Caleb Foster
Black and blue toenails are often caused by trauma, fungus, or repeated injuries that create a collection of thickened blood under the nail, also known as a subungual hematoma. The discolouration will grow out as your nail grows and could be gone in a couple of months. However, regrowth may be delayed if there has been injury to the nail bed, and it could take anywhere from 6 months to 2 years for the nail to fully regrow.
| Characteristics | Values |
|---|---|
| Cause | Trauma, fungal infection, bacterial infection, yeast infection, psoriasis, melanoma, vitamin B12 deficiency, diabetes, vascular disease, weak immune system, or heart infection |
| Symptoms | Discoloration (black, dark red, purple, burgundy, yellow), throbbing pain, discharge, unpleasant smell, swelling, bleeding, or thickening of the nail |
| Treatment | Antibiotic ointment, stitches, surgical removal, topical prescription medications, oral medication, cold compress, biotin supplements, saline solution, or band-aid |
| Regrowth Time | 6 months to 2 years, depending on the severity of the injury and overall health |
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What You'll Learn
- Black toenails are often caused by trauma, fungus, or repeated injuries
- A subungual hematoma is a collection of blood underneath the toenail
- Toenail regrowth tends to be slower after an injury or trauma
- Factors that affect the speed of regrowth include age, climate, and season
- Complications from a black toenail can include permanent damage
Black toenails are often caused by trauma, fungus, or repeated injuries
Black toenails can be unsightly and sometimes painful. They are often caused by trauma, fungus, or repeated injuries. A black toenail is usually the result of an injury that causes blood to pool beneath the nail, known as a subungual hematoma. This can occur due to a sudden impact injury, such as dropping a heavy object on your toe or stubbing your toe. It can also result from repeated minor trauma, such as wearing ill-fitting shoes, running, or playing sports.
Fungal infections are another common cause of black toenails. Toenails are particularly susceptible to fungi as shoes and socks create a warm and moist environment for their growth. Fungal infections typically cause white or yellowish discolouration, but debris can build up, causing the nail to appear black. Certain health conditions, such as diabetes, vascular disease, and a weakened immune system, can also increase the risk of fungal infections and discoloured toenails.
In some rare cases, black toenails can be indicative of more serious underlying health issues. For example, black toenails have been associated with melanoma, the most aggressive form of skin cancer. Additionally, health conditions affecting circulation, such as diabetes, kidney disease, heart disease, psoriasis, or anemia, can also lead to discoloured toenails. Therefore, it is important to seek medical advice if you are concerned about the discolouration of your toenails.
The treatment for black toenails depends on the underlying cause. In many cases, the discolouration will grow out as your nail grows, and the issue will resolve itself. However, if the subungual hematoma is large or causing pain, a healthcare provider may recommend draining the blood to reduce pressure and pain. In severe cases, nail removal and stitches may be necessary to prevent infection and complications.
To prevent black toenails, it is recommended to wear properly fitted shoes that provide adequate room for your toes. Keeping your toenails cut short and avoiding tight or narrow shoes can also help reduce the risk of trauma to your toenails. Additionally, maintaining good foot hygiene, including keeping your toes clean and dry, can help prevent fungal infections.
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A subungual hematoma is a collection of blood underneath the toenail
Subungual hematomas can sometimes be treated conservatively and may resolve on their own without treatment. Most cases will heal within a few months, but it can take up to 18 months for a toenail to fully regrow. Home remedies such as resting, icing, applying compression, and elevation can encourage healing. Over-the-counter pain relievers can also help reduce discomfort and swelling.
If the pain is severe or unmanageable, medical treatment may be necessary. A doctor may drain the hematoma by making a hole through the nail into the hematoma (trephining) or, less conservatively, by removing the entire nail. This procedure is usually painless but may be performed under local anaesthetic if necessary. After treatment, it is important to keep the wound dry and covered to protect the sensitive skin underneath the toenail.
In rare cases, a subungual hematoma can be associated with a malignant tumour of the nail unit, such as melanoma or squamous cell carcinoma. Melanoma can cause a dark mark to form under the nail and is usually painless and not linked to an injury. It is important to contact a doctor if you experience severe pain, bleeding that does not stop, signs of infection, or if the hematoma does not go away on its own.
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Toenail regrowth tends to be slower after an injury or trauma
Toenail injuries are common, and in many cases, the injured nail will fall off as a new nail grows in its place. Toenail regrowth tends to be slower after an injury or trauma, taking anywhere from 6 months to 2 years.
A black or blue toenail is often caused by trauma, fungus, or repeated injuries that create a collection of thickened blood under the nail, known as a subungual hematoma. This can result from a sudden crush injury, such as dropping a heavy item on the nail, or from repeated minor stresses like wearing ill-fitting shoes, running, or playing sports. In some cases, fungal infections can also cause toenails to turn black due to the darkening of the keratin tissue under the nail.
If the subungual hematoma is small or painless, treatment may not be necessary, and the discoloured area will grow out as the nail grows, typically within a few months. However, if the pooled blood separates the nail from the nail bed, the toenail may fall off, and a new toenail will take about six months to fully regrow. Regrowth may be delayed if there has been injury to the nail bed or surrounding tissues, and the new nail may not always grow back with a normal appearance.
To promote nail health and speed up the healing process, it is recommended to keep your toenails cut short and wear properly fitted shoes. Additionally, maintaining overall health is important, as nail growth can slow down if you are sick or malnourished. Biotin supplements can also be taken to promote cell growth and contribute to faster nail growth.
In more severe cases of black toenail, such as when the discoloration affects a large portion of the nail or there are signs of infection, it is important to seek medical attention. A podiatrist or healthcare provider may recommend nail removal and stitches to prevent infection and complications. They may also suggest different decompression methods to drain the pooled blood, reducing pressure and pain. After treatment, it is crucial to keep the treated nail bandaged and elevated.
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Factors that affect the speed of regrowth include age, climate, and season
Toenails generally grow at an average rate of 1.62 mm per month, and it can take up to a year and a half for a lost toenail to fully regrow. However, several factors can influence the speed of toenail regrowth, including age, climate, and season.
Age plays a significant role in nail growth. As people age, blood circulation slows down, leading to a decrease in nail growth speed. For example, Dr. William Bean observed that his left thumbnail growth rate decreased from 0.123 mm per day at age 23 to 0.095 mm per day at age 67. Hormonal changes throughout life, such as during puberty, pregnancy, and lactation, can also impact nail growth rates, with growth typically peaking during puberty and declining as hormone levels balance out with age.
Climate and seasonal changes can also influence nail growth. While the specific mechanisms are not well understood, it is believed that these factors can affect blood circulation and nutrient availability, which in turn impact nail growth. For example, fingernails tend to grow faster during the summer months, possibly due to increased circulation and nutrient delivery to the nails.
Other factors that contribute to nail growth include overall health, diet, exercise level, sex, hereditary factors, and nail care practices. Maintaining good nail hygiene, such as keeping nails clean and trimmed, can support overall nail health and promote growth. Additionally, certain health conditions, such as fungal infections, injuries, or illnesses, can affect the nail matrix, the area where nail growth occurs, and subsequently impact the speed of regrowth.
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Complications from a black toenail can include permanent damage
Black toenails are often caused by trauma or injury, such as stubbing your toe or dropping a heavy object on it. This can result in a subungual hematoma, which is a collection of blood underneath the toenail. The blood darkens, causing the nail to appear black. In many cases, the discolouration will simply grow out as your nail grows, and could be gone in a couple of months. However, if the pressure created by the pooled blood becomes too intense, it may be necessary to see a doctor or podiatrist to drain the blood and reduce the pressure and pain.
In some cases, black toenails can indicate more serious underlying health conditions that may cause permanent damage. These include:
- Fungal infections, which can cause debris to build up and turn the nail black. Fungal infections are often treated at home, but if left untreated, they can spread to other parts of the foot and body.
- Melanoma, the most serious form of skin cancer, which can appear as a dark patch under the toenail.
- Medical conditions such as diabetes, vitamin deficiency, heart disease, or kidney disease.
If the black toenail is due to one of these underlying conditions, it may be possible to prevent permanent damage by treating the root cause. However, in some cases, the nail may never return to its normal appearance, and there is a risk of permanent damage, such as the nail growing back misshapen or thickened.
It is important to see a healthcare provider if you notice any discolouration as the nail regrows, or if the black toenail is not causing you pain but more than half of the nail is black. They can examine your toenail and ask about any recent injuries, activities, and footwear to determine the best course of treatment.
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Frequently asked questions
Toenails can take anywhere from 6 months to 2 years to grow back. The rate of regrowth depends on the scenario and can be influenced by factors such as age, climate, overall health, and the severity of the injury.
Black and blue toenails are often caused by trauma, fungus, or repeated injuries that create a collection of thickened blood under the nail (also known as a subungual hematoma). This condition can result from dropping heavy objects on your toe, falling, running, or wearing ill-fitting shoes.
If the discoloration is minor and causing no pain, treatment may not be necessary as the nail will grow out over time. However, if the problem is severe or persists, it is recommended to consult a podiatrist or healthcare provider. They may recommend nail removal, stitches, or decompression methods to drain the blood and reduce pressure and pain.
