Caleb Foster
If you've injured your fingernail or toenail, you may notice blood pooling under the nail, causing a bruise known as a subungual hematoma. While small hematomas may not require any treatment, larger ones can be intensely painful and may cause the nail to fall off. Although it is possible to drain the blood from under the nail at home, it is not recommended, as it may lead to infection. Instead, you should see a doctor, who can quickly and painlessly drain the hematoma by making a small hole in the nail to allow the blood to flow out.
| Characteristics | Values |
|---|---|
| What | Removal of old blood from under the nail, also known as draining a subungual hematoma |
| When | Within the first 2 days of the injury |
| Who | A doctor or healthcare professional |
| Risks | Infection, loss of nail, re-accumulation of hematoma |
| Symptoms of Infection | Fever, warmth at the injury site, pus, swelling |
| Home Relief | Not recommended due to risk of infection |
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What You'll Learn
See a doctor for advice
If you notice blood under your nail, it is important to see a doctor for advice. This is especially true if you have not experienced any injury that could have caused this. Your doctor will be able to examine your nail and determine if there is any underlying cause for concern. They may recommend imaging tests, such as X-rays, to check for any bone fractures or other injuries that may be associated with the presence of blood under your nail.
If you have experienced an injury, such as crushing or stubbing your finger or toe, and notice blood pooling under your nail, it is still important to seek medical advice. This is known as a subungual hematoma, which can cause severe pain and throbbing due to the pressure of blood collecting under the nail. While small hematomas may not require drainage, it is important to let a doctor make this judgment. They may recommend a procedure called trephination, which involves draining the hematoma to relieve pressure and pain. This procedure is typically performed within the first 48 hours after the injury, as the blood begins to clot after this time, making drainage more difficult.
If you experience a severe blow to your finger or toe, it is crucial to seek immediate medical attention. This is especially important if there is deformity, as it could indicate broken bones or serious damage to the nail bed and surrounding tissues. Do not attempt to drain the hematoma at home, as it may lead to infection and further complications.
In summary, seeing a doctor for advice is essential when dealing with blood under your nail. They can provide a proper diagnosis, recommend appropriate treatment options, and help prevent any potential complications.
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Drainage procedure
It is important to note that you should never attempt to drain a subungual hematoma at home and should always seek medical care. Drainage procedures can be performed quickly and relatively painlessly in a doctor's office or urgent care center.
When to Drain
Small hematomas may heal on their own without any issues. Doctors recommend draining subungual hematomas when they cause pain or make up 50% or more of the nail. Drainage should be performed within the first 48 hours of the injury, as the blood begins to clot after this amount of time, making drainage difficult.
Decompression Methods
To relieve the hematoma, a doctor may perform decompression, also called trephination, to allow the underlying blood to drain, relieving pressure and pain in the area. Before the procedure, the doctor may numb the affected finger or toe with a nerve block. The doctor may use one of the following decompression methods:
- Cautery: A heated wire (electrocautery device) or carbon laser is used to burn a hole or holes. The heated tip of the wire is cooled by contact with the hematoma, preventing injury to the nail bed.
- Needle: A needle is used to make a hole in the nail. After the procedure, the doctor will bandage the nail.
Aftercare
You will need to keep the finger or toe bandaged and elevated and may also need to use cold compresses during the first 12 hours after decompression. In some cases, a splint may be recommended for up to 3 days until the tenderness subsides. The nail may bleed a bit right after draining, but the bleeding should stop soon after.
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Avoid home methods
It is not recommended to drain a subungual hematoma at home. A subungual hematoma is a bruise caused by a crushing or stubbing injury to the fingers or toes, resulting in blood pooling under the nail. While it is possible to drain blood from under the nail at home, it is important to avoid doing so to prevent potential health risks.
One common home method for removing old blood from under the nail is to use a heated pin or paper clip to make a hole in the nail. This method is not safe and can lead to serious infections. The high temperature of the pin or paper clip can burn the skin, and the sharp object can introduce bacteria into the wound, causing an infection. Infections can often cause much more damage than the initial injury and may require medical attention.
Another potential risk of attempting to drain a subungual hematoma at home is incomplete or improper drainage. If the hole made in the nail is too small or not in the correct location, the blood may not drain effectively. This can lead to persistent pain and pressure under the nail. In some cases, the blood may re-accumulate under the nail, causing the same symptoms to recur.
Additionally, home drainage of a subungual hematoma may cause damage to the nail itself. The hole created in the nail during the drainage process can weaken the nail, making it more susceptible to cracking or breaking. In some cases, the nail may fall off partially or completely, requiring a longer recovery time for the nail to regrow.
It is always advisable to seek medical advice before attempting any home treatments for subungual hematomas. A doctor can assess the severity of the hematoma and determine if drainage is necessary. If drainage is required, it should be performed by a medical professional in a sterile environment to minimize the risk of infection and ensure proper aftercare.
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Symptoms of infection
It is important to note that you should not attempt to drain a subungual hematoma at home. Using home methods such as a heated pin or paper clip to make a hole in the nail may cause infection from bacteria entering the wound. Infections can often cause much more damage than the simple injury they stem from.
- Redness or discoloured skin around the nail
- Pus
- Fever
- Warmth at the injury site
- Swelling
- Pain
If you notice any of these symptoms, see a healthcare professional right away.
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Subungual hematoma
Small subungual hematomas may not require any treatment at all and can be left to resolve on their own. To manage any pain and swelling, it is recommended to ice and elevate the affected area and take over-the-counter anti-inflammatories. If the hematoma is causing severe pain or covers a large area of the nail, it may need to be drained by a medical professional. This procedure, called trephination, involves creating a small hole in the nail to allow the blood to drain out, relieving the pressure and pain. Trephination can be performed quickly and relatively painlessly by a doctor using a heated wire (electrocautery device), a carbon laser, or a needle to create the hole. The wound is then covered with a dry bandage and kept clean and dry while it heals.
It is important to note that you should not attempt to drain a subungual hematoma at home as it may lead to infection. Drainage must also be performed within the first 48 hours after the injury. If the injury is not treated promptly, the nail may need to be removed and the nail bed repaired surgically.
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Frequently asked questions
Subungual hematoma is the medical term for blood pooling under the nail bed's surface, usually caused by a crushing or stubbing injury.
You should not attempt to drain a hematoma at home. Drainage can be performed quickly and relatively painlessly by a medical professional.
Doctors recommend draining subungual hematomas when they cause pain or make up 50% or more of the nail.
Without drainage, you may experience intense pain, pressure on the nail, or the nail falling off partially or completely.
