Liam Carter
Black toenails are usually caused by trauma or injury, such as repeatedly bumping your toenail or stubbing your toe, which can cause a collection of thickened blood under the nail. They can also be caused by fungal infections, which can be treated with anti-fungal medication, or, in rare cases, by a malignant melanoma tumour. If the cause is a subungual hematoma, the discolouration will grow out with the nail, which can take a couple of months. If the cause is a tumour, the discolouration will stay in the same spot. Toenails typically take about six months to fully regrow.
| Characteristics | Values |
|---|---|
| Average daily growth rate of fingernails | 0.1 mm |
| Average monthly growth rate of fingernails | 3.47 mm |
| Time taken for a new fingernail to regrow | 8 weeks |
| Time taken for a new toenail to regrow | 6 months |
| Toenail discoloration causes | Trauma, fungus, ingrown toenail, melanoma |
| Toenail trauma causes | Running injury, crush injury, blunt-force injury |
| Toenail fungus characteristics | White, yellow, or black discoloration |
| Toenail melanoma characteristics | Dark, irregular-looking skin patches |
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What You'll Learn
Black toenail causes
Black toenails are usually caused by trauma or injury to the toe. This could be a sudden or blunt force injury, such as stubbing your toe or dropping a heavy object on your foot, which causes the blood vessels beneath the nail bed to break and blood to pool under the nail. It could also be a repetitive injury, such as a toenail repeatedly bumping into the tip of your shoes, which creates a collection of thickened blood under the nail, also known as a subungual hematoma. This is a common injury for runners, and long-term pressure on the toes from ill-fitting shoes can also cause black toenails.
Another common cause of black toenails is a fungal infection. Toenails are particularly susceptible to fungal infections as socks and shoes provide a warm and moist environment for fungi to grow. While fungal infections typically cause white or yellowish discolouration, debris can build up near the infection, causing the nail to appear black.
In rare cases, a black toenail may be a sign of a more serious underlying health condition, such as melanoma, the most aggressive form of skin cancer, which often appears as a dark brown misshapen spot. It could also be a sign of nutritional deficiencies, heart disease, diabetes, kidney disease, or an autoimmune disease such as psoriasis.
If you are unsure what is causing your black toenail, it is a good idea to see a doctor or dermatologist, especially if you suspect melanoma or another underlying health condition.
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Treatment options
Black toenails are usually caused by trauma, fungus, or repeated injuries that create a collection of thickened blood under the nail, also known as a subungual hematoma. The discoloration can range from black or brown spots to covering the entire nail. It is often coupled with throbbing pain generated by the pressure of the thickened blood collecting between the nail and the nail bed. In rare cases, discoloration can be caused by a malignant melanoma tumor.
If you have no history of injury, it is important to have the nail evaluated by a healthcare provider. The change in color could be caused by a fungal infection, which will need to be treated with antifungal medication. In some cases, black toenails can be a symptom of a deeper health issue, such as diabetes, poor circulation, autoimmune disease, nutritional deficiencies, or certain medications.
Rest
If your black toenail is caused by stubbing your toe or wearing tight shoes for a short period, rest may be sufficient. Healing can take a few days or weeks, depending on the severity.
Drainage procedures
If the trauma is more severe and has caused significant pain or pressure, you may need to consult a podiatrist. Podiatrists can perform a drainage procedure, which involves puncturing a small hole in the nail to release trapped blood.
Antifungal treatments
When the condition results from a fungal infection, the treatment requires addressing the source of the black toenail fungus. Antifungal prescription-strength solutions can target fungi on and around the nail. Oral medication may also be prescribed to address the infection from within your body.
Correcting ingrown toenails
If your black toenail results from an ingrown toenail and infection, targeted treatments will address the nail and the surrounding skin. A podiatrist can trim or remove the ingrown portion of the nail and treat the infection. They may also suggest better treatment options or a surgical procedure, if necessary.
Addressing underlying health conditions
If your black toenail is caused by an underlying health condition such as diabetes, poor circulation, vitamin deficiencies, or autoimmune disease, treating the root cause is crucial. Consult your healthcare provider to discuss proper medication, diet, and exercise to manage the condition.
Laser treatment
Laser treatment is another option for treating black toenails. It is a painless procedure that has been found to be about 80% effective.
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Preventative measures
While black toenails are usually not a serious condition, they can be painful and embarrassing. Black toenails are often caused by trauma or injury, such as stubbing your toe or dropping something on it. The injury causes bleeding underneath the nail, which appears as a black or dark brown discolouration. In rare cases, black toenails can be a symptom of a more serious underlying condition, such as melanoma, a type of skin cancer. Therefore, it is important to take preventative measures to reduce the likelihood of developing a black toenail and to seek medical advice if necessary.
- Keep your feet and toes clean, dry, and moisture-balanced: Good foot hygiene helps prevent fungal infections and other conditions that can lead to black toenails. Fungi thrive in warm and moist environments, so keeping your feet clean and dry is crucial.
- Wear properly fitting shoes: Tight or ill-fitting shoes can rub or compress the toes, damaging the nail and causing trauma. Choose comfortable shoes that provide enough room for your toes to move freely.
- Avoid open-toed sandals in hazardous environments: Protect your toes from potential stubbing or crushing injuries by wearing closed-toe shoes when working or walking in places where your toes might be at risk.
- Avoid exposing your feet to the sun: Excessive sun exposure can increase the risk of melanoma, a rare but serious cause of black toenails.
- Use sunscreen on your feet and toes: When exposing your feet to the sun, apply sunscreen to protect your skin and nails from UV damage.
- Trim your toenails properly: Cut your toenails straight across to prevent ingrown toenails, which can lead to irritation and discolouration.
- Treat underlying health conditions: Certain underlying health conditions, such as diabetes, kidney disease, heart disease, or anaemia, can increase the risk of black toenails. Properly managing these conditions can help reduce the risk.
- Take supplements: Consider taking biotin supplements, as research has shown that they can help strengthen nails and reduce breakage.
- Use nail hardeners sparingly: While nail hardeners can temporarily strengthen nails, prolonged use can break down the nail over time. Always follow the instructions and limit their use.
- Avoid glue-on nails and toxic polishes: These products can increase the risk of nail breakage and damage. Instead, opt for nontoxic or water-based polishes.
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Potential complications
If left untreated, toenail fungus can spread to other toes and even other parts of the foot and body. In some cases, the toenail may fall off due to pooled blood, and a new toenail may take up to six months to fully regrow.
If the black toenail is caused by melanoma, the most aggressive form of skin cancer, it may spread elsewhere in the body. Melanoma often appears as a dark brown misshapen spot, and can grow beneath the nail bed. As melanoma develops slowly and without other symptoms, it often goes unnoticed in its early stages, especially if it originates under the toenail.
If the black toenail is caused by trauma or injury, the toenail may begin to detach from the nail bed, and a person should seek medical treatment. In some cases, the trauma may be a one-time blunt-force injury, such as dropping a heavy object on the foot or stubbing the toe. This can cause blood vessels in the nail bed to break, resulting in a buildup of blood that causes pain and swelling.
In rare instances, medications used to treat fungal infections of the toenail can cause side effects.
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When to seek medical attention
Black toenails are usually caused by trauma, fungal infections, or repeated injuries that create a collection of thickened blood under the nail, known as a subungual hematoma. In most cases, the discolouration will grow out naturally over time without treatment. However, if you experience any of the following, it is important to seek medical attention:
- If you notice any black spots that might be spreading throughout the nail, or if they don’t go away despite your toenail growing out, you should see a doctor. Fungal infections can spread throughout your feet and other parts of your body if left untreated, and they can also cause permanent nail damage.
- If you have diabetes, it is important to see your doctor for treatment, as toenail fungus can be a complication of this condition.
- If you suspect melanoma, a form of skin cancer that can develop under the nail, you should see a dermatologist. Melanoma often appears as a dark brown misshapen spot, and it has metastatic potential. It grows gradually and is often painless, so it can go undetected.
- If your toenail begins to detach from the nail bed, you should seek medical treatment. This can be treated by a doctor, who will drain the blood with a needle to alleviate pressure.
- If you experience a severe blow, crush injury, or other serious toe injury that causes a black toenail, seek immediate medical attention.
- If you have a repetitive injury, such as from ill-fitting shoes, a doctor will likely recommend resting your foot and wearing different shoes.
- If you have no history of injury and notice black, red, or purple discolouration, you should have the nail evaluated by a healthcare provider.
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Frequently asked questions
In most cases, a black toenail will grow out in a couple of months. However, if the nail has detached from the nail bed, it may take up to six months for a new toenail to fully regrow.
Black toenails are usually caused by trauma or injury, such as repeatedly bumping your toenail on the tip of your shoe, or a sudden crush injury. They can also be caused by fungal infections, which can be treated with anti-fungal medication.
If you experience a sudden, unexplainable black toenail, or if it does not heal with time and at-home treatments, it is best to consult a doctor. Additionally, if there is severe pain, discharge, or an unpleasant smell, seek immediate medical attention.
Yes, keeping your feet clean, dry, and moisture-balanced can help prevent fungal infections and other conditions that lead to black toenails. Wearing properly fitting shoes can also help prevent long-term pressure on the toes, reducing the risk of toenail injuries and trauma.
