Isla Bennett
A subungual hematoma, or bleeding under the nail, can be extremely painful. It occurs when blood vessels under the nail break open, causing blood to collect and become trapped under the nail. This can happen due to a sudden injury, such as stubbing your toe, or even from wearing tight shoes. While most cases heal on their own within a few months, it is important to seek medical attention if you experience severe pain, bleeding that does not stop, signs of infection, or if the hematoma does not go away over time. A doctor may recommend a simple drainage procedure called nail trephination to relieve the pressure and pain. This involves making a small hole in the nail to allow the blood to drain out.
| Characteristics | Values |
|---|---|
| Medical Term | Subungual Hematoma |
| Cause | Trauma to the nail, such as stubbing a toe, hitting a finger with a hammer, or dropping a brick on a toe |
| Symptoms | Severe throbbing pain, nail discoloration, swelling, darkened areas under the nail, bleeding under a large area of the nail surface |
| Treatment | Drainage procedure, removal of the nail, stitches, home remedies like rest, icing, compression, and elevation |
| Healing Time | A few days to a few months, depending on the severity; a new nail can regrow in 8 weeks (fingernail) to 6 months (toenail) |
| Precautions | Do not attempt drainage at home, seek medical care; keep the area clean and dry |
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What You'll Learn
- See a doctor if you experience severe pain, bleeding that doesn't stop, or signs of infection
- Do not attempt to drain the blood at home?
- Apply ice to the affected area
- Minor subungual hematomas usually heal over time without treatment
- A doctor may need to remove the nail plate to repair tissues underneath
See a doctor if you experience severe pain, bleeding that doesn't stop, or signs of infection
Subungual hematoma, or bleeding under the nail, is usually caused by direct trauma to the nail, such as crushing or stubbing. This can cause severe throbbing pain and pressure due to the pooling blood under the nail plate.
While subungual hematomas are typically minor injuries that heal without treatment, you should see a doctor if you experience severe pain, bleeding that doesn't stop, or signs of infection. It is important to seek medical attention within 48 hours of the injury, as the blood begins to clot after this time, making drainage more difficult.
If you are experiencing severe pain, your doctor may recommend a simple drainage procedure, also called trephination, to relieve the pressure and provide pain relief. This procedure involves making a small hole in the nail with a laser, needle, or heated wire to allow the blood to drain out. It is important not to attempt this procedure at home, as it can cause infections or further damage to the nail bed.
If you are experiencing bleeding that doesn't stop, it could indicate a more serious injury, such as damage to the nail bed or surrounding tissues. In some cases, your doctor may need to remove the entire nail and use stitches to repair the nail bed. This is more likely if there is a large area of bleeding or if there are broken bones or deep cuts associated with the injury.
If you notice any signs of infection, such as redness, swelling, warmth, or pus, it is important to seek medical attention. Infections can cause more damage than the initial injury and may require antibiotics or other treatments to resolve.
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Do not attempt to drain the blood at home
Attempting to drain the blood at home can lead to serious infections. Using non-sterile instruments, such as a heated paper clip or pin, to make a hole in the nail can introduce bacteria into the wound. Infections can cause much more damage than the initial injury and may lead to further complications.
It is always advisable to seek medical care for a subungual hematoma. A doctor will be able to assess the severity of the injury and determine if drainage is necessary. In some cases, a small hematoma may not require drainage and can heal on its own with proper care. Your doctor may recommend simple home care measures, such as elevating the affected area, applying ice, and taking over-the-counter anti-inflammatories to manage pain and reduce swelling.
Additionally, drainage of a subungual hematoma is time-sensitive. It can only be performed within the first 48 hours after the injury, as the blood begins to clot after this time frame, making drainage difficult. Therefore, it is crucial to seek prompt medical attention if you are considering drainage as an option.
In summary, do not attempt to drain a subungual hematoma at home. Always seek medical advice and leave the procedure to trained professionals. By doing so, you can ensure the safety and effectiveness of the treatment while minimizing the risk of complications.
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Apply ice to the affected area
If you have trapped blood under your nail, it's important to act quickly to reduce pain and promote healing. Applying ice to the affected area is a recommended first step.
Icing the affected area can help to reduce swelling and relieve pain. It is important to ice the area as soon as possible after the injury to help manage these symptoms. The ice will also help to constrict the blood vessels, reducing the flow of blood to the injured area. This can help to minimise the amount of blood that collects under the nail.
To ice the affected area, wrap an ice pack or a bag of ice in a thin towel or cloth. You can also use a cold compress or a bag of frozen vegetables. Apply the ice pack to the injured nail and surrounding area for 15-20 minutes at a time, several times a day. Make sure not to apply ice directly to the skin, as this can cause ice burns.
It is important to elevate the affected area while applying ice. This will further help to reduce swelling and promote drainage of the pooled blood. Keep the injured area elevated above the level of your heart as much as possible, especially during the first 24-48 hours after the injury.
In addition to icing and elevating the area, you can take over-the-counter anti-inflammatory medications such as aspirin, ibuprofen, or naproxen to help manage pain and reduce inflammation. These medications can be continued as needed for the first few days after the injury.
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Minor subungual hematomas usually heal over time without treatment
A subungual hematoma is a bruised fingernail or toenail that occurs when blood vessels under the nail break open, causing blood to pool underneath the nail. This can be caused by something falling on the nail, stubbing the toe, or wearing tight shoes. While subungual hematomas can be very painful, they are typically minor injuries, and the pain usually subsides within a few days.
However, if the hematoma is causing significant pain, bleeding, or other concerning symptoms, it is important to seek medical advice. A healthcare provider can perform a simple drainage procedure, known as nail trephination, to relieve pressure and pain. This procedure involves creating a small hole in the nail to allow the blood to escape. It is important to note that this procedure should not be attempted at home, as it can lead to infections or further injury to the nail bed.
While waiting for the hematoma to heal, there are several home remedies that can be used to manage the pain and encourage healing. These include resting the affected finger or toe, applying ice to reduce swelling and pain, using compression to reduce blood pooling, and keeping the hand or foot elevated. Over-the-counter pain relievers can also help reduce discomfort and swelling.
It is important to be mindful of any signs of infection or other complications. If the hematoma does not heal or improve over time, it is recommended to consult a healthcare professional for further evaluation and treatment.
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A doctor may need to remove the nail plate to repair tissues underneath
A subungual haematoma is a bruised fingernail or toenail that occurs when blood pools under the nail plate, causing severe throbbing pain and nail discolouration. This is usually the result of blunt force trauma, such as crushing your finger in a door or dropping a heavy object on your toe. In some cases, a subungual haematoma can be caused by repetitive pressure, such as running in shoes that are too tight.
If you have a subungual haematoma, it is important to seek medical attention. While a small haematoma may not require treatment, a healthcare provider can perform a simple drainage procedure to relieve pressure and pain. This procedure should not be attempted at home. If you have a broken bone, deep cut, or other injuries, your doctor may need to remove your nail plate to repair the tissues underneath.
Nail removal surgery is a delicate procedure that requires careful inspection and surgical repair of the nail matrix to avoid nail deformity. The distal nail plate must be avulsed to allow visualisation and placement of sutures in the lacerated matrix. The proximal aspect of the nail plate is left in place to protect the matrix, and any firmly attached nail bed tissue is left intact. The injured nail tissue is irrigated and conservatively debrided to avoid removing healthy nail tissue. The lacerated nail bed and matrix are then repaired with sutures or cyanoacrylate glue.
After nail removal surgery, the avulsed nail is cleaned, trimmed, and reattached to the nail bed. The repaired nail is dressed with sterile petroleum jelly gauze or Xerofoam, followed by a soft, thick dressing. It typically takes a long time for the nail to recover, with a new but abnormal nail growing back within three months. A return to a normal nail can take up to nine months. To prevent stiffness in your fingers during the healing process, it is recommended to perform finger exercises as often as possible.
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Frequently asked questions
A subungual hematoma is a bruised fingernail or toenail that develops after sudden trauma to your nail, like dropping something on your toe or finger, or wearing tight shoes.
If the affected area continues to collect blood, you experience extreme pain, or the injury is at the base of the nail, it's best to see a healthcare provider as soon as possible.
A doctor may perform a procedure called nail trephination to drain the blood from under the nail. This involves making a small hole in the nail with a laser, needle, or heated wire to relieve pain and pressure.
No, you should never attempt to drain a subungual hematoma at home as it can cause infections or further injury to the nail bed.
