Isla Bennett
Weak nails and excessive bruising can be indicative of underlying health issues. Weak nails can be caused by overexposure to moisture or chemicals, or indicate nutritional deficiencies, such as iron deficiency, hypothyroidism, or zinc deficiency. Excessive bruising under the nail, known as subungual hematoma, can be a result of trauma or injury to the blood vessels under the nail bed. In rare cases, bruising and weak nails can be indicative of more serious conditions, including skin cancer, psoriasis, endocarditis, or nail melanoma. While some nail abnormalities are harmless, it is important to seek medical advice if you are concerned about the appearance of your nails or if you experience persistent symptoms.
| Characteristics | Values |
|---|---|
| Medical Term | Subungual Hematoma |
| Cause | Sudden trauma to the nail, such as a heavy object falling on the toe or finger |
| Symptoms | Pain, swelling, nail discoloration, throbbing |
| Treatment | Drainage procedure, decompression, trephination, home remedies (RICE method), pain relievers |
| Healing Time | 4 to 6 months for a fingernail, 12 to 18 months for a toenail |
| Prevention | Wear proper footwear, be cautious when closing doors or using tools |
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What You'll Learn
Subungual haematoma
The first symptom of a subungual haematoma is throbbing pain in the nail area, caused by the pressure of blood pooling under the nail bed. This is followed by discolouration of the nail, which typically starts as reddish-purple and eventually turns dark brown and black as the blood clots. The pain usually subsides within a few days, but the nail itself will take longer to recover. The discolouration will grow out with the nail, which can take anywhere from 4 to 6 months for a fingernail and 12 to 18 months for a toenail. In some cases, the nail may fall off or need to be removed and will be replaced by a new, healthy one.
Simple trephination, or decompression, can be performed to relieve the pressure and pain caused by the pooled blood. This involves making a small hole in the nail with a heated wire (electrocautery device), a carbon laser, or a needle, to allow the blood to drain. This procedure should be performed by a medical professional within 48 hours of the injury to prevent clotting and potential weeks of unnecessary pain.
To reduce swelling, it is recommended to elevate the affected hand or foot and ice the area. Over-the-counter anti-inflammatories and pain medications can also be taken to relieve discomfort and reduce inflammation. In some cases, further treatment may be required if there is additional damage, such as a broken bone or deep cut.
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Bone fractures
While excessive bruising and weak fingernails are not direct symptoms of bone fractures, they can be indicators of underlying issues that may be related to fractures. Bruising under the fingernails, known as subungual hematoma, can result from trauma or injury to the fingers, such as crushing or slamming the finger in a door. This can lead to bleeding and bruising under the nail, causing pain and swelling. In some cases, a subungual hematoma may indicate a more serious underlying condition, such as a broken bone or fracture.
To diagnose a fracture, a doctor will typically order imaging tests such as X-rays or ultrasounds. These tests help visualize the bone and identify any breaks or abnormalities. In the case of a subungual hematoma, a doctor may also perform imaging tests to check for underlying fractures, especially if there is severe pain or deformation of the finger or toe.
Treating a bone fracture typically involves immobilizing the affected area to allow the bone to heal. This may involve the use of casts, splints, or braces to stabilize the bone and surrounding joints. In some cases, surgery may be necessary to realign the broken bones and ensure proper healing.
The healing time for a bone fracture varies depending on the severity of the break and the bone involved. Simple fractures may take a few weeks to heal, while more complex fractures can take several months. During the healing process, it is crucial to follow the doctor's instructions and take the necessary precautions to ensure proper bone alignment and recovery.
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Nerve damage
Nerve pain can manifest in various ways, including numbness, tingling, buzzing, or weakness. If a nerve that controls muscles is injured, the affected muscles can become weak or stop functioning altogether. This loss of function can lead to muscle atrophy, where the muscles get smaller due to prolonged inactivity. Nerve injuries can also cause pain at the site of the injury or along the entire nerve up to the spinal cord. Skin changes, such as alterations in color, texture, and sweating, may also indicate nerve damage.
The treatment for nerve damage depends on the severity and location of the injury. Minor nerve damage may only require rest and splinting to protect the affected area. In more severe cases, surgery may be necessary to repair the nerve. This involves reconnecting the ends of the cut nerve or using a nerve graft to bridge the gap if the nerve ends cannot be reconnected. If the nerve cannot be repaired, surgeons may attempt to reconstruct its function using nerves or muscles that are still functional.
It is important to seek medical attention if you suspect nerve damage or experience symptoms like prolonged pain, numbness, or weakness. Early diagnosis and treatment can help improve the chances of recovery and reduce potential complications.
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Melanoma
While excessive bruising and weak fingernails can be indicative of a subungual hematoma, a rare form of skin cancer called subungual melanoma can also cause changes in nail pigmentation. Melanoma can occur under a fingernail or toenail and can cause a dark mark to form under the nail. However, it is important to note that melanoma is typically not associated with pain or injury.
The exact causes of melanoma in the nail unit are not fully understood, but it is believed to arise from the uncontrolled growth of melanocytes, which are the cells that produce melanin, the pigment that gives colour to the skin and nails. Risk factors for melanoma in the nail unit include genetic factors, family history of melanoma, and exposure to ultraviolet (UV) radiation, although the role of UV radiation in nail unit melanoma is not as clear as in other types of melanoma.
The signs and symptoms of melanoma in the nail unit can include changes in nail pigmentation, such as a new dark streak or band, or a change in the colour or shape of an existing streak. Other possible symptoms include nail thickening, brittleness, or cracking, as well as bleeding, ulceration, or discharge in the nail bed. In some cases, there may be pain or discomfort associated with the affected nail.
If you notice any suspicious changes in your nails, such as persistent discolouration or abnormal growth, it is important to consult a dermatologist or healthcare provider for a thorough evaluation. They may perform a physical examination, take nail clippings or biopsies, and possibly order imaging tests or blood work to confirm a diagnosis. Early detection and treatment of melanoma are crucial for improving outcomes.
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Home treatments
Weak nails and excessive bruising can be caused by nutrient deficiencies or underlying health issues. While home treatments can help alleviate the symptoms, it is important to address any underlying causes.
- Avoid using your nails as tools, as this can lead to breakage and chipping, which weakens the nail.
- After removing nail polish, or if you think you are dehydrated, moisturize your nails with hand cream.
- File your nails in one direction, rather than using a back-and-forth motion, as this can weaken the nails.
- Avoid filing the sides of the nails too much, as this can also weaken them.
- See a dermatologist or another skincare professional if you have tried multiple treatments for several weeks and have not noticed any change in your nails. They may be able to prescribe a prescription-strength nail treatment.
- Lifestyle changes can also help strengthen nails.
- Apply ice to the bruise to reduce blood flow to the area and prevent the bruise from worsening.
- Wrap the bruised area in an elastic bandage to help prevent blood vessels from leaking.
- Elevate the bruised area above the level of your heart to relieve pain and drain fluid away from the bruised area.
- Apply heat to boost circulation and increase blood flow, helping to clear away the trapped blood.
- Eat foods that contain bromelain, such as pineapple, which has anti-inflammatory properties and may help reduce bruising.
- Apply topical treatments such as vitamin K cream or arnica, which can help reduce inflammation and swelling.
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Frequently asked questions
Excessive bruising under the nails is called a subungual hematoma. It occurs when an injury breaks open blood vessels under the nail, causing blood to collect and become trapped. This can lead to symptoms such as intense pain and throbbing.
If you have a subungual hematoma, you should seek medical attention. Your doctor may recommend a simple drainage procedure called trephination to relieve the pressure and pain. This procedure should be done within the first 48 hours of the injury to prevent weeks of unnecessary pain.
Yes, a subungual hematoma can cause your nails to become weak and fall off. The pooled blood under the nail can separate it from its bed, causing the nail to fall off on its own after several weeks. A new fingernail can regrow in as little as 8 weeks, while a toenail may take about 6 months.
