths in cold seawater ?? ), pray to whatever deity you consider appropriate that the nail will toss before your trip, and rock on.

good luck,
v.

[W I S N E R !]

I tape it up to surf so I don't catch it, I'll just keep doing the same.
I didn't know you could keep the healthy part and cut the other off…I thought it would all eventually go.

Think I'm just going to leave it alone and see what happens then.

Thanks all.

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