Caleb Foster
Blood blisters under the nail, medically known as subungual hematomas, are usually caused by a crushing or stubbing injury. They can be very painful and cause throbbing as blood collects under the nail. The blood can turn dark over time, and the pressure of the hematoma may cause the nail to come off completely. To relieve the pain and pressure, doctors may drain the blood, a procedure called trephination. This procedure is ideally performed within 48 hours of the injury, as the blood begins to clot after this amount of time, making drainage difficult. Without drainage, a subungual hematoma may take several months to reabsorb or grow out, and a new nail may take up to several weeks to several months to grow back, depending on whether it is a fingernail or toenail.
| Characteristics | Values |
|---|---|
| Medical Term | Subungual Hematoma |
| Cause | Bleeding under the nail due to a crushing or stubbing injury |
| Symptoms | Severe throbbing pain, discoloration (darkened area under the nail), swelling, inability to move the finger or toe, fracture |
| Treatment | Drainage or trephination within 48 hours of injury, elevation of hand or foot, cold compress, compression |
| Nail Regrowth | Fingernail: 8 weeks to 6 months, Toenail: 6 months to 18 months |
Explore related products
Drainage of blood blisters
A blood blister under the nail, also known as a subungual hematoma, is usually caused by a crushing or stubbing injury. Over time, the blood may turn dark, and the pressure of the hematoma may cause your nail to come off completely (avulsion). To relieve the pain and pressure, you can choose to drain the hematoma. This procedure, called trephination, involves making a small hole in the nail to allow the blood to flow out. Drainage should be performed by a doctor, ideally within the first 48 hours after the injury, as the blood begins to clot after this amount of time, making drainage difficult.
During the procedure, the doctor may numb the affected finger or toe with a nerve block before using one of the following decompression methods:
- Cautery: Using a heated wire (electrocautery device) or carbon laser to burn a hole or holes.
- Trephination: Making a small hole in the nail to allow the blood to drain. This can be done quickly and relatively painlessly in a doctor's office or urgent care centre. Doctors recommend draining subungual hematomas when they cause pain or make up 50% or more of the nail.
It is important to note that you should not attempt to drain a hematoma at home. Using home methods such as a heated pin or paper clip to make a hole in the nail may cause infection from bacteria entering the wound. Infections can often cause much more damage than the initial injury.
The amount of time it takes for a hematoma to reabsorb without drainage depends on its size. In general, it may take several months for a fingernail hematoma to reabsorb or grow out, while a toenail hematoma may take between 12 and 18 months. Small hematomas may heal on their own without much issue, and you can reduce symptoms by elevating your hand or foot, using a cold compress for pain and swelling, and applying compression to slow the bleeding under the nail.
The Perfect Time to Remove Tin Foil from Nails
You may want to see also
Explore related products
Pain relief
A blood blister under the nail, also known as a subungual haematoma, is usually caused by a crushing or stubbing injury. This results in blood collecting under the nail, which can be extremely painful due to the pressure exerted. The pain from a subungual haematoma typically lasts for a few days, but in some cases, it can persist or be severe, warranting a visit to a healthcare provider.
If the haematoma is small and not causing significant pain, it can often be left to heal at home. Applying ice and elevating the affected area can help reduce swelling, and over-the-counter anti-inflammatory medications like aspirin, Advil, Motrin, or ibuprofen can be taken to manage minor pain. However, if the pain is intense or persistent, it is advisable to seek medical attention.
One effective method to alleviate pain associated with subungual haematomas is trephination or decompression, which involves draining the accumulated blood to relieve pressure. This procedure can be performed by a healthcare professional within 48 hours of the injury. During trephination, the doctor may use a heated wire (electrocautery device) or a carbon laser to burn a small hole in the nail, allowing the blood to drain out. This technique is quick and generally painless. Alternatively, a heated needle or cautery device can be used to create the drainage hole.
After the procedure, it is crucial to keep the treated finger or toe bandaged and elevated during the initial 12 hours. Cold compresses may also be recommended during this period. In some cases, a splint may be necessary for a few days until the tenderness subsides. Additionally, soaking the affected area in a warm solution with Epsom salts for 15 minutes daily can help alleviate pain and promote drainage.
It is important to note that attempting to drain a subungual haematoma at home is not recommended due to the risk of infection. Always seek medical advice before deciding on the appropriate course of action.
The Evolution of Nail Art: Are We Overdoing It?
You may want to see also
Explore related products
Healing time
The healing time for a blood blister under the nail, or subungual haematoma, depends on the size of the haematoma and whether it is drained. Small haematomas may heal on their own without causing any issues.
If left to heal on their own, haematomas may take several months to reabsorb or grow out. Toenails may take between 12 and 18 months to grow back, while fingernails may take between 4 and 9 months. Nails that grow back may have ridges or other abnormalities.
If the haematoma is drained, the wound should heal within a few weeks. Drainage can be performed within the first 48 hours of the injury, after which the blood will begin to clot, making drainage difficult. During the procedure, a small hole is made in the nail to allow the blood to flow out. The hole should be large enough to let the blood drain, which takes about a day or two. The wound should be covered with sterile gauze during this time.
Dip Nails: How Long Should You Wait?
You may want to see also
Explore related products
Potential complications
A subungual hematoma, or blood blister under the nail, can lead to several potential complications if left untreated or improperly treated. Here are some possible complications to be aware of:
- Infection: If the blood blister is not drained properly, there is a risk of infection. Attempting to drain the hematoma at home using unsterile methods, such as a heated pin or paper clip, can introduce bacteria into the wound, leading to infection. Infections can often cause more damage than the initial injury.
- Nail loss: The pressure from the built-up blood can cause the nail to fall off partially or completely. This is more likely to occur if the hematoma is large or left untreated. Nail loss can also occur as a result of the drainage procedure if not performed correctly.
- Abnormal nail growth: After a nail falls off due to a hematoma, there is a chance that the new nail may grow back with ridges or other abnormalities. In some cases, damage to the nail matrix (the area where nails form) can result in the nail not growing back at all or growing back with an abnormal appearance.
- Prolonged healing time: Even if the hematoma is small and does not require drainage, it may take several months for it to reabsorb or grow out completely. Without proper care, the healing process can be prolonged, and the risk of infection or other complications may increase.
- Pain and discomfort: Subungual hematomas can cause intense pain and throbbing due to the pressure of blood collecting under the nail. If left untreated, this pain can persist and affect daily activities. Proper drainage and pain management can help alleviate discomfort.
- Fracture: If the injury that caused the hematoma was severe, there may be underlying fractures in the finger or toe. Symptoms such as swelling or inability to move the affected digit could indicate a fracture. Seeking medical attention can help diagnose and treat any potential fractures.
Glass Nail Files: How Long Before You Need a Replacement?
You may want to see also
Explore related products
Prevention
To prevent blood blisters under your nails—known medically as subungual hematomas—you should avoid crushing or stubbing injuries to your fingers and toes. This can happen when something falls on your nail, you stub your toe, you wear tight shoes, or you engage in repetitive stress movements such as running.
If you have artificial nails, be extra cautious as you may not be able to see a subungual hematoma forming. If you feel intense pain and pressure, remove the artificial nail and examine the nail bed.
If you experience bleeding under your nail, see your healthcare provider as soon as possible, ideally within 48 hours. They may recommend draining the hematoma if it covers 25% or more of your nail, or 50% or more according to another source. Drainage can relieve pain and pressure and prevent the nail from falling off.
If you are unable to see a healthcare provider, you can treat a minor subungual hematoma with at-home methods while the injury heals. Over-the-counter pain relievers can reduce discomfort and swelling. The RICE method can also be useful:
- Rest: Rest the finger or toe and avoid using it where possible.
- Ice: Use an ice pack to reduce swelling and pain.
- Compression: Apply pressure, such as a wrap, to the area immediately to reduce the amount of blood that can pool.
- Elevation: Keep the affected hand or foot elevated to reduce swelling.
Do not attempt to drain the hematoma at home as this may cause infection. If home measures don't provide relief, contact a doctor for further advice.
Toe Nail Healing: Understanding Bruise Recovery Time
You may want to see also
Frequently asked questions
A blood blister under the nail, also known as a subungual hematoma, usually lasts for several months without treatment and can cause the nail to fall off.
If the blood blister is small, you may not need to seek medical care. However, if the pain is intense or the blister covers more than half of the nail, it is recommended to drain the blister by performing nail trephination, which should be done within 48 hours of the injury.
Symptoms of a blood blister under the nail include severe throbbing pain, discoloration (red to purple to dark brown or black), and pressure under the nail.
