Q. What can be done for bleeding and pus discharge from toenail?

Answered by
Dr. Ashwini V Swamy
and medically reviewed by iCliniq medical review team.
Published on Dec 18, 2018

Hi doctor,

I have toenail problem. I had bleeding and pus formation. I consulted a doctor and she had prescribed the following treatment. Tablet Novamox CV 625 three times a day for five days. Apply T-bact ointment twice a day. After taking the above treatment, the pus formation stopped. But there is some bleeding and wound. I am attaching the images so that you can have a better look. I am getting married in a couple weeks, so I do not want to opt for nail removal. Kindly let me know what needs to be done.

Dr. Ashwini V Swamy

Dermatology Venereology
#

Hi,

Welcome to icliniq.com.

How did this start? Did you have trauma to the nail? Is it painful? Is it only one to nail? How many times it has bled? You have mentioned there was pus, was it greenish? Or just frank white pus? Does it smell bad? Your other toenails appear yellow (attachment removed to protect patient identity). Are you using any cream or lotion like Betadine or Turmeric? When did you take the last dose of the antibiotic pill? It looks like pyogenic granuloma growing underneath as per the pictures you have attached, also there is a secondary infection. Pyogenic granuloma is a benign growth of blood capillaries that are usually painless but bleeds with trauma. It can also be pseudomonas nail infection. Can you please answer the above questions so that I can make a concrete diagnosis?

Thank you doctor,

As usual, I had cut my nail and after a few days, there was a pain. Later pus started to form and pus was white and there was a bad smell. I have pain when touched, else there is no pain. Earlier it used to bleed very frequently, but now it is not bleeding often. Yes, the problem is with the only one nail. Someone said to apply turmeric, I tried a couple of times, but it did not help and I stopped applying turmeric. I stopped taking antibiotics a week ago.

Dr. Ashwini V Swamy

Dermatology Venereology
#

Hi,

Welcome back to icliniq.com.

Features are more consistent with pyogenic granuloma with a secondary bacterial infection. Since there is added infection, it should be treated along with it. Take another course of antibiotics for seven days, tablet Ciprofloxacin 500 mg one tablet twice a day after food for seven days. Best treatment for pyogenic granuloma is removing it off by either cryotherapy, or silver nitrate or electric cautery or laser. Please consult your dermatologist and discuss these options, if you do not want to get any procedure done then you can use Timolol drops, it takes 2 to 3 weeks to see positive results. For those raw growths, after cleaning it, apply Timolol maleate 0.5 % drops (eye drop) four times a day for 3 to 4 weeks. Please avoid tight shoes and avoid using cotton, use cotton gauze to clean the area, use warm salt water to clean it. Avoid getting hit on the nail, any minor trauma will cause bleeding, if it becomes raw there will more chances of infection.

Thank you doctor,

From morning, there is some bleeding and in case of bleeding what should I do? Can I keep the toenail in salt warm water around 15 minutes? Should I use any ointment when going for sleep? Should I cover the toenail with a bandage at night to avoid any injury when sleeping?

Dr. Ashwini V Swamy

Dermatology Venereology
#

Hi,

Welcome back to icliniq.com.

Clean the toe with warm salt water, do not soak in it. For bleeding, apply pressure with cotton gauze for 5 to 7 minutes, it should stop. If it continues, then put that gauze around the toe and wrap with cotton rollers bandage. Keep the foot elevated when it bleeds. The best treatment would be to get it cauterized so that it does not bleed often.

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