Caleb Foster
A bruised nail, medically referred to as a subungual haematoma, occurs when blood vessels under the nail break and leak blood into the area underneath the nail. This can be caused by a heavy object crushing the finger or toe, or by repeatedly jamming the toes into a too-tight shoe. The pain from a subungual haematoma typically lasts for a few days, and the nail usually takes several months to recover.
| Characteristics | Values |
|---|---|
| Medical term | Subungual hematoma |
| Cause | Trauma to the nail |
| Symptoms | Darkened area under the nail, severe throbbing pain |
| Treatment | Drainage, decompression, cautery, antibiotics, stitches, reattachment, splints, elevation, ice |
| Healing time | Pain relief is immediate, nail regrowth takes 4-18 months |
| Prevention | Keep the nail clean and dry, protect with a sterile dressing |
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What You'll Learn
Bruise healing time
The healing time for a nail bruise, medically known as a subungual haematoma, varies depending on the severity of the injury and whether there are any additional complications, such as broken bones or damage to the nail bed.
The pain from a subungual haematoma typically subsides within a few days, but the nail itself takes longer to recover. The discoloured nail will eventually grow out and be replaced by a new, healthy nail. According to the American Academy of Dermatology, it takes approximately 4 to 6 months for a fingernail to grow out and 12 to 18 months for a toenail. However, these timelines may be extended if there is damage to the nail bed or surrounding tissues.
In some cases, the injured nail may fall off or need to be removed by a medical professional. If the nail is removed, it will take about 7 to 10 days for the nail bed to heal. A new fingernail will typically take 4 to 6 months to grow back, while a toenail may take up to 12 months or more. The new nail may have grooves, ridges, or a different shape.
To promote healing and prevent complications, it is important to keep the injured nail clean and dry. Avoid soaking the nail, as this can lead to infection. Additionally, elevate the affected hand or foot and apply ice to reduce swelling and pain. If there is an open wound or infection, a healthcare provider may prescribe antibiotics to aid in healing and prevent further complications.
It is important to note that if the bruise is very large or there is a broken bone, the healing time may be extended, and medical attention should be sought. X-rays may be required to assess the extent of the injury and determine the appropriate treatment plan.
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Pain relief
A subungual hematoma, or a bruised nail, is a common injury that occurs when there is bleeding below the hard part of the nail (nail plate) due to trauma. This results in blood collecting under the nail, causing intense throbbing pain and pressure.
To relieve pain from a nail bruise, you can try the following methods:
Rest, Ice, and Pain Medication
If the hematoma is small and does not cause significant pain, it can be managed at home with rest, ice, and over-the-counter pain medication. Wrap ice in a soft cloth and apply it to the affected area to help reduce swelling and pain. Keep the injured area elevated to further reduce swelling. Over-the-counter anti-inflammatory medications such as aspirin, Advil, or Motrin can help manage minor pain.
Trephination or Decompression
If the pain is severe, a healthcare provider may recommend a simple, quick, and painless procedure called trephination or decompression to drain the blood and relieve pressure and pain. This procedure is most effective if performed within 48 hours of the injury, before the blood clots and forms a bulk under the nail, which can cause prolonged pain. During the procedure, the affected area is numbed with a nerve block, and a heated wire (electrocautery device), carbon laser, or needle is used to create a hole for the blood to drain. After the procedure, it is important to keep the nail clean and dry, avoiding soaking it to prevent infection.
Antibiotics and Further Treatment
In some cases, a bruised nail may lead to an infection, especially if the nail comes off, leaving an opening for germs to enter. Signs of infection include fever, redness, warm skin, swelling, and increased pain. If an infection develops, a healthcare provider may prescribe antibiotics and further treatment to address the underlying cause, such as a fracture or other injuries.
It is important to note that a new fingernail can regrow in about 8 weeks, while a toenail may take up to 6 months. However, if there is damage to the nail bed or surrounding tissues, the new nail may take longer to grow and may not look normal. Therefore, it is recommended to seek medical attention if there are any concerns or problems with the nail as it heals and regrows.
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Preventing infection
A bruised nail, also known as a subungual hematoma, occurs when there is bleeding and bruising under the nail. This can be caused by a heavy impact or repetitive friction, impact, and pressure. The pain from a subungual hematoma typically lasts a few days, while the nail itself can take several months to grow out and heal.
To prevent infection, it is important to keep the injured area clean and dry. Avoid soaking your nail, as this can increase the chances of infection. If you do get your nail wet, for example, in the bath or shower, thoroughly dry the nail by applying light pressure with a towel, followed by a tissue. This will help to prevent fungal infections and reduce moisture in the bruise.
If your nail comes off, you likely have an opening where an infection could start. Protect any exposed area with a sterile dressing while it heals. You can also cover the area with a bandage to provide extra protection and reduce pain. Keep an eye out for signs of infection, including fever, feeling unwell, redness or red streaks in the skin, skin or nail that feels warm to the touch, swelling, and significant pain. If you notice any of these symptoms, seek medical attention immediately.
In some cases, your doctor may prescribe antibiotics to prevent or treat an infection. If you have a broken bone, your doctor may place a wire in your finger or toe to keep the bone in place during healing.
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Regrowing nails
A bruised nail, or subungual haematoma, is caused by blood trapped under the nail, which puts pressure on the nerves in your fingers or toes. This can be extremely painful and may require a procedure called trephination to drain the blood and relieve the pressure.
After a nail injury, it's important to keep the area clean and dry to prevent infection. You should also allow the injured area to breathe as much as possible, only covering it with a bandage when necessary.
Nails will usually grow back, but the rate of regrowth can vary depending on various factors. Fingernails typically take anywhere from 3 to 8 weeks to several months or up to 6 months to regrow. Toenails tend to grow back even more slowly, with estimates ranging from 6 months to 2 years.
The growth rate of nails can be influenced by several factors. For example, nails tend to grow slower in older adults and in colder climates, while nails on the dominant hand tend to grow faster. Trauma or injury can also increase the rate of regrowth due to increased blood flow to the area. Overall health, nutrition, and hormones can also impact nail growth.
In some cases, a detached or torn nail may not reattach, and the nail bed may require medical treatment or surgery to improve its appearance. It's important to monitor the area for any signs of infection, such as redness, swelling, or pus, and seek medical attention if necessary.
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Complications and further care
A bruised nail, or subungual hematoma, can be extremely painful due to the pressure generated by the pooled blood under the nail. The pain typically goes away in a few days, but the nail itself will take longer to recover. It could take anywhere from 4 to 6 months for a fingernail to grow out, and 6 to 18 months for a toenail.
If the bone is broken or the bruise is very large, the nail may need to be removed and the nail bed repaired. The nail will likely fall off on its own if it is badly damaged and not removed by a doctor. If the nail comes off, there is a risk of infection, and antibiotics may be prescribed. Signs of infection include fever, feeling unwell, redness, skin or nail that feels warm to the touch, swelling, and significant pain. It is important to keep the injured area clean and dry to prevent infection.
If there has been damage to the nail bed and surrounding tissues, the new nail may take longer to grow and may not look normal. The new nail will likely have grooves or ridges and be somewhat misshapen.
If there is a broken bone in the finger or toe, it will take about 4 weeks to heal. A small bone break can be hard to spot without medical tests, so it is important to get an X-ray to check for fractures or other injuries. Untreated fractures could heal incorrectly, causing long-term pain and interfering with the natural function of the finger or toe.
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Frequently asked questions
It depends on the severity of the injury. The pain from a nail bruise typically goes away in a few days, but the nail itself will take longer to recover. It could take anywhere from 4 to 6 months for a fingernail to grow out, and 6 to 18 months for a toenail.
If you have a nail bruise, it is important to keep the area clean and dry to prevent infection. You can also ice the area to reduce swelling and pain. If the pain is severe or lasts longer than a few days, see your healthcare provider.
If you have a large bruise under your nail, there is a chance that you may have a broken bone as well. You should see a doctor right away if you suspect a broken bone or if there are signs of infection, such as redness, swelling, or fever.
