What to Do If You Step on a Nail

Stepping on a nail may cause a puncture wound on the foot. The wound may look minor, but the puncture may be deeper than it appears. Sometimes, if the wound isn’t severe, it can be treated without medical attention. Other times, the puncture will require more treatment than you can provide at home.

This article discusses what to do in minor and major cases of stepping on a nail.

What to Do

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

• The depth of the wound
• The cleanliness of the nail you stepped on

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, it may be safe to just take care of the wound at home. Follow these simple steps to clean and cover the wound.

Wash Your Hands

The most important consideration is preventing the wound from getting infected. That starts with making sure your hands are clean. Wash your hands with soap and warm water before touching your foot.

Apply Pressure

Use your hands to apply pressure to the area around the wound. This will help keep it from bleeding more. Remember to have clean hands before they go near the wound.

Clean the Wound

Regardless of how dirty or clean the nail was, it is crucial to clean the wound to prevent infection. Although it may be a little bit uncomfortable, it needs to be done. 

Follow these steps:

1. First, put the wounded foot under running water for five minutes so that the wound can be rinsed. Ideally, a saline (salt in water) solution is used. If saline is not accessible, use bottled water.
2. Next, use soap to wash the affected area.
3. Take a good look at the wound to see if there is any debris or a piece of the nail in the wound. Look, but don’t touch.
4. If there is nothing visible, you are set to keep treating the wound yourself. However, it is always best to receive advice from a medical professional.

Apply Antibiotic Cream

Next, apply antibiotic cream, such as Neosporin (neomycin/polymyxin B/bacitracin) to the wound. You don’t need a whole lot, just enough to cover the wound. The antibiotic cream will help prevent bacterial infection in the open wound.

Cover the Wound

Once antibiotic cream has been applied on the wound, cover it with a clean bandage. Make sure the padding (the white square) on the bandage is big enough so that the adhesive doesn’t stick to the wound.

Treatment

A minor wound usually can be treated at home. Keeping the wound clean is the key.

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.

Risks

Stepping on a nail, while an accident, is not without its risks. Puncture wounds on the feet are more likely to get infected. This is why cleaning the wound is incredibly important. 

Puncture wounds caused by nails are a common way that bacteria that cause tetanus get into the body. 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 is very important, especially when accidents like stepping on a nail happen.  

Puncture wounds also run the risk of excessive bleeding. However, a lot of bleeding usually only occurs with severe wounds, in which case a healthcare provider should be called on.

When to See a Healthcare Provider

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:

• The puncture wound is large or deep, even if it’s not bleeding a lot.
• The nail that caused the puncture wound is rusty.
• The nail is stuck in your foot (do not remove it yourself).
• The wound looks infected, such as warmth and redness, swelling, a red streak, or pus in the area.
• You haven’t had a tetanus shot or booster in the last 10 years.
• You are immunocompromised.

If either of the following applies, call 911:

• You have lost feeling in the injured foot.
• The bleeding is severe and won’t stop (for example, if it’s still bleeding after applying pressure for 10 minutes).

Summary

Minor wounds caused by stepping on a nail may be treated at home in a few simple steps. If the wound is severe, like a deep puncture, or if the nail that was stepped on is rusty, it’s best to see a healthcare provider. 

A Word From Verywell

Stepping on a nail is painful. Not knowing the condition of the nail or how deep the wound is can be scary. What to do about it depends on how severe the wound is. If you were lucky enough to get only a minor scratch, the steps above will help, and you shouldn't need medical attention. If the wound is more than a scratch, seeing a healthcare provider is your best bet.