Toenails
Should I worry about a bruised toenail?
Bruised toenails are pretty common, yet many people wonder if they should be worried about them. Here, we give you the lowdown on bruised toenails, what causes them, what you can do to prevent them, and when you may need to see a podiatrist.
What is a bruised toenail?
At some stage, you’ve probably had a bruise on your body. A bruise is when part of your body becomes injured and blood from the damaged blood vessels leak out. Because the blood has nowhere to go, it becomes trapped under the skin and forms a red, purplish or black mark.
Just like other parts of your body, your toenail can also become bruised. But instead of the blood and other fluid being trapped under your skin, it becomes trapped under your toenail. The medical term for a bruised toenail is subungual haematoma.
Symptoms of a bruised toenail
Bruised toenails can differ in appearance. There may be a small, dark spot under the nail, or a large area of discolouration. You may also notice:
- the nail appears red, purplish, brown or black
- throbbing pain
- bleeding under your nail
- painful pressure on the nailbed
- cuts or tears to your nail
- part or all of your toenail is disconnected from the nailbed.
What causes bruised toenails?
Bruised toenails are caused by trauma or injury to the nail. This can be due to:
- direct force — for example, when something falls on your toe, stubbing your toe, or kicking a ball
- repetitive stress — for example, wearing poorly fitting shoes or engaging in activities that put repetitive strain your feet such as running or hiking
Things that increase the risk of getting a bruised toenail include:
- participating in physical activities that may involve repetitive stress such as long-distance running, soccer and dancing
- wearing footwear such as thongs or sandals that don’t provide protection
- wearing ill-fitting shoes
- not keeping your nails trimmed – these can hit the front part of your shoe causing trauma
- having a bleeding or blood clotting disorder
- having nerve damage such as diabetic neuropathy which changes the way you feel pain.
Should I be worried about bruised toenails?
Most of the time, bruised toenails are nothing to worry about. If less than half your toenail is discoloured and it’s not causing you any pain, you may be able to manage it at home.
This involves the RICE protocol:
- Rest — rest your toe if possible
- Ice — apply ice to reduce swelling and pain
- Compression — apply pressure to the area to reduce the amount of blood that will pool under the nail
- Elevation — elevate your foot to reduce swelling.
If it’s painful you can also use over-the-counter (OTC) pain relief.
After an injury to your toenail, the nailbed can take anywhere between seven and 10 days to heal. Your nail may fall off on its own (don’t pull it off) or it may just grow out over time. However, if the injury is more serious, and your toenail does fall off, it can take up to 12 months for it to completely regrow.
Podiatrist Sydney
When to see a podiatrist about a bruised toenail?
Not all bruised toenails should be managed at home. You should visit a podiatrist if:
- the bruise is large
- the bruise is painful
- your nail has been torn or cut
- your nail is raised, loose or separating from the nailbed
- there is discharge coming from the nail
- you suspect your toe may be broken or you have a cut that needs stitches
- you have other health conditions that affect healing and circulation such as neuropathy, peripheral artery disease or diabetes.
It’s important to see a podiatrist to get things checked out if you’re concerned or if you notice any of the symptoms above. If damage to the nailbed is left untreated, it can lead to permanent damage where the nail won’t grow back properly, or infection.
It’s also important to check out blackened toenails if you’re unsure if they are a result from trauma. Other causes could include a fungal infection, diabetes, or melanoma (although this is rare).
How are bruised toenails treated?
Podiatry treatment for a bruised toenail often involves relieving pressure on the nail to relieve pain and help the blood drain. This may involve drilling a hole in the nail.
Note: NEVER drill a hole in your nail yourself as this could lead to infection or damage to your nailbed.
If damage is severe or your nail has separated from your toe, your podiatrist may decide to remove the nail. If there are signs or risk of infection, you may also need antibiotics.
How to prevent bruised toenails
As they often say, prevention is better than cure, so here’s a few things you can do to prevent bruised toenails in the first place.
- wear proper-fitting shoes that allow plenty of room for your feet
- wear protective footwear when playing sports, working in the garden or on building sites
- avoid open-toed shoes or thongs if you’re in an environment where your foot may be stepped on
- keep your toenails clean and trimmed
- wear moisture-wicking socks when exercising as moist socks can increase pressure on your nails.
The Foot Hub team is here to help with bruised toenails or any other foot condition.
References
Verywell Health, Causes and treatments for a bruised toenail, https://www.verywellhealth.com/toenail-trauma-1337801
Health, What is a bruised toenail? https://www.health.com/bruised-toenail-8613078
Medical News Today, Your guide to subungual hematomas (blood under the nail), https://www.medicalnewstoday.com/articles/321836