couple hiking in summerIt's the end of the summer and you're itching to get in some hikes before the weather turns. Perhaps during your last few hikes you've noticed your toenails have been hitting the front of shoes when you hike down. Maybe you've felt pain or your toenails are starting to look sketchy.

Instead of doing something about it, you go on that terrific new hike and your toenail loses its grip.

Now what do you do?

What You'll See and Feel

Perhaps your toenail came off completely. That can happen. But more likely it's only partially detached. Either way you'll experience bleeding (subungual hematoma) which causes pain. That's because the pressure from the build-up of blood needs to be released and instead it's pushing on your toe.

What To Do About Toenail Loss on the Trail

  • If your nail is still partially attached, tape it to your toe. It will help protect the underlying area.
  • Always bring salt with you. Combine salt and water and soak your toe for 15 mins. This will help prevent infection and it can be soothing as it draws out some of the blood. 
  • Apply a topical antibiotic such as Bactroban or Neosporin after soaking and cover with a bandage.

What To Do About Toenail Loss When You Get Home

Remove as much of the nail with a toenail clipper as soon as possible so that the underlying nail bed can start to heal. Continue soaking using Epsom salts in warm water for ten minutes a day.

If your pain increases or you see red streaks going up your toe or pus, it's time to see a Seattle podiatrist. These are signs of infection.

How to Prevent Toenail Loss

While it's great to know what to do when you lose a toenail, it's better not to lose one to start with. Here's how:

  • Make sure your hiking boots fit. Even an adult's feet can get longer as a result of weight gain or flattening of the arches. Be sure to get your feet measured the next time you go shopping for boots. Boots that are too short will push against your toenails, causing damage and eventually toenail loss. 
  • Make sure your toenails are clipped. Again pressure of your nails against the top of your boot can cause damage and toenail loss.
  • Improper boot lacing. If your boots aren't laced properly your feet can slip forward, causing the nails to hit the top of the boot.
  • Make sure your socks aren't too thick. Wearing socks that are too thick will increase the volume of your foot in your boots causing your toenail to hit the top.

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Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.
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