Stepped on a Nail? Here’s What to Do

If you've stepped on a nail, it's important to immediately clean the wound and determine how serious it is. A minor injury can be treated at home, but deeper punctures and injuries caused by dirty or rusty nails require treatment from a healthcare provider. It is also important to make sure you are up to date on your tetanus shot before deciding to treat your injury at home.

This article discusses what to do in minor and major cases of stepping on a nail. It also presents information about when to seek professional medical care for your puncture wound.

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If you’ve stepped on a nail, there are a few factors to consider when determining if you should seek medical attention, including:

It can be difficult to tell how deeply a nail penetrated your foot.

If the nail appears to have only scratched the surface of your foot and it wasn't rusty or dirty, it may be safe to just take care of the wound at home. Follow these simple steps to clean and cover the wound:

Wash the wound regularly, such as one to two times per day, and apply fresh antibiotic cream and a clean bandage after doing so. Antibiotic cream can be found over the counter, usually in the same section where you would find bandages.

Continue this cycle of cleaning and covering the wound until the wound closes. If the wound is painful, over-the-counter (OTC) pain reliever medication may help. Always check with your healthcare provider before starting any new medication.

Sometimes a puncture wound caused by a nail needs medical attention right away. If any of the following are true, call your healthcare provider immediately:

If either of the following applies, call 911:

Some signs of infection include:

Stepping on a rusty nail can lead to tetanus infection, with nail puncture wounds a common way for the bacteria to get into the body. Symptoms of tetanus can include:

It's important to seek treatment immediately if you suspect tetanus infection, as symptoms of the illness typically progress and can prove fatal.

Being immunized prevents tetanus. Many people get tetanus shots as part of routine care. You should get a tetanus shot every 10 years, staying up to date on tetanus boosters.

Stepping on a nail, while an accident, is not without its risks. Other complications can include:

Some puncture wounds from nails occur when using a nail gun, which can propel nails at speeds of about 150 feet per second. These wounds typically affect the hands and arms, but they can occur in other parts of the body. Seek medical care if this is how a nail entered your foot.

For many people, recovery after stepping on a nail will happen quickly. You may experience mild pain at the site and feel you need to wait a few days before returning to normal activities that irritate it while the wound is healing. Over-the-counter pain medication can help.

In some cases, your healthcare provider may prescribe an antibiotic medication. It's important to complete this treatment and take it as directed.

If you experience complications, your recovery may take longer. Of special concern is the higher risk in people who heal slowly because of age or an underlying health condition like diabetes.

Minor wounds caused by stepping on a nail may be treated at home in a few simple steps. Once you've applied pressure to stop any bleeding and thoroughly washed the wound, you can apply an antibiotic cream and bandage.

If you see any debris trapped at the site, or if the wound is severe, like a deep puncture, it's best to see a healthcare provider. That's especially true if the nail that was stepped on is rusty or dirty, or you have other factors (like an overdue tetanus booster) that could make your risk of tetanus more likely.

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Victoria First Aid. What are the antibiotics commonly used for puncture wounds?

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O'Kane L, Hooda Z, Molavi I. Delayed presentation of nail gun-associated traumatic pneumothorax with a retained foreign body: A case report. Am J Case Rep. 2022;23:e937641. doi:10.12659/AJCR.937641.

By Emily Brown, MPHEmily is a health communication consultant, writer, and editor at EVR Creative, specializing in public health research and health promotion. With a scientific background and a passion for creative writing, her work illustrates the value of evidence-based information and creativity in advancing public health.