Caleb Foster
Blood under the nail, also known as a subungual hematoma, is a common injury that can occur from crushing or stubbing your finger or toe. The blood can pool under the nail, causing pain and pressure. Depending on the severity of the injury, the blood under the nail can be left to reabsorb over time or drained by a medical professional. So, how long should blood stay under your nail?
| Characteristics | Values |
|---|---|
| When to see a doctor | Within the first 48 hours after injury |
| Clotting time | 48 hours |
| Reabsorption time | Several months to years |
| Nail growth time | 4-18 months |
| Treatment | Drainage, stitches, bandaging, elevation, compression, etc. |
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What You'll Learn
When to drain blood under the nail
Blood under the nail, also known as a subungual haematoma, is usually caused by a crushing injury to the nail. Over time, the blood may turn dark, and the pressure of the haematoma may cause your nail to come off completely. Before that happens, you may choose to relieve the pain and pressure by draining the haematoma.
It is recommended that you visit a doctor within the first 48 hours of the injury for the best results. The blood begins to clot after this time, making drainage difficult. Drainage can be performed quickly and relatively painlessly in a doctor's office or urgent care centre.
Doctors recommend draining subungual haematomas when they cause pain or make up 50% or more of the nail. If the area of bleeding is very small, the nail will usually fall off on its own after several weeks, as the pooled blood has separated it from its bed. A new fingernail can regrow in as little as eight weeks, while a toenail may take up to six months to fully regrow.
If you have not experienced an injury, but notice a darkened area under your nail, you should see your doctor to rule out other possible causes.
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When to leave blood under the nail
Blood under the nail, or subungual hematoma, occurs when an injury breaks open blood vessels under the nail, causing blood to collect and become trapped. It can affect both fingernails and toenails.
- If the subungual hematoma is small and the pain is mild, it will usually resolve without treatment. The trapped blood will eventually be reabsorbed, and the discolouration will disappear.
- If the blood under your nail is the result of a minor injury and the bleeding has stopped, you can leave it be. Keep the area clean and dry, and follow general advice for caring for an injured nail, such as keeping the hand or foot elevated to reduce swelling.
When not to leave blood under the nail:
- If the affected area continues to collect blood, you experience extreme pain, or the injury is at the base of the nail, see a healthcare provider.
- If you have other symptoms like swelling, an inability to move the finger or toe, or signs of infection, seek medical attention.
- If the blood under your nail is the result of a more serious injury, such as a broken bone or deep cut, you will likely need further treatment and more time to heal.
It is important to note that you should never attempt to drain a subungual hematoma at home. If the hematoma is bothering you, see a doctor within the first 48 hours after your injury for the best results. After this amount of time, the blood begins to clot, making drainage difficult.
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How to drain blood under the nail
Blood under the nail, or subungual hematoma, is usually caused by a crushing or stubbing injury. Over time, the blood may turn dark, and the pressure may cause your nail to fall off. To relieve the pain and pressure, you may consider draining the blood.
When to Drain
Not all subungual hematomas need to be drained. Small hematomas may heal on their own without causing any issues. Doctors recommend draining subungual hematomas when they are causing pain or make up 50% or more of the nail. If the injury is causing you severe pain, this means the blood is causing too much pressure.
Where to Get it Done
Nail trephination is a quick, outpatient procedure that can be performed in a doctor's office, emergency room, or urgent care clinic.
How it's Done
The procedure involves making a small hole in the middle of your nail plate with a needle, electrocautery device, or a special tool designed for trephination. This hole allows the blood to flow out and relieves the pressure and pain under your nail.
Aftercare
You'll be able to go home right after the procedure. You may notice drainage through the hole in your nail for the next 24 to 36 hours, which is normal and temporary. Keep the area dry and clean, and follow your provider's instructions for changing bandages and caring for your finger or toe.
Risks
Nail trephination rarely leads to complications, but it is possible to develop an infection or minor injury to your nail bed. Trying to drain the blood yourself may lead to worse damage or infection from bacteria entering the wound.
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What causes blood under the nail
Blood under the nail is called a subungual hematoma. It is usually caused by a crushing or stubbing injury, such as hitting your nail with a hammer, dropping a heavy object on your toe, or even running in shoes that are too tight. These types of injuries damage the blood vessels just under the nail plate, causing blood to pool and put pressure on the nail, which can be extremely painful.
Subungual hematomas are typically minor injuries and the pain usually gets better in a few days. The blood under the nail may turn dark over time, and the pressure may cause the nail to come off completely. If the hematoma is small, it may not need to be drained at all and can heal on its own. However, if the hematoma is causing pain or covers a large area of the nail, it is recommended to drain it to relieve the pressure and pain.
Drainage of a subungual hematoma, also known as trephination, should be performed by a doctor within the first 48 hours after the injury, as the blood will start to clot after this amount of time, making drainage difficult. During the procedure, the doctor will numb the affected area with a local anesthetic and then make a small hole in the nail to allow the blood to flow out.
If you have a darkened area under your nail and haven't had any injury, it is important to see your doctor to rule out other possible causes, such as melanoma.
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How to treat blood under the nail
Blood under the nail, or subungual haematoma, is usually caused by a crushing or stubbing injury. Over time, the blood may turn dark, and the pressure of the haematoma may cause your nail to come off completely. Before that happens, you may choose to relieve the pain and pressure by draining the haematoma. This procedure, also called trephination, involves making a small hole in the nail to allow the blood to flow out. Drainage should be performed by a doctor in their office or at an urgent care centre. Doctors recommend draining subungual haematomas when they cause pain or make up 50% or more of the nail.
If the area of bleeding is very small, the nail will usually fall off on its own after several weeks because the pooled blood has separated it from its bed. A new fingernail can regrow in as little as 8 weeks, while a toenail may not fully regrow for about 6 months. If there has been an injury to the nail bed or surrounding tissues, the new nail may take longer to grow and may not look normal.
To treat blood under the nail, you can try the following:
- See a doctor within the first 48 hours of the injury. The blood begins to clot after this amount of time, making drainage difficult.
- Ice and elevate the area to reduce swelling.
- Take over-the-counter anti-inflammatories like aspirin, Advil, or Motrin for minor pain.
- If you are experiencing intense pain or feeling pressure on the nail, contact your doctor. They may recommend draining the haematoma.
- Do not attempt to drain the haematoma at home, as this can cause infection.
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Frequently asked questions
A subungual hematoma is a bruise that occurs when blood vessels under the nail are damaged, causing blood to collect and become trapped.
Blood under the nail, or subungual hematoma, can take several months or years to heal on its own. However, it is important to seek medical attention within the first 48 hours of the injury, as drainage may not be possible after this time due to blood clotting.
If you have a subungual hematoma, you should elevate your hand or foot, use a cold compress for pain and swelling, and apply compression to slow the bleeding. It is recommended to see a doctor within the first 48 hours to drain the hematoma and relieve the pressure. Do not attempt to drain the hematoma at home as it may cause infection.
