Dermatologist Questions Dermatologist

Toenail issue?

I did a lot of work moving out of a house, at the end of the day, my lower legs and ankles were swollen. I came home and my toenails were long, I hadn't clipped in awhile. I clipped big toe on each foot, I didn't clip it too short. Immediately, clear fluid came out, and if I push on the toe, more fluid comes out. Then saw that the whole toenail had separated from the skin. Now the skin around, especially at the top is red and swollen. Painful and very tender. I have my feet up and raised on the pillow overnight. The fluid is getting better but especially right toe tender, especially to walk on. This has never happened before. Is it because of fluid draining down from ankles? What do I do?

Female | 48 years old
Complaint duration: 2 days
Medications: No
Conditions: No

6 Answers

Likely with the long nails you damaged the nail and it lifted off of the base area and will eventually fall off actually. The trauma was from wearing shoes and long toenails. It may take a while for this to feel better, could try a band-aid over the toe and try to hold the nail down more but do let it fall off if it is going to fall off.
Separation of a toe nail often comes from some type of injury. It isn't always black and blue. Protect the nail, keep it short, and a new nail should grow out and most likely be normal.
You had too much pressure either distally (at the end of the toe) from your nail hitting the end of the shoe/foot sliding and nail hitting the end of the shoe, or from dorsally (from the top of the nail) where the shoe pressure was hitting the top of the nail and causing irritation. Fluid, like a blister, then formed under the nail. In some patients, it is blood that forms under the nail. Regardless, the fluid separated the nail plate from the nail bed, and then the fluid build up underneath, and thus drained out when you cut your nails. It is better to have shorter nails when exercising or doing heavy work, like moving, so the nail is not impinged by the shoe in any way. This will resolve. This is a common way for a nail to become fungal-you may note that the nail gets thick and discolored as the next year to 2 years progress secondary to the trauma you've caused to your toenails
It seems that you developed a blister under the toe nail and that it the fluid that came out. There may be more fluid trapped underneath and a Podiatrist can help you release the rest of it, which should make you a lot more comfortable.
Without examination or medical history, I cannot give you an exact diagnosis. One likely possibility is that there is clearly separation between the nail plate and bed. There may be a localized infection due to the repetitive microtrauma of the nail hitting the shoe. You should consult a foot specialist and be seen in the office in case a procedure is necessary.

More than likely you irritated the during the move an loosened the connection of the nail plate to the nail bed that will cause the clear liquid to come out from under the. The redness and tenderness is the remaining part of the nail that is still attached is stressed. You may need the nail removed as a new nail is probably already growing causing more stress. See a Podiatrist