Caleb Foster
Subungual hematoma, or bleeding under the nail, is a common injury that can affect both fingernails and toenails. It occurs when blood vessels under the nail break open, causing blood to collect and become trapped under the nail, leading to swelling, discoloration, and pain. While small hematomas may heal on their own, larger hematomas may require medical attention, especially if the bleeding does not stop or there is severe damage to the nail bed. In this paragraph, we will explore the topic of how long it takes for under-nail bleeding to stop and the various factors that influence the healing process.
| Characteristics | Values |
|---|---|
| Medical Term | Subungual Hematoma |
| Description | Bruised Fingernail or Toenail |
| Causes | Direct Trauma to the Nail, such as Stubbing, Crushing, or Tight Shoes |
| Symptoms | Severe Throbbing Pain, Discoloration, Swelling |
| Treatment | Drainage, Bandaging, Keeping the Area Clean and Dry, Elevating the Hand or Foot, Using a Cold Compress |
| Healing Time | Varies, from a Few Days to Several Months or Years |
| Complications | Infection, Nail Avulsion, Nail Abnormalities |
| Prevention | N/A |
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What You'll Learn
Minor subungual hematomas usually heal without treatment
Subungual hematoma, or bleeding under the nail, is usually caused by a crushing or stubbing injury. This can be something falling on the nail, slamming it in a door, or from sports activities, especially those involving sudden accelerations, such as soccer, basketball, and tennis. Repeatedly thrusting the toes against a shoe's toe box can cause a subungual hematoma called jogger's toe, runner's toe, or black toenail. This injury can happen easily and affect both toenails and fingernails.
For more severe cases, medical treatment may be necessary. Doctors may recommend draining subungual hematomas when they cause pain or make up 50% or more of the nail. Drainage can be performed quickly and relatively painlessly in a doctor's office or urgent care center. In a hospital or medical setting, trephining is generally accomplished by using an electrocautery device or an 18-gauge needle. The hole is covered with a sterile dressing and must be kept dry afterward.
In some cases, a doctor may need to remove the entire nail and use stitches to repair the nail bed. The main complication associated with decompression is a small risk of infection in the residual hematoma.
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Drainage procedures are available for larger hematomas
Subungual haematomas are usually caused by a trauma or injury to the nail unit, such as slamming a door on your fingers or dropping a weight on your toe. The injury may also be caused by wearing ill-fitting shoes or participating in certain sports such as football, basketball, or ballet.
While minor subungual hematomas typically do not cause serious health issues and can resolve without treatment, it is advised to seek medical advice if the pain is unbearable or there is significant damage to the nail. Drainage procedures, such as trephination, are available for larger hematomas that cover a substantial portion of the nail or cause severe pain.
Trephination is a safe and effective procedure performed by trained medical professionals, such as podiatrists, to treat subungual hematomas. It involves creating a small hole in the nail to release the trapped blood, thereby reducing pain and pressure. The procedure is typically quick, relatively painless, and can be performed in a doctor's office or urgent care center.
- Cleaning the Area: Before starting the procedure, the affected area is cleaned with alcohol, iodine, chlorhexidine, or another suitable solution to reduce the risk of infection.
- Administering Anesthesia: Depending on the severity of the injury and the presence of other damage, the doctor may administer a digital block or another form of local anesthesia to numb the area and minimize pain during the procedure.
- Drainage: Using a heated 18-gauge needle, cautery device, or specialized laser, gentle pressure is applied to the nail to create a small hole. This allows the built-up blood to drain out, providing immediate relief from pain and pressure.
- Post-Procedure Care: After the procedure, it is normal to experience drainage through the hole in the nail for up to 24 to 36 hours. Patients are advised to follow instructions for changing bandages and keeping the area clean and dry to promote proper healing.
It is important to note that attempting to drain a subungual hematoma at home using methods like heated pins or paper clips is not recommended due to the risk of infection and further complications. Always seek the help of a trained medical professional for proper diagnosis and treatment.
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Home remedies can encourage healing
Subungual hematoma, or bleeding under the nail, can be extremely painful. It is caused by an injury that damages the blood vessels under the nail, resulting in blood collecting and becoming trapped under the nail. This can lead to swelling, nail discolouration, and throbbing pain.
- Rest: Rest the affected finger or toe and avoid using it.
- Ice: Apply an ice pack wrapped in a soft cloth to the area to help reduce swelling and pain.
- Compression: Apply pressure to the area with a wrap to reduce the amount of blood that can pool under the nail.
- Elevation: Keep the affected hand or foot elevated to reduce swelling.
Over-the-counter pain relievers can also help manage pain and swelling. It is important to keep the wound clean and dry while it heals.
If the bleeding is severe, accompanied by extreme trauma, or does not stop, it is important to seek medical advice. A doctor may recommend a simple procedure called trephination, which involves draining the blood from under the nail to relieve pressure and pain. In some cases, the nail may need to be removed to allow the nail bed to heal.
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Hematomas are caused by blood vessel damage
Subungual haematoma is the medical term for bleeding and bruising under the nail. This occurs when blood leaks underneath the nail due to trauma or injury to the nail unit. This can be caused by a single major trauma, such as dropping a weight on the toe, or multiple minor traumas, such as wearing ill-fitting shoes. Subungual haematomas can cause intense pain and throbbing as blood collects under the nail.
Hematomas are areas of blood that collect outside of blood vessels, often in the surrounding tissues. They are caused by damage to the blood vessel walls, which can be the result of various traumas or injuries. This damage causes the blood vessel walls to break, allowing blood to escape and pool outside the vessel. Hematomas can occur in any blood vessel, including veins, arteries, and capillaries.
While many hematomas are relatively harmless, some can indicate more serious medical problems. Most hematomas do not cause complications unless they involve a lot of bleeding. However, they can lead to swelling, discoloration, and warmth, and may require medical treatment. Hematomas inside the head are particularly dangerous due to the limited space, which can lead to pressure on the brain and eventual damage.
It is important to note that you should not attempt to drain a subungual hematoma at home. Draining a hematoma involves cleaning the area, administering pain relief or anesthesia, and then applying gentle pressure to the nail with a heated needle or cautery device. This procedure should only be performed by a medical professional to avoid the risk of infection and other complications.
To manage a hematoma under the nail, it is recommended to rest the injured area and apply an ice pack wrapped in a towel to reduce pain and swelling. Wrapping or splinting the area can also help keep the blood vessel from reopening during the healing process. Minor subungual hematomas usually resolve without treatment, and over-the-counter painkillers can help reduce initial inflammation and discomfort.
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Seek medical attention for severe damage or pain
Subungual hematoma, or bleeding under the nail, is usually caused by a crushing or stubbing injury. This can happen easily and is usually not worrisome unless there is broken bone or damage to the nail bed and/or surrounding tissues.
If you experience severe pain or pressure, you should seek medical attention. A doctor can perform a simple draining procedure to relieve the pressure and provide relief. 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.
If you have a subungual hematoma that does not heal, you should contact a doctor. You should also seek medical attention if you experience a cut or laceration, or if there are signs of infection, such as red/discoloured skin around the nail, swelling, pus, fever, or warmth at the injury site.
In rare cases, a subungual hematoma may be caused by a malignant tumour, such as melanoma or squamous cell carcinoma. If you have a darkened area under your nail and haven't had an injury, see your doctor to rule out other possible causes.
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Frequently asked questions
A subungual hematoma is a bruised fingernail or toenail that may cause severe, throbbing pain. It occurs when blood vessels under the nail break open, causing blood to collect and become trapped under the nail.
If the hematoma is small and the pain is mild, it will usually heal without treatment. You can treat it at home with rest, ice, and pain medication. However, if the hematoma is large, you are experiencing extreme pain, or there is additional injury, you should seek medical care.
To stop the bleeding under your nail, your doctor may perform a procedure called nail trephination or decompression to drain the blood. This involves making a small hole in the nail with a laser, heated wire, or needle to relieve the pressure and pain.
A subungual hematoma may take months or years to heal completely. The new nail may grow out within around 4 to 9 months, but this can vary for each person.
