Isla Bennett
Blood under the nail, also known as a subungual hematoma, is a common injury that occurs when blood vessels under the nail break open, causing blood to collect and become trapped under the nail. This can be caused by a single major trauma, such as slamming your finger in a door, or multiple minor traumas, such as wearing ill-fitting shoes. The blood under the nail can cause intense pain and throbbing due to the pressure of the blood collecting between the nail and the nail bed. While small subungual hematomas may not require medical treatment, larger hematomas or those causing severe pain may need to be drained by a doctor to relieve the pressure and pain. The new nail typically grows out within 6-9 months, but this can differ for each person and may take up to a year.
| Characteristics | Values |
|---|---|
| Medical Term | Subungual Hematoma |
| Cause | Trauma or injury to the nail unit |
| Appearance | Darkened discolouration, such as black spots |
| Symptoms | Pain, throbbing, pressure, swelling, inability to move the finger or toe |
| Treatment | Drainage, decompression, removal of the nail, home remedies (rest, ice, elevation, compression) |
| Healing Time | A few days to a few weeks for pain relief; 6-9 months for the nail to grow back |
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Subungual hematoma causes
Subungual haematomas are injuries of the nail bed, in which bleeding develops under the nail. They are caused by a direct blow or crush injury to the distal phalanx, such as getting a finger pinched in a doorway. As blood enters the space under the nail, it applies painful pressure to the nail bed. This pressure can cause severe throbbing pain.
Subungual haematomas can happen to both fingernails and toenails. They occur when something causes the blood vessels under the nail to break open, with blood collecting and becoming trapped under the nail. Possible causes include something falling on the nail or crushing it, stubbing a toe, wearing tight shoes, and repetitive stress from movements such as running. They can also be caused by non-traumatic factors, such as a variety of tumours, including melanoma, or splinter haemorrhages.
Subungual haematomas are very common and are usually not dangerous unless there is severe damage to the nail bed or surrounding tissues. They can be very painful and may require medical treatment, especially if the pain is unmanageable. However, most cases will heal on their own within a few months, and home remedies such as resting, icing, applying compression, and elevation can encourage healing.
If the pain is severe or lasts longer than a few days, it is recommended to seek medical advice to check for infection, fracture, or other injuries. In some cases, a doctor may perform a procedure called decompression or trephination, which involves creating a small hole in the nail to drain the blood and relieve pressure and pain. This procedure is typically done within 48 hours of the injury, as the blood will start to clot after this time, making it harder to drain.
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Healing time
The medical term for blood under the nail is a subungual haematoma. This occurs when blood vessels under the nail break and leak, causing blood to pool and become trapped under the nail. This can be the result of a single major trauma, such as dropping something heavy on the toe, or multiple minor traumas, such as wearing ill-fitting shoes or running.
Subungual haematomas can be extremely painful and cause throbbing as blood collects under the nail. The pressure from the blood building up can be intense, and the blood will cause the nail to turn blue, purple, black, or brown.
Most subungual haematomas will heal on their own within a few months. The new nail typically grows out within 6–9 months, but this can differ for each person and may take up to a year. Minor haematomas usually heal without treatment, with the blood eventually being reabsorbed and the discolouration disappearing. However, if there is severe damage to the nail bed, the nail may grow back malformed or there may be little to no regrowth.
To aid healing, it is recommended that you rest the digit, use a cool pack, keep the hand or foot elevated, and apply compression. Over-the-counter painkillers can help reduce inflammation and discomfort. If the haematoma is large or causing a lot of pain, you should seek medical care for drainage and additional treatment.
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Home remedies
Blood under the nail, or subungual haematoma, is usually caused by a traumatic injury. This can include stubbing your toe, hitting your finger with a hammer, or slamming your finger in a car trunk. The injury causes blood vessels under the nail to break open, resulting in blood collecting and becoming trapped under the nail. This can cause severe throbbing pain due to the pressure of the pooled blood.
If the subungual haematoma is small and the pain is mild, it usually does not require medical treatment. Home remedies can be used to encourage healing and manage pain. These include:
- Resting the affected digit
- Icing the area to reduce swelling
- Elevating the affected hand or foot
- Applying compression
- Taking over-the-counter anti-inflammatory medications, such as aspirin or ibuprofen, for minor pain
It is important to note that while most subungual haematomas will heal on their own within a few months, some cases may require medical attention. If you experience severe pain, bleeding that does not stop, signs of infection, or a subungual haematoma that does not go away, it is recommended to contact a doctor. Additionally, if the injury affects a baby or child, seek medical advice.
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Medical treatments
Blood under the nail, or subungual haematoma, is usually caused by a crushing or stubbing injury that damages the blood vessels under the nail bed. The blood may turn dark, and the pressure may cause the nail to come off.
If the affected area continues to collect blood, you are in severe pain, or the injury is at the base of the nail, it is best to see a healthcare provider. You should also seek medical attention if you notice signs of infection, such as pus, redness, or heat around the nail.
If you are experiencing pain or other symptoms, a doctor may perform a procedure called nail trephination or drainage. This involves creating a small hole in the nail to allow the blood to drain out. This procedure can be performed quickly and relatively painlessly in a doctor's office. It is important not to attempt this procedure at home, as it may lead to infection or permanent damage to the nail or finger.
If the nail is badly damaged, your doctor may also remove it. The wound should heal within a few weeks, but it may take up to six months for a fingernail and up to 18 months for a toenail to grow back. In some cases, the new nail may grow back abnormally or may not grow back at all if the nail matrix is damaged.
To care for your finger or toe after treatment, keep the area clean and dry, and follow your provider's instructions for changing any bandages. The bruise will gradually grow out over the next few weeks or months, and the discolouration will fade.
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Prevention
Subungual hematomas, or blood under the nail, are usually caused by trauma to the nail. This can include something falling on the nail, crushing it, stubbing the toe, wearing tight shoes, or repetitive stress from movements such as running.
To prevent blood under the nail, it is important to take precautions to avoid any trauma to the nail. Here are some ways to help prevent subungual hematomas:
Wear Proper Footwear: Choose comfortable and well-fitting shoes that provide adequate protection for your toes. Avoid wearing shoes that are too tight or narrow, which can increase the risk of crushing or injuring your toenails.
Protect Your Hands and Feet: When engaging in activities that may involve impact or trauma to the nails, such as sports or manual labour, consider wearing protective gear such as gloves, toe guards, or sturdy shoes. This can help absorb some of the impact and reduce the risk of nail injuries.
Avoid Repetitive Stress: If you participate in activities that involve repetitive motions, such as running or certain types of manual labour, take regular breaks and practice proper form to reduce stress on your nails and surrounding structures.
Be Mindful of Your Surroundings: Pay attention to your environment and take precautions to avoid potential hazards that could cause nail injuries. For example, be cautious when lifting heavy objects to prevent crushing your nails, and avoid walking barefoot in areas where you might stub your toes.
Trim Your Nails Regularly: Keeping your nails trimmed and filed can help reduce the risk of them catching or tearing during everyday activities. Well-maintained nails are less likely to suffer trauma or become injured.
Seek Prompt Medical Attention: If you do experience a nail injury, it is important to seek medical attention as soon as possible. Early intervention can help prevent complications and promote proper healing. Additionally, do not try to drain a subungual hematoma yourself; always seek professional medical help.
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Frequently asked questions
A subungual hematoma is the medical term for bleeding under the nail, which can affect both fingernails and toenails. It occurs when blood vessels under the nail break and leak, causing blood to collect and become trapped under the nail.
Subungual hematomas are usually caused by trauma or injury to the nail, such as slamming your finger in a door or dropping something heavy on your toe. They can also be caused by wearing tight or ill-fitting shoes.
The healing time for a subungual hematoma can vary. The blood under the nail will eventually dry up and grow out, or the nail will fall off. This process can take anywhere from a few weeks to several months or even years. In some cases, the nail may not grow back or may grow back disfigured.
