Trauma is a common reason for black toenails. The medical term for black toenails, caused by trauma and resulting in bruising under the nail is subungual hematoma. This can occur after an injury, as a result of breaking open blood vessels under the nail. The pooling of blood under the nail presents as a black discolouration.
Bruising under the nail although it may look unsightly or cause discomfort, can be easily fixed and prevented with a trip to see your local podiatrist. However there are other more serious reasons your nails may be changing colour, such as skin cancer, gangrene or aggressive fungal infections that form under the nail plate.
Causes For Nail Trauma:
One of the common causes for black toenails caused by trauma is poorly fitting shoes, especially if the person is very active. Shoes that are too tight or narrow can put pressure on the toenail, breaking blood vessels and leading to a pool of blood under the nail.
Running or hiking down steep hills or stopping and starting suddenly, such as while playing soccer or basketball, can also cause bruising under the nail plate.
Signs of Nail Trauma:
- Black discolouration/ blood under the nail.
- Nail being sore or tender to touch.
- Feels like there is pressure under the nail.
Treatment for Black Toenails:
- Have nail examined by a podiatrist, to get a correct diagnosis and exclude malignancies, gangrene or fungal infections of the nail bed.
- If wearing an artificial nail: remove artificial nail and have the nail examined.
- If there is damage to the nail bed or pain see a podiatrist to relieve the pressure and fix the damaged nail.
- R.I.C.E regime (rest, ice, compress, elevate) for acute injuries within the first 48 hours.
- Removal of the nail by a podiatrist in very severe cases.
- If bone fracture is suspected, X-ray needs to be performed to confirm.
- Drainage of the blood from under the nail to relive pain and pressure, performed by a podiatrist if necessary.
- Antibiotic medication if signs of an infection present, such as:
- Fluid or pus draining from under the nail.
- Increased swelling or throbbing pain in the toe.
- Odour from the nail bed.
- Red streaks in the skin and/or around the area of injury.
- A fever or feeling unwell.
