Caleb Foster
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. While minor hematomas usually heal over time without treatment, it is important to seek medical attention if the injury is severe or if the pain is unmanageable. The healing time for a subungual hematoma can vary, depending on the severity of the injury and whether or not the nail falls off. In general, it may take several months to a year for the nail to fully heal and grow back.
| Characteristics | Values |
|---|---|
| Medical term | Subungual hematoma |
| Cause | Sudden trauma to the nail, such as hitting your fingertip with a hammer or dropping a brick on your toe |
| Symptoms | Severe throbbing pain, discoloration, pressure, and pain |
| Treatment | Drainage procedure, removing the nail, stitches for deep cuts, splint for broken fingertips |
| Healing time | A few days after drainage, a few weeks after nail removal, 6–9 months for a new nail to grow out, several months to years for the hematoma to heal |
| Home remedies | Elevating the affected hand or foot, using a cold compress, applying compression |
| When to see a doctor | Within 48 hours of injury, severe pain, worsening pain, deep cut, bleeding that won't stop, suspected broken bone, signs of infection |
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What You'll Learn
Trephination/drainage
A subungual hematoma is a bruised fingernail or toenail that occurs when an injury breaks open blood vessels under the nail, causing blood to collect and become trapped. This can result from stubbing your toe, hitting your finger with a hammer, or slamming your finger in a car trunk. The blood may turn dark over time, and the pressure of the hematoma may cause your nail to come off completely. Before this happens, you may opt to relieve the pain and pressure by draining the hematoma. This procedure, called trephination, involves making a small hole in the nail to allow the blood to flow out. It can be performed quickly and relatively painlessly in a doctor's office or urgent care centre.
It is important to seek medical care for trephination/drainage within the first 48 hours of the injury for the best results. After this time, the blood begins to clot, making drainage difficult. Trephination can be performed by a doctor or healthcare professional in their office or at an urgent care centre. They will numb the area before removing the nail to prevent pain. Following the procedure, the wound should be covered with sterile gauze to prevent infection and promote healing.
After trephination, it is crucial to follow your healthcare provider's instructions for caring for your finger or toe. They may recommend soaking the affected area in a warm solution with Epsom salts for 15 minutes daily to aid in fluid drainage and pain relief. It is also essential to keep the area clean and dry, as the nail may bleed a bit right after drainage.
The time it takes for a hematoma to reabsorb and the nail to grow back varies. It may take several weeks for the wound to heal, and a new fingernail may regrow in as little as 8 weeks. However, a toenail may take 6 to 18 months to grow back completely, and the new nail may take longer if there was injury to the nail bed or surrounding tissues. In some cases, the nail may not grow back, or it may look different, with ridges or other abnormalities.
While a minor subungual hematoma may heal without treatment, it is always best to seek medical advice. Your doctor can provide guidance on managing pain and preventing complications. They may recommend elevating the affected hand or foot, using a cold compress, and applying compression to slow the bleeding.
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Healing time
The healing time for blood under the nail, or subungual hematoma, varies depending on the severity of the injury and the treatment received. Subungual hematomas can usually heal on their own over several months or years, with the blood being gradually reabsorbed and the nail growing out. However, proper medical care should be sought as soon as possible, ideally within 48 hours of the injury, to ensure the best results and prevent complications.
Small or minor subungual hematomas may not require medical treatment and can often resolve without intervention. The pain associated with these minor cases typically eases within a few days, and the trapped blood will eventually be reabsorbed, causing the discolouration to disappear. For more serious injuries, medical treatment may be necessary. If left untreated, severe damage to the nail bed can result in permanent nail malformation or even the nail failing to regrow.
The healing time for a subungual hematoma can be shortened by performing a simple procedure called trephination or nail trephination, which involves draining the blood from under the nail. This can be done quickly and relatively painlessly in a doctor's office or urgent care centre. After this procedure, the wound should heal within a few weeks, but it may take about six to nine months for the nail to grow back completely and return to its normal colour. Soaking the affected finger or toe in a warm solution with Epsom salts can help drain fluid and alleviate pain during the healing process.
In some cases, the nail may need to be removed, either due to extensive damage or to relieve pain and pressure. If the nail is removed, the wound should heal within a few weeks, but it may take even longer for the nail to grow back, especially for toenails. Fingernails can regrow in as little as eight weeks, while toenails may take up to 12 to 18 months. During the healing process, it is important to keep the area clean and dry, and the wound should be covered with sterile gauze to prevent infection.
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Regrowing nails
If you have blood under your nail, it is called a subungual hematoma. This is usually caused by a crushing or stubbing injury. The blood may turn dark over time, and the pressure of the hematoma may cause your nail to come off completely. If your nail falls off due to a hematoma, it may take between 4 and 6 months for a fingernail to fully grow back, and a toenail may take between 12 and 18 months. Nails that regrow may have ridges or other abnormalities.
To help your nails grow back faster and stronger, you can try the following:
- Keep your nails clean and dry to prevent bacteria from growing beneath them.
- Trim your nails straight across with sharp manicure scissors or clippers, then round the tips of your nails into a soft curve.
- Moisturize your hands and nails with lotion, especially at the base of your nails where the cuticles are located.
- Avoid biting your nails or cutting them too short.
- Wear gloves when washing dishes, clothes, and surfaces to prevent water or cleaning products from sitting on top of your nails.
- Keep your nails filed into a slightly rounded or squared shape to prevent them from snagging and breaking.
- Eat a well-balanced diet full of fresh fruits and vegetables, lean sources of protein, an adequate amount of carbohydrates, and plenty of healthy fats.
It is important to note that you cannot make your nails grow faster magically. However, by taking care of them, they will grow stronger and last longer, making them less prone to breakage.
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Pain management
Blood under the nail, or subungual hematoma, is usually caused by a crushing or stubbing injury. It can cause severe throbbing pain due to the pressure of blood collecting between the nail and the nail bed.
If you have a subungual hematoma, you can try the following to manage the pain:
- Elevate your hand or foot to reduce swelling.
- Apply a cold compress to the affected area to alleviate pain and swelling.
- Take over-the-counter anti-inflammatories, such as aspirin, Advil, or Motrin, for minor pain.
- Use compression to slow the bleeding under the nail and reduce the amount of blood that can pool.
- Soak your finger or toe for 15 minutes a day in a warm solution with Epsom salts to help drain fluid and alleviate pain.
If the pain is severe or unmanageable, you should seek medical treatment. A doctor can drain the excess fluid and relieve the pressure, which can be performed quickly and relatively painlessly. If the nail is severely injured, a doctor may need to remove it.
Healing Time
The healing time for a subungual hematoma depends on various factors, such as the size of the hematoma and whether it is on a fingernail or toenail. Small hematomas may heal on their own without any issues, while larger hematomas may take several months to reabsorb or grow out. It typically takes around 6-9 months for a new nail to grow out, but this can vary for each person. In some cases, the nail may not grow back or may have abnormalities.
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Preventative measures
To prevent blood from pooling under your nail, you should be aware of your hands and feet when closing doors, and avoid going barefoot or wearing open-toed shoes when lifting heavy objects. It is also important to avoid distractions when using tools like hammers, and to wear appropriate gloves, shoes, and boots when doing manual labor. Ensure your shoes fit properly and do not put pressure on your toes.
If you have artificial nails, be aware that you may not be able to see a subungual hematoma. If you feel intense pain and pressure, remove the artificial nail and examine the nail bed.
If you experience bleeding under your nail, seek medical attention as soon as possible. If it has been less than 48 hours, a healthcare provider can drain the excess fluid and relieve the pressure. If the bleeding does not stop, or there is severe damage to the nail bed, seek medical treatment.
If you have a minor subungual hematoma, you can apply pressure with a wrap to the area to reduce the amount of blood that pools under the nail. Keep the affected hand or foot elevated to reduce swelling, and take over-the-counter anti-inflammatories for minor pain.
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Frequently asked questions
It is the medical term for a bruised nail, caused by a crushing or stubbing injury.
If the bleeding is severe, or the pain is unmanageable, seek medical attention as soon as possible. If it has been less than 48 hours, a doctor can drain the excess fluid and relieve the pressure.
If you have intense pain, a deep cut, or the bleeding won't stop, seek medical attention. Also, look out for signs of infection, such as redness or pus around the nail.
A minor subungual hematoma usually heals over time without treatment. The trapped blood will eventually be reabsorbed, and the discolouration will disappear. This can take a few months to a few years.
It can take anywhere from 6 to 18 months for a nail to grow back, depending on whether it is a fingernail or toenail.
