Liam Carter
A fingernail can turn purple due to a subungual hematoma, which is a collection of blood under the nail. This can be caused by blunt force or crush injuries, such as slamming your finger in a door. The colour of the nail can change to purple or black due to the pooling of blood under the nail, which can be extremely painful. In addition to nail discoloration, symptoms of a subungual hematoma include pain, nail sensitivity, and separation of the nail plate from the nail bed. While subungual hematomas are typically minor injuries, it is important to seek medical attention if there is intense pain, a deep cut, or bleeding that won't stop. In some cases, a doctor may perform a simple draining procedure to relieve the pressure and provide relief. Additionally, purple fingernails can also be a sign of cyanosis, which is caused by a lack of oxygen in the blood.
| Characteristics | Values |
|---|---|
| Cause | Subungual hematoma, a minor injury caused by blunt force trauma or crush injuries |
| Symptoms | Pain, nail discolouration, nail sensitivity, separation of nail plate from nail bed |
| Treatment | Simple draining procedure, decompression or trephination, removal of nail plate, stitches |
| Prevention | Being aware of your hands and feet, wearing appropriate footwear and gloves, avoiding distractions when using tools |
| Discolouration | Initially red or purple, gradually turns dark brown or black |
| Healing time | 6 to 9 months for a nail to completely grow out and return to its normal colour |
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Subungual hematoma
A subungual hematoma is a common injury where blood collects under a fingernail or toenail, causing pain and discolouration. It is usually the result of a crush injury to the distal phalanx, such as getting a finger trapped in a door, or blunt force trauma, like hitting your finger with a hammer. The injury causes blood to pool under the nail, creating painful pressure on the nail bed. The discolouration can be red, purple, blue, brown or black.
The amount of force required to cause a subungual hematoma can also result in other injuries, such as broken bones or deep cuts. If there is no additional injury, a subungual hematoma is not typically a cause for concern and can be treated at home by icing the area and taking over-the-counter anti-inflammatories. However, if there is a broken bone or other injury, further treatment and recovery time is needed.
If the pain is intense or gets worse over time, it is important to seek medical attention. A healthcare provider can perform a simple draining procedure, known as trephination, to relieve the pressure and reduce pain. This involves making a small hole in the nail with a heated wire (electrocautery), a carbon laser, or a needle. The procedure is usually quick and painless, and the patient will be given a local anaesthetic. After the procedure, the nail will be bandaged, and the patient will be advised to keep the area elevated and use cold compresses for the first 12 hours.
In some cases, the entire nail may need to be removed, and the nail bed repaired with stitches. This is more likely if there is bleeding under a large area of the nail surface. The nail will usually fall off on its own after several weeks, and a new fingernail can regrow in as little as eight weeks. However, there is a possibility that the new nail may not look normal. Complications are rare but can include infection or abnormally growing tissue, such as melanoma.
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Nail bruising
A bruised fingernail, or subungual hematoma, is usually the result of a minor injury, such as blunt force trauma or a crush injury. It can be extremely painful due to the pressure of blood collecting between the nail and the nail bed. The nail may appear red or purple initially, but this will gradually turn to dark brown or black. The bruise will grow out over several weeks or months, and the nail will return to its normal colour in about six to nine months.
If you have a bruised nail, it is important to assess whether there are any other injuries, such as a broken bone, deep cut, or damage to the nail bed or surrounding tissues. These types of injuries may require further treatment and a longer recovery time. In some cases, the nail may need to be removed surgically to repair the underlying tissues.
To relieve pain and reduce swelling, you can ice and elevate the affected area and take over-the-counter anti-inflammatories. If you experience severe or worsening pain, or if there is bleeding that won't stop, it is important to seek medical care right away. A healthcare provider can perform a simple draining procedure, known as decompression or trephination, to relieve the pressure and provide relief.
It is worth noting that blue or purple nails can also be a sign of cyanosis, which is caused by a lack of oxygen in the blood. This can be due to exposure to cold temperatures, certain lung and heart conditions, circulation problems, or issues with hemoglobin. If you experience blue or purple nails along with difficulty breathing, it is important to seek immediate medical attention.
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Loss of blood flow
Fingernail injuries can affect the nail plate and the nail bed, which can crack and bleed. When an injury occurs, the blood vessels in the nail bed are damaged, causing them to leak blood, which then builds up underneath the nail plate. This is known as a subungual hematoma. The blood has nowhere to go, so it pools and puts pressure on the nail plate, causing pain and discoloration. The color may initially look red or purple but will gradually turn dark brown or black.
If you experience a loss of blood flow to the injured finger, it is important to get it checked out by a healthcare professional. To assess the blood flow, press on a portion of the nail or finger that is not injured. If the area turns white and then turns pink within seconds when you release the pressure, you have good capillary refill, indicating that blood is still flowing. However, if the area remains white or takes a long time to turn pink, it could be a sign of reduced blood flow.
Another sign to look out for is a loss of sensation in the fingertip. Touch the tip of your finger to ensure you still have feeling in the area. If you can feel sensations, it is unlikely that you have nerve damage. However, if you experience numbness or a lack of sensation, it could indicate a more serious issue.
In addition, keep an eye out for unusual colors in your fingertip, such as blue or blanched white. These colors could indicate a lack of oxygen in the blood, a condition known as cyanosis. Cyanosis can be caused by various factors, including exposure to cold temperatures, certain lung and heart conditions, circulation problems, or issues with hemoglobin. While not always serious, it is important to seek medical attention to determine the underlying cause and receive appropriate treatment.
It is important to note that subungual hematomas are typically minor injuries, and the pain usually improves within a few days. However, if there is intense pain or other injuries such as a broken bone or deep cut, further treatment and time may be needed for healing. Applying ice and elevating the affected area can help reduce swelling and minor pain. In some cases, a healthcare provider may perform a simple draining procedure to relieve the pressure and provide relief.
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Infection
When a fingernail turns purple due to injury, it is often a result of subungual haematoma, commonly known as a "black nail." This occurs when blood collects under the nail, typically due to trauma to the nail bed or the finger. The time it takes for the nail to turn purple can vary depending on the severity of the injury and the amount of blood accumulating under the nail. Usually, it can take just a few minutes to a few hours for the purple discolouration to appear, but in some cases, it may take up to a day or so for the full extent of the bruising to become visible.
Now, let's discuss the possibility of infection in such an injury:
Signs of infection to watch for include increasing pain, swelling, redness, and warmth around the nail and finger. There may also be a foul odour and pus drainage from under the nail. In some cases, the infected nail may separate from the nail bed, a condition known as onycholysis. These symptoms typically develop within a few days to a week after the initial injury, but they can sometimes take longer to manifest, especially if the infection is slow-growing.
If you suspect an infection, it is important to seek medical attention promptly. A doctor will likely prescribe oral antibiotics to treat the infection and may also recommend soaking the affected finger in warm water and mild soap to help drain any pus and keep the area clean. In more severe cases, or when the infection is not responding to antibiotics, surgical intervention may be necessary to drain the abscess and remove any infected tissue.
To prevent infection, proper care of a fingernail injury is crucial. After the initial trauma, apply pressure to the nail to stop any bleeding and reduce the amount of blood collecting under the nail. Clean the area gently with soap and water, and consider applying a topical antibiotic ointment to prevent bacterial growth. Cover the nail and finger with a sterile dressing, and change it daily or as needed if it becomes wet or soiled. Keep an eye on the injury for any signs of infection and seek medical advice if concerned.
Remember, while a purple fingernail from injury is usually not a cause for immediate alarm, it is important to be vigilant for any signs of infection and to take appropriate steps to prevent it. With proper care and prompt medical attention when needed, most fingernail injuries will heal without complications.
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Peripheral cyanosis
In people with lighter skin tones, peripheral cyanosis can appear as blue or gray tips on the fingers. In those with darker skin, it may be easier to detect under the nails, around the eyes, or under the lips, tongue, and gums. The area of the body most affected by cyanosis can help determine the cause. For example, peripheral cyanosis can result from problems with an artery delivering blood and oxygen to the hands and feet, or from heart failure, which can prevent the heart from pumping blood effectively throughout the body.
Central cyanosis, on the other hand, affects the core organs of the body, as well as the lips, tongue, or both. It occurs due to a decrease in arterial oxygen saturation, indicating a cardiopulmonary condition. While peripheral cyanosis is rarely life-threatening, central cyanosis can be more serious.
The treatment for peripheral cyanosis depends on the underlying cause. Doctors may prescribe medications to treat heart and lung conditions and improve blood flow and oxygen supply to the affected areas. Warming or massaging the blue areas can also help restore blood flow and color to the skin.
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Frequently asked questions
A purple discolouration of the fingernail is usually caused by a subungual hematoma, which is bleeding under the nail. This can be a result of blunt force trauma or crush injuries. It is typically a minor injury and can be treated by a simple draining procedure to relieve pressure.
A subungual hematoma can cause the nail to turn red or purple initially, and then gradually darken to brown or black. The discolouration may take a few weeks or months to grow out.
If you experience a subungual hematoma, you can reduce swelling by icing and elevating the area. You can also take over-the-counter anti-inflammatories for minor pain. It is important to seek medical care if you experience intense pain, a deep cut, or continuous bleeding.
