Ava Monroe
A bruised nail, also known as a subungual hematoma, is usually the result of an injury that causes blood to collect under the nail. This can be extremely painful and may take a while to heal. In some cases, the nail may fall off. To treat a bruised nail, it is recommended to apply ice, elevate the area, and take pain relievers. If the bruise is severe, medical care may be required, and a healthcare provider may perform trephination, a procedure that drains the pooled blood from under the nail.
| Characteristics | Values |
|---|---|
| Cause | Trauma or injury |
| Symptoms | Pain, bleeding, discoloration, pressure, throbbing pain, severe blow to a finger or toe, deformed finger or toe, broken bones, damage to the nail bed, swelling, significant pain, redness, warm skin, fever, feeling unwell, numbness |
| Treatment | For mild toenail bruises: ice, pain relievers, foot soak using warm water and Epsom salts, rest, elevation, compressing the toenail with a bandage to stop bleeding; for severe cases: decompression, trephination, cautery, surgery |
| Healing Time | A new fingernail can regrow in as little as 8 weeks; a toenail may take about 6 months to fully regrow; with proper home or post-surgery care, a bruised toenail will typically heal and grow out within 6-9 months |
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What You'll Learn
When to seek medical attention
A bruised nail, or subungual haematoma, is usually the result of an injury. It is important to seek medical attention in the following cases:
- If you experience intense pain or pain that worsens over time, you should seek medical care. The pain from a bruised nail is caused by blood trapped under the nail, which puts pressure on the nerves of the finger or toe. This pressure can be excruciating and may interfere with your ability to work or perform daily activities. Nerve pain from trapped blood can take weeks to get better unless a doctor drains the blood through a procedure called trephination. Trephination must be performed within 48 hours of the injury, as blood that clots under the nail can cause weeks of unnecessary pain.
- If you notice signs of infection, such as fever or feeling unwell, redness or red streaks in the skin, skin or nail feeling warm to the touch, swelling, or significant pain, you should seek medical attention. A nail injury can lead to infection if germs enter your body through a break in your nail or skin.
- If you have a large bruise under your nail, there is a chance that you have a broken bone. A small bone break in your finger or toe can be hard to spot without medical tests, and untreated fractures could heal incorrectly, causing long-term pain and interfering with the natural function of your finger or toe.
- If you have a cut or laceration, or if the bleeding does not stop, you should seek medical attention.
- If you have broken bones or serious damage to the nail bed and/or surrounding tissues, you should seek immediate medical attention.
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Home remedies
A bruised nail is usually the result of an accident or trauma, such as stubbing your toe or finger, or dropping something heavy on it. This is called a subungual hematoma, where blood collects under the nail, causing pressure and pain. While it is always advised to seek medical attention for a bruised nail, there are some home remedies that can help ease the pain and support healing.
To reduce throbbing and swelling, it is recommended to ice the area. Wrap ice in a cloth and apply it to the injured nail for 20 minutes every 2 hours on the first day, then 3 to 4 times a day after that. Keep your hand or foot elevated above the level of your heart. Over-the-counter anti-inflammatory medications like ibuprofen, aspirin, Advil, or Motrin can also help with minor pain.
It is important to note that home drainage methods are not recommended as they can cause pain and infection. If home measures do not provide relief, contact your doctor for further advice and treatment options.
It is also important to be mindful of potential signs of infection, such as fever, warmth, redness, pus, or swelling at the injury site. If any of these symptoms develop, seek medical attention promptly.
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Preventing infection
Keep the injured area clean and dry: Wash the affected area gently with mild soap and water to remove any dirt or debris. Ensure that your nail is thoroughly cleaned, especially if there is any breakage or exposure of the underlying tissue. Pat the area dry with a clean towel afterward. Keeping the injured area clean is crucial in preventing the entry of germs that can cause infection.
Apply ice: Wrap ice in a towel and apply it to the affected area to reduce swelling and pain. This will help manage the inflammation and prevent further injury. Remember not to place ice directly on the skin to avoid ice burns.
Elevate the injured area: When possible, elevate your injured finger or toe above the level of your heart to reduce swelling. This will aid in reducing pain and promoting proper circulation, which is essential for healing.
Protect the area: Cover the injured nail with a bandage to provide extra protection and support. This is especially important if you need to engage in activities that could put pressure on the injured area. Choose open-toed shoes or sandals to allow the injured toe to breathe and heal. Avoid tight-fitting shoes or any activity that may cause further trauma to the nail.
Monitor for signs of infection: Keep a close eye on the injured area for any signs of infection, such as redness, red streaks, warmth, swelling, or increased pain. Also, be alert for accompanying symptoms like fever, feeling unwell, or any discharge, as these could indicate an infection. If you notice any signs of infection, seek medical attention promptly.
With proper care and attention to preventing infection, you can promote the healing of your bruised nail and reduce the risk of complications.
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Surgical procedures
Trephination is the standard surgical procedure for treating large or more severe bruises. During this procedure, a healthcare provider will create a small hole in the nail using a laser, needle, or electrocautery (heat from an electric current). This hole allows the blood and fluid to drain out, thereby relieving the pressure and pain. The area may be numbed with a nerve block before the procedure. After the procedure, the area may be wrapped in a bandage, and blood may continue to drain for up to 3 days.
In some cases, the entire nail may need to be removed, especially if there is severe damage to the nail bed or if there is a broken bone. Stitches may be used to repair the nail bed, and a new nail should grow back within 6 to 9 months. However, the new nail may be malformed or cracked, and there is a possibility that it may not regrow at all.
It is important to seek medical attention for a bruised nail, especially if it affects more than a quarter of the nail or is accompanied by symptoms such as intense pain, bleeding, or signs of infection.
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Healing time
The medical term for a bruised nail is a subungual haematoma. This occurs when blood pools below the nail plate, causing pressure and pain. The colour may change over time as the injury heals.
If the nail is bothering you, a healthcare provider can usually safely remove it. A new nail will grow in, but it will take several months. Fingernails can take 4 to 6 months to grow back, while toenails can take about 12 months. If there has been injury to the nail bed or surrounding tissues, the new nail may take longer to grow and may not look normal.
If the blood under the nail is not drained within 48 hours, it clots, causing a bulk under the nail that could lead to weeks of unnecessary pain. However, if the blood is drained within the first 48 hours, the pain should ease right away.
If you have a large bruise under your nail, there is a chance you have a broken bone. A small bone break in your finger or toe can be hard to spot without medical tests, so it is important to get an X-ray to check for any fractures or other injuries. Untreated fractures could heal incorrectly, causing long-term pain and interfering with the natural function of your finger or toe.
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Frequently asked questions
A bruised nail, also known as a subungual hematoma, happens when there is an injury that causes blood to collect under the nail.
If you have a bruised nail, you should seek medical attention, especially if there is bleeding or severe pain. For mild cases, you can treat the injury at home with ice and pain relievers. Keep the injured area clean and dry, and avoid any activities that may cause further injury.
To treat a bruised nail at home, you can apply ice wrapped in a towel to the affected area to reduce swelling. You can also elevate your injured finger or toe and take over-the-counter pain relievers to reduce discomfort. Keep the area clean and dry, and avoid any activities that may cause further injury.
The healing time for a bruised nail varies depending on the severity. With proper home care or post-surgical care, a bruised nail can typically heal and grow out within 6 to 9 months.
You should see a doctor for a bruised nail if there is bleeding or severe pain that persists. It is also recommended to seek medical attention if you notice any signs of infection, such as redness, warmth, or discharge around the nail. Additionally, if the bruise affects more than half of the nail or does not improve after several weeks of home treatment, it is advisable to consult a healthcare provider.
