Liam Carter
Bruises and nail marks on the skin can be unsightly and painful. Most often, they are the result of accidents such as stubbing a toe or finger, or from blunt force trauma. This can cause the tissue under the nail to bruise and bleed, known as a subungual hematoma, which can be very painful due to the pressure of blood collecting under the nail. Treatment for subungual hematomas depends on the severity of the injury and may include ice, elevation, and over-the-counter anti-inflammatories. In some cases, a simple procedure called trephination may be recommended to drain the accumulated blood and relieve pressure and pain. While most bruised nails heal without complications, it is important to seek medical care to rule out any underlying issues and ensure proper healing.
| Characteristics | Values |
|---|---|
| What is a bruised nail | A bruised nail is usually the result of an accident. Most people have experienced the agony of stubbing a toe or slamming a finger in a door. |
| What to do | If you have a large bruise under your nail, there’s a good chance you have a broken bone, too. See a healthcare provider. |
| What not to do | Do not soak your injured nail in a bath or hot tub. Avoid swimming until your provider says it's OK. Do not cover it up and move on. Do not tough it out. |
| Treatment | Your provider may recommend a simple procedure called trephination. This is the drainage of the hematoma to relieve pressure. |
| Healing time | A new fingernail will take about 4 to 6 months to grow to replace the lost nail. Toenails take about 12 months to grow back. |
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What You'll Learn
See a doctor if you have a large bruise under your nail
If you have a large bruise under your nail, it is important to seek medical attention. A bruised nail is usually the result of an accident, such as stubbing your toe or finger, or an injury such as hitting your fingertip with a hammer. While it might seem harmless, a nail bruise can cause excruciating pain and requires medical attention for several reasons. The pain you feel is due to the pressure of blood trapped under your nail, which puts pressure on your finger or toe nerves. This nerve pain can take weeks to get better and can interfere with your daily activities.
It is important to see a doctor if you have a large bruise under your nail, as it could indicate a broken bone or fracture. A small bone break can be hard to spot without medical tests, and X-rays are often necessary to diagnose a fracture. Untreated fractures can heal incorrectly, causing long-term pain and interfering with the natural function of your finger or toe.
Additionally, a bruised nail can be a sign of a subungual hematoma, which is a collection of blood under the nail that can cause severe, throbbing pain. Subungual hematomas usually occur after trauma to the nail, such as slamming your finger in a door or dropping something on your toe. They can cause the nail to turn purple, blue, or black, and may require a simple drainage procedure called trephination to relieve pain and support healing.
If you notice any discoloration or a bruise under your nail without any apparent injury, it is important to see a healthcare provider. Nail discolouration can sometimes signal a health condition that requires treatment, such as skin cancer. Your doctor will examine your nail and may perform imaging tests, such as X-rays or ultrasounds, to check for any underlying issues.
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Apply ice to the affected area to reduce swelling
Applying ice to the affected area is a great way to reduce swelling and ease the pain caused by bruises and nail marks. When you experience trauma to the nail, the blood vessels under the skin break and spread into the surrounding tissue, causing the bruise. The cold temperature from an ice pack slows down blood flow in that area, reducing the amount of blood that leaks out of your vessels and preventing the bruise from being too apparent.
To apply ice to the affected area, wrap ice cubes or a cool pack in a soft, clean cloth or towel and gently press it onto the bruised area for several minutes. Do not press ice directly onto the skin. You can also use a bag of frozen vegetables, like peas, wrapped in a cloth or towel. Apply the ice pack for about 10 minutes at a time, and wait for 20 minutes before reapplying.
While bruises usually go away on their own within a couple of weeks, applying ice immediately after the injury can help speed up the healing process and reduce the size of the bruise. It is important to note that if the pain gets worse over the next few hours, you should seek medical care.
In addition to ice, there are other home remedies that can help reduce swelling and speed up the healing process, such as arnica ointment, vitamin K cream, and eating foods that contain bromelain, like pineapple.
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Avoid swimming or soaking your injured nail
If you have a bruised or injured nail, it is important to avoid swimming or soaking your nail in a bath or hot tub. Nails can bruise or fall off after an injury, and this can be extremely painful. The tissue under the nail is bruised, and the blood gets trapped underneath, causing pressure and pain. This is known as a subungual hematoma.
Dr. Capin advises against soaking injured nails or swimming, as this can "lead to breaks in the skin and an invitation for infection". An injury to the nail can cause onycholysis, which is when the nail separates from its nail bed. This can be caused by keeping your nails in water for too long.
If you have a bruised or injured nail, it is important to keep the area clean and dry. Cover it with a bandage only when it needs extra protection or if you are in significant pain. A nail injury can lead to infection if germs enter your body through a break in the nail or skin. If your nail comes off, you are likely to have an opening where an infection could start.
It is always best to seek medical advice if you have a bruised or injured nail. Your healthcare provider can advise you on the best course of treatment and let you know when it is safe to go swimming or soak your nails again. They may recommend a procedure called trephination, which involves draining the blood under the nail to relieve pressure and pain.
In summary, if you have a bruised or injured nail, avoid swimming or soaking your nails, as this can increase the risk of infection and further damage. Always seek medical advice and keep the area clean and dry to promote healing and prevent complications.
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Protect the skin of the nail bed with a plaster
Protecting the skin of the nail bed is important, especially after an injury. A subungual haematoma, for instance, can be extremely painful as blood accumulates under the nail, putting pressure on the tender skin of the nail bed. In such cases, doctors may treat the injury by stitching the nail bed and reattaching the nail, or using a synthetic nail if the natural nail is too damaged.
To protect the nail bed, a plaster can be used to cover the area and provide support. This is especially useful if the nail has been damaged and needs to be reattached. The plaster will help keep the nail in place and protect the skin underneath from further injury or infection. It is important to keep the nail bed clean and dry to prevent any potential infections.
When using a plaster, ensure that it is the right size and shape to cover the nail bed adequately. It should be secure but not too tight, as this could restrict blood flow and cause further damage. The plaster should also be changed regularly to keep the area clean and allow for healing.
In addition to using a plaster, keeping your nails trimmed short can prevent them from catching on objects and causing further injury to the nail bed. Avoiding biting your nails is also important, as this can damage the nail bed and increase the risk of infection.
Protecting the nail bed with a plaster can provide support and protection while the nail heals and regrows, helping to prevent further injury and potential infection.
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Drain the blood and fluid to relieve pain
Bruises are the result of trauma or injury to the skin that causes blood vessels to burst and spread into the surrounding tissue. This can happen when you hit something hard, and the small blood vessels beneath your skin break. The blood leaks out and has nowhere else to go, so it stays there until your body absorbs it as the injury heals.
A subungual hematoma is a bruise that forms under the nail after trauma. This happens when blood vessels under the nail break and start to bleed. Since the nail is connected to the finger or toe on all sides, the blood gets trapped underneath, causing pain and a blue, purple, black, or brown discolouration.
If you have a subungual hematoma, it is important to seek medical care soon, preferably within 48 hours of the injury. A healthcare provider will be able to evaluate the extent of the injury and recommend treatment. They may suggest a procedure called trephination, which involves draining the hematoma to relieve pressure and provide pain relief.
To drain blood and fluid and relieve pain, you can try the RICE method: Rest, Ice, Compression, and Elevation. This can help reduce swelling and slow down blood flow to the bruised area. Here are some specific instructions:
- Rest the injured area and keep it elevated above the level of your heart. This will help keep the bruise small by preventing blood from pooling and making it larger.
- Apply ice to the bruise to reduce blood flow to the area and prevent the bruise from getting worse. Wrap the ice in a soft cloth or towel and apply it for 10 minutes at a time, with 20-minute breaks in between. Do not put ice directly on the skin, and do not leave it on for too long, as this can harm your skin.
- Compress the bruise with an elastic bandage wrapped firmly but not too tightly. This will help prevent blood vessels from leaking and reduce swelling.
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