Caleb Foster
A subungual haematoma is a bruised fingernail or toenail that may cause severe, throbbing pain. It is usually caused by a traumatic injury, such as stubbing your toe, hitting your finger with a hammer, or slamming your finger in a car trunk. The injury can lead to swelling, nail discolouration, and pain. If you experience bleeding under your nail, it is important to see a healthcare professional as soon as possible. They may recommend a simple drainage procedure to relieve the pressure and ease your pain.
| Characteristics | Values |
|---|---|
| What | Subungual hematoma, or dried blood under the fingernail |
| Cause | Direct trauma to the nail, such as something crushing or slamming it |
| Symptoms | Severe, throbbing pain, swelling, nail discoloration |
| Treatment | A simple drainage procedure can ease pain and support healing; if there is additional damage, such as a broken bone or deep cut, further treatment and time to heal may be needed |
| First aid | Ice and elevate the area to reduce swelling, take over-the-counter anti-inflammatories like aspirin, Advil, or Motrin for minor pain |
| Medical treatment | A healthcare provider can perform a draining procedure to relieve pressure and pain; if the nail is removed, the wound should heal within a few weeks, but it may take about six months for a new nail to grow back |
| Prevention | Wear appropriate shoes that are not too tight |
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What You'll Learn
See a doctor if you have other symptoms
If you are experiencing other symptoms beyond dried blood under your fingernail, it is important to see a doctor. This is especially true if you are experiencing symptoms such as swelling or an inability to move the affected finger or toe, as these could indicate a fracture. If the wound continues to bleed, it may be a laceration that requires sutures.
Another reason to see a doctor is if you experience severe pain or throbbing, which can be caused by the pressure of blood collecting between the nail and the nail bed. If the pain worsens over several hours, seek medical attention. Your doctor may recommend a procedure called trephination, which involves draining the hematoma to relieve pressure and pain.
In some cases, a subungual hematoma (bleeding under the nail) can lead to complications such as a bacterial infection, especially if the injury is severe or involves damage to the bone. If you suspect a bone fracture or other injury, your doctor will likely order imaging tests such as X-rays or an ultrasound to assess the extent of the damage.
Additionally, if the injury is at the base of the nail or covers more than half of the nail surface, it is important to seek medical attention. In these cases, the nail bed may be injured, and your doctor may need to remove the entire nail and use stitches to repair the damage. Even with proper repair, the new nail may take longer to grow back and may not look normal.
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Drainage procedure
If you are experiencing dried blood under your fingernail, also known as a subungual hematoma, it is recommended that you seek medical care from a healthcare provider. A subungual hematoma is caused by a traumatic injury that results in bleeding and bruising under the nail, leading to symptoms such as swelling, nail discolouration, and pain. While it is a minor injury, a simple drainage procedure can be performed to relieve pain and support healing.
- Before the procedure: Before performing the drainage procedure, your healthcare provider will assess the extent of the injury. They may recommend an X-ray to check for any underlying fractures or other injuries. If you visit a healthcare provider within 48 hours of the injury, they may be able to drain the excess fluid and relieve the pressure. Otherwise, the nail may need to be removed or it may fall off by itself.
- Numbing the area: To ensure your comfort during the procedure, the affected finger or toe will be numbed using a nerve block, also known as a digital block. This will prevent you from feeling any pain during the drainage process.
- Drainage methods: There are several methods that can be used to perform the drainage. One common technique is nail trephination, which involves piercing the nail plate to create a hole for drainage. This can be done using a hot metal wire, an electrocautery device, or a spinning, large-bore needle. The hole created should be large enough to allow the blood to drain out.
- During drainage: During the drainage process, it is important to keep the area clean and sterile. The wound should be covered with sterile gauze to collect the draining blood. Your doctor will provide instructions on how often the bandage needs to be changed.
- Aftercare: Following the procedure, your doctor will bandage your nail to protect the area. It is important to keep the finger or toe bandaged and elevated during the first 12 hours. Cold compresses and over-the-counter pain relievers, such as ibuprofen, can help manage any discomfort. In some cases, a splint may be recommended for a few days until the tenderness subsides.
- Healing process: The wound should heal within a few weeks, but it may take several months for your nail to grow back completely. During this time, follow your healthcare provider's instructions on caring for your injured nail. Soaking the affected area in a warm solution with Epsom salts can help drain fluid and promote healing.
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Keep the area clean and dry
Keeping the wound clean and dry is essential to prevent infection and promote healing. After a nail trephination procedure, your doctor will bandage the wound, and it's important to follow their instructions for changing the bandage. The wound should be kept elevated, and cold compresses can be applied during the first 12 hours.
It's also important to keep the wound clean. This can be done by gently washing around the wound twice a day and then covering it with a non-stick bandage. It's normal for a small amount of bleeding to occur right after the drainage procedure, but if it continues for an extended period, it could indicate a laceration that requires sutures.
If you notice any signs of infection, such as pus, redness, heat around the nail, or a red streak extending from the wound, seek medical attention. Your doctor may prescribe antibiotics or perform a minor surgical procedure to treat the infection. In some cases, they may also recommend soaking the affected finger or toe in a warm solution with Epsom salts to help drain fluid and alleviate pain.
It's important to follow your healthcare provider's instructions for caring for the wound, including keeping it clean and dry, to ensure proper healing and reduce the risk of complications. This may include recommendations for pain relief and methods to alleviate discomfort during the healing process.
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Soak your finger in a warm solution with Epsom salts
Soaking your finger in a warm solution with Epsom salts is a great way to help drain fluid and alleviate pain. This method is often recommended by healthcare providers and can be done at home.
To start, prepare a mixture of warm water and Epsom salts. You can use a basin or a bowl that is large enough to submerge your finger comfortably. Ensure that the water is warm but not too hot, as you will be soaking your finger for a while. The temperature should be comfortable and soothing.
Once you have prepared the solution, submerge your affected finger in the warm Epsom salt bath. Keep your finger soaked for about 15 minutes. You can do this once a day or a few times a day, depending on the severity of your condition and your comfort level. While soaking your finger, you can gently massage the area to further promote circulation and help reduce any inflammation.
After the soak, dry your finger thoroughly. It is important to ensure that your finger is completely dry before you proceed. You can then apply a thin layer of antibacterial cream or ointment to the affected area. This will help keep the area moisturized and protected.
By following this routine, you will be able to effectively soak your finger in a warm solution with Epsom salts to address the dried blood between your nail and finger. Remember to always monitor your symptoms and seek medical advice if necessary.
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Use a cold compress
A subungual haematoma is the medical term for bleeding and bruising under the nail. This occurs when an injury causes the blood vessels under the nail to break open, with blood collecting and becoming trapped under the nail. This can happen when a heavy object crushes a finger or toe, or when a person repeatedly jams their toes into a too-tight shoe.
To treat a subungual haematoma at home, you can use a cold compress. Here is a step-by-step guide:
Step 1: Create a cold compress
Wrap ice cubes or crushed ice in a thin cloth or towel. Do not apply ice directly to the skin, as this can cause tissue damage. Alternatively, you can use a cool pack.
Step 2: Apply the cold compress to the affected area
Place the cold compress on the injured finger or toe. Make sure to elevate your hand or foot while applying the cold compress. This will help to reduce swelling and slow down the bleeding under the nail.
Step 3: Limit application time
Do not apply ice to the injured area for more than 20 minutes at a time. Take breaks as needed to avoid skin damage.
Step 4: Repeat as needed
You can reapply the cold compress multiple times a day to help reduce pain and swelling. Continue this process until the pain and swelling have subsided.
It is important to note that this treatment is only suitable for minor subungual haematomas. If the injury is severe, causing extreme pain, or located at the base of the nail, it is best to seek medical attention. A doctor may recommend a procedure called nail trephination to drain the blood and relieve pressure and pain. This typically involves making a small hole in the nail with a laser or needle, allowing the blood to drain out.
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Frequently asked questions
A subungual hematoma is a bruised fingernail or toenail that may cause severe, throbbing pain. It occurs when blood pools under your nail plate, causing discoloration.
If you have dried blood under your fingernail, see a healthcare provider as soon as possible. If it has been less than 48 hours, they can drain the excess fluid and relieve the pressure. If there is damage to your nail matrix, your nail may not grow back or may look different when it does.
Nail trephination is a procedure that uses a hot metal wire, an electrocautery device, or a spinning, large-bore needle to pierce the nail plate for drainage. The nail plate is numbed beforehand so that the procedure is painless.
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