Noah Sinclair
A black nail is often a symptom of a subungual hematoma, which is a common injury that occurs when blood collects under the nail, causing intense pain and throbbing. The blood can turn dark in colour over time, and the pressure may cause the nail to fall off. A minor subungual hematoma usually heals over time without treatment, but it can take several months or even years for the new nail to grow out.
| Characteristics | Values |
|---|---|
| Time taken to heal | A few days to several months or years |
| Treatment | Drainage of excess fluid, stitches, bandaging, splints, home remedies, pain relievers, RICE method, decompression, trephination, cautery, electrocautery, digital block |
| Symptoms | Darkened discolouration, intense pain, throbbing, swelling, inability to move the finger or toe, pus, redness, heat around the nail, bleeding, broken bones, damage to the nail bed, fracture, cut in the nail bed, bruising |
| Complications | Loss of nail, infection, deformity of the new nail, melanoma |
| Prevention | Rest the finger or toe, ice, compression, elevation, antibiotics |
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What You'll Learn
Healing time for subungual haematomas varies
A subungual haematoma is a common injury that occurs when blood collects under the nail, causing intense pain and throbbing. This is usually caused by a crush or stubbing injury to the fingertip or toe. The blood may turn dark over time, and the pressure may cause the nail to fall off.
The healing time for subungual haematomas varies depending on the severity of the injury and the treatment method. Small haematomas may heal on their own within a few days without any issues. Home remedies such as resting the affected digit, using ice or cold compresses, keeping the hand or foot elevated, and applying compression can help manage pain and swelling and slow bleeding under the nail. Over-the-counter pain relievers can also be taken to reduce discomfort.
If the haematoma is larger, it may cause intense pain and pressure on the nail. In such cases, medical treatment may be necessary. One option is to drain the blood from under the nail through a procedure called nail trephination. This procedure should be performed by a doctor within 48 hours of the injury, as blood will start to clot after this time frame, making it difficult to drain. During trephination, the doctor will numb the finger or toe and create a small hole in the nail to allow the blood to drain out. The area will then be bandaged, and drainage may continue for up to 3 days.
In some cases, the nail may need to be removed to check for lacerations or repair the nail bed. This is more likely if there is severe damage to the nail bed or surrounding tissues. After nail removal, the wound should heal within a few weeks, but it may take around 6-9 months for a new nail to grow back. In some cases, the nail may not regrow, or it may grow back malformed or cracked.
Overall, the healing time for subungual haematomas can range from a few days to several months or even years, depending on the severity of the injury and the treatment method. It is important to seek medical attention if there are signs of infection, continuing pain, or other concerning symptoms.
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Drainage procedures
A black nail is usually a subungual haematoma, which is blood trapped under the nail. This can be caused by a stubbed toe, an ingrown toenail, an underlying health condition, or a fungal infection. Subungual haematomas are very common and are often painful, but they are not usually dangerous. They can sometimes indicate a more serious issue, such as melanoma, a form of skin cancer. If you are concerned about any unusual discolouration, it is important to seek medical advice.
If you have a subungual haematoma, the nail may fall off a few weeks after it appears, and it can take up to six months for a new nail to grow back. This timeframe can differ for each person, and it can take up to nine months for the nail to grow out. In some cases, the nail may never regrow, and there may be some malformation.
If you have a subungual haematoma, you can treat it with home remedies to help with pain and recovery. The RICE method can be used:
- Rest: Rest the 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 to reduce blood flow.
- Elevation: Keep the affected foot elevated to reduce swelling.
If the haematoma is small and not causing much pain, you can let it heal at home. However, if the pain is severe or lasts longer than a few days, seek medical advice.
If the haematoma is causing severe pain, your healthcare provider may recommend draining the blood. This procedure should be done within 48 hours of the injury, as the blood will start to clot after this time, making it hard to drain.
During the procedure, your toe will be numbed with a local anaesthetic so that you don't feel any pain. A healthcare professional will then create a small hole in your nail using a cautery device (a tool that uses electricity to produce heat) or a laser or needle. This allows the blood to drain out and relieves the pressure and pain. The area may be wrapped with a bandage, and it may continue to drain for up to three days.
It is important to note that nail drainage procedures should not be attempted at home, as they can cause infections or further injury to the nail bed. Always seek professional medical advice and treatment for such procedures.
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Home remedies
A black nail is often caused by a subungual haematoma, which is a collection of blood under the nail that causes intense pain. This can be the result of an injury, such as stubbing your toe or dropping something on it, or from running or walking a lot in ill-fitting shoes. In rare cases, black nails can be caused by melanoma, a form of skin cancer, or by certain medications or deficiencies, such as a vitamin B12 deficiency.
If you have a black nail, you should see a doctor if:
- You suspect it may be caused by melanoma—this usually appears as a dark streak.
- The injury is severe, or there is severe damage to the nail bed.
- There is severe bleeding or trauma.
- There are signs of infection, such as redness, swelling or pus.
- It is painful due to swelling or pressure.
If you are experiencing pain, you can try the following home remedies to reduce discomfort and swelling:
Rest
Rest the toe or finger and avoid using it where possible.
Ice
Use an ice pack or a cool pack wrapped in a towel to reduce swelling and pain. Do not apply ice directly to the skin.
Compression
Apply pressure to the area, such as a wrap, to reduce the amount of blood that can pool.
Elevation
Keep the affected hand or foot elevated above the level of your heart to reduce swelling.
Over-the-counter pain relievers
Take over-the-counter pain medications to reduce discomfort and swelling.
If your black nail is caused by a fungal infection, there are several home remedies you can try. However, keep in mind that these may take longer to work than prescription medications. You should not use home remedies for toenail fungus if you have diabetes or a weakened immune system.
Topical ointments
Apply a small amount of Vicks VapoRub or an antifungal cream to the affected area at least once a day.
Plant-based remedies
Apply Snakeroot (Ageratina pichinchensis) extract to the affected area every third day for the first month, twice a week for the second month, and once a week for the third month.
Tea tree oil
Apply 100% tea tree oil to the affected area.
Patches
Apply a treated patch to your nails overnight. These contain urea, a substance that improves the look of your nails by making them less brittle and discoloured.
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Potential complications
A black nail is usually caused by a subungual hematoma, which is a bruised nail resulting from blunt or crush trauma. Blood collects under the nail, causing pressure and pain. While subungual hematomas are typically minor injuries, there are some potential complications to be aware of.
Firstly, if the trauma caused additional damage, such as a broken bone or deep cut, further treatment and a longer healing time may be necessary. In some cases, the nail may need to be partially or completely removed to assess the extent of the injury and provide treatment. This can lead to the risk of infection and permanent damage to the nail or finger if not performed by a medical professional.
Another potential complication is nail loss. If there is damage to the nail matrix (the cells responsible for nail regeneration), the nail may fall off or grow back with a different shape. This could be temporary or permanent.
In rare cases, a black nail can be a sign of melanoma, a type of skin cancer. Melanoma under the nail can cause a dark streak or spot and is usually not linked to any injury or pain. Early detection and treatment of melanoma are crucial for improving the prognosis. Therefore, it is important to seek medical attention if you have any concerns about the appearance of your nail or if the hematoma does not heal.
Additionally, subungual hematomas can be painful and may require pain management. Over-the-counter pain relievers can be used to reduce discomfort and swelling. The RICE method (Rest, Ice, Compression, and Elevation) can also be effective in reducing pain and swelling.
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When to seek medical attention
A black nail is usually caused by a subungual hematoma, or blood under the nail. This can be the result of a crush injury to the tip of the finger or toe, causing blood to collect and become trapped under the nail. While subungual hematomas usually aren't dangerous, there are some instances where you should seek medical attention.
Firstly, if you have a darkened area under your nail and haven't experienced any injury, you should see your doctor to rule out other possible causes. Melanoma can occur under a fingernail or toenail, and while rare, it can cause a dark mark to form under the nail without causing pain or being linked to an injury.
Secondly, if you have a subungual hematoma that covers more than a quarter of the nail, or if you are experiencing continuing, intense pain, you should seek medical attention. Pain from a subungual hematoma usually goes away within a few days, so if your pain is severe or lasts longer, you should see your doctor. They will check for infection, fracture, and other injuries that could be causing the pain.
Thirdly, if you experience any signs of infection such as redness, swelling, oozing pus, warmth at the injury site, or a fever, you should contact a healthcare professional right away. In addition, if the bleeding under your nail does not stop, or there is severe damage to the nail bed, you should seek medical advice.
Finally, if you have a cut or laceration under your nail, you may need sutures to repair the wound. If you have broken bones or serious damage to the nail bed and/or surrounding tissues, you should seek medical attention immediately.
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Frequently asked questions
A subungual hematoma (blood under the nail) can take several months or years to heal. The new nail may grow out within 6 to 9 months, but this can differ for each person and depends on whether it is a fingernail or toenail.
If you have a black nail, you should see a healthcare professional as soon as possible. If it has been less than 48 hours, a doctor can drain the excess fluid and relieve the pressure. If there is severe bleeding or trauma, it is important to seek medical attention to check for more serious issues.
There are several home remedies that can help manage a minor subungual hematoma while the nail heals. This includes over-the-counter pain relievers to reduce discomfort and swelling, and the RICE method: Rest, Ice, Compression, and Elevation.
