A puncture wound in your foot is nothing to take lightly, even if it is not deep. Many people who suffer small foot puncture wounds—such as may be incurred by stepping on a thumbtack—treat themselves at home rather than seeking medical attention.

In some cases there is nothing wrong with this approach—one doesn’t go to the doctor with every little scratch—but it’s important to know that even small foot puncture wounds can become infected if bacteria are introduced into the wound, and infection can lead to much more serious problems.

Common Causes of Foot Puncture Wounds

The most common cause of a puncture wound in the foot is stepping on a nail—in fact, 98 percent of such injuries are acquired in this manner, although animal bites or stings can also cause foot punctures.

Because nails and similar sharp or pointed objects are so often the cause, most foot puncture injuries occur on the sole of the foot. Needless to say, a high percentage of foot puncture wounds occur to people who are barefoot, often outdoors, at the time of the injury.

Potential Complications of Foot Puncture Wounds

If a puncture wound is not properly disinfected, infection (usually cellulitis caused by streptococcus or staphylococcus bacteria) may result; this happens in about 15 percent of all foot punctures. Punctures are harder to clean than lacerations or scrapes, which is why a trip to the doctor may be advisable even if the wound does not seem deep.

An untreated cellulitis infection is a very serious and possibly life-threatening condition, and the nature of a puncture wound is such that infectious bacteria can easily be introduced to tissue well below the surface of your skin, where you cannot disinfect without medical assistance. The infection can then spread to the rest of your body.

Symptoms of cellulitis infection include:

• Swelling and redness of the skin surrounding the wound (this area may expand over time)
• Pain and tenderness
• Skin that is warm to the touch
• Fever

Once a cellulitis infection has gotten under your skin, it can enter your bloodstream and spread throughout your body. In some cases, it may spread to the deeper layer of tissue known as the fascial lining, causing a life-threatening condition known as necrotizing fasciitis.

Another possible consequence of a puncture wound in your foot is tetanus (known colloquially as lockjaw). This condition is caused by infection with the Clostridium tetani bacterium, which is generally found in soil—that is, on the ground, where a bare foot is likely to encounter a nail.

Tetanus causes painful muscle contractions, especially in the jaw and neck. Thanks to the prevalence of vaccinations, however, severe cases of tetanus are rare in developed countries like the United States.

Finally, foot puncture wounds in some cases may involve a foreign object or debris lodged in the wound, deep below the surface of the skin. In rare instances, a tiny part of a sock or shoe may have gotten into the wound. In addition to being a painful irritant, this creates a very serious risk of infection.

How Is A Puncture Wound in My Foot Treated?

Many people will attempt to treat small puncture wounds by themselves by disinfecting with alcohol or hydrogen peroxide and bandaging the wound. These attempts can sometimes be successful, but the risk of infection is always cause for concern, especially if the injured person suffers from diabetes, peripheral neuropathy, or peripheral vascular disease (according to Podiatry Today magazine). Underlying diabetes, in particular, may be reason for hospital admission.

If you sustain a puncture wound in your foot, you must administer first aid immediately. Apply direct pressure to the wound with a clean cloth in order to stop the bleeding, and wash the wound with clean water.

If necessary, use tweezers to remove the object that has caused the wound. Apply an antibiotic ointment to the wound (most first-aid kits contain one), and bandage it to keep bacteria from entering.

After administering first aid, you should seek medical attention at an urgent-care clinic or at the emergency room. The doctor who sees you will want to know if you have had a tetanus shot within the last few years, and will also ask you how and when the injury occurred, and whether you were wearing shoes.

Your doctor will want to know what type of object punctured your foot and whether you have removed any foreign matter from the wound. If the object was lodged in your foot and you removed it yourself, the doctor may want to take x-rays in order to make sure that no part of it remains stuck inside your foot (or possibly MRI, if the suspected object was not metallic).

If the puncture wound was caused by an animal bite, the doctor will want to know whether the animal was captured so that it can be determined whether you have been exposed to rabies or other diseases. Depending on the severity of the wound, surgical debridement (removal) of damaged tissue may be necessary.

How Can I Prevent A Puncture Wound in My Foot?

To prevent puncture wounds in your feet, it is best to wear shoes when walking around outdoors. If you are going to be walking in a dangerous area such as a construction site, remember to wear appropriately heavy boots.

Going barefoot is fine in the relatively safe environment of your backyard, but in urban environments—even in city parks—it is safer to wear shoes at all times.