Noah Sinclair
There are many reasons why someone's fingernails might turn black. It could be due to an injury or trauma to the nail bed, such as dropping a heavy object on it or a fungal infection. In some cases, it can indicate an underlying health issue, such as melanoma on the nail, or a bacterial infection. It is always best to consult a healthcare professional for an accurate diagnosis and appropriate care.
| Characteristics | Values |
|---|---|
| Cause | Trauma or injury to the nail bed, such as a blow to the finger, stubbing your toe, or dropping heavy objects on them |
| Alternative Cause | Fungal infection, bacterial infection, viral infection, or melanoma on the nail |
| Medical Name | Subungual hematoma |
| Treatment | Ice, anti-inflammatory medication, or draining blood from under the nail |
| When to Seek Medical Attention | When the black nail is persistent or accompanied by pain, swelling, or other concerning symptoms |
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What You'll Learn
Trauma or injury to the nail bed
A black fingernail is usually caused by a build-up of blood under the nail, known as a subungual hematoma. This is often the result of trauma or injury to the nail bed, such as a crush injury or blunt force trauma. For example, you may have hit your fingertip with a hammer, dropped a heavy object on your finger, or even slammed your finger in a door. This type of injury can cause considerable pain and the affected nail may lift up from the nail bed due to the pressure of the pooled blood.
If you have experienced trauma or injury to the nail bed, it is important to assess the severity of the injury. In most cases, a subungual hematoma can be treated with ice and anti-inflammatory medication to reduce pain and inflammation. However, if the injury is particularly painful or the bleeding covers more than 25% of the nail, it is recommended to seek medical attention. A doctor may drain the blood from under the nail by creating a small hole using a cautery, needle, or sterilized paper clip. This procedure will reduce the pressure under the nail and provide relief.
It is important to note that a subungual hematoma can sometimes indicate a more serious injury. If the trauma caused additional damage, such as a broken bone or deep cut, further treatment and healing time may be required. In some cases, the entire nail may need to be removed, and stitches may be necessary to repair the nail bed. The new nail may take longer to grow and may not always appear normal.
While less common, it is also important to consider other potential causes of black fingernails, such as nail infections, vitamin deficiencies, or, in rare cases, nail cancer. Therefore, if you are experiencing any concerns or persistent symptoms, it is always best to consult with a healthcare professional for a proper diagnosis and treatment plan.
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Underlying health conditions
Fingernails turning black can be indicative of several underlying health conditions. One of the most common causes is a fungal infection, also known as onychomycosis or tinea unguium, which occurs when there is an overgrowth of fungus in the fingernails or toenails. This can usually be treated with antifungal medications.
Another underlying health condition that can cause black fingernails is melanoma, a type of skin cancer. Melanoma on the nail is characterised by the appearance of a dark brown or black spot, which tends to increase in size over time. It is most common on the index finger, thumb, or big toe. If melanoma is suspected, it is crucial to consult a dermatologist, as treatment typically involves surgical removal of the malignant tissues.
In some cases, black fingernails can be a sign of melanonychia, which is a brown or black discolouration of the nail. Melanonychia can have various causes, ranging from harmless to potentially fatal. It can be associated with endocrine disorders such as Addison's disease, inflammatory skin diseases, infections, or poor nutrition. Melanonychia can also occur naturally in individuals with darker complexions.
Additionally, black fingernails can be indicative of underlying health conditions such as lung disease or rheumatoid arthritis. In some cases, it may be a sign of an iron deficiency or a vitamin B12, vitamin D, or protein deficiency.
It is important to consult a healthcare professional if you notice any changes in the colour or appearance of your nails, as it could indicate an underlying health condition that requires attention and treatment.
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Melanoma on the nail
Melanoma is the deadliest form of skin cancer and can develop under the nail. It is a rare type of cancer that accounts for only 5% of all cancers, but if left untreated, it can spread to other parts of the body and become life-threatening.
Nail melanoma often presents as a dark streak or band under the nail, which may appear as a brown or black stripe that starts at the bottom of the nail bed and continues to the top. This can occur on any nail but typically appears on the thumb or big toe of the dominant hand or foot. It is important to note that these streaks can also be caused by trauma, nutritional deficiencies, or medication.
Other signs of nail melanoma include dark skin next to the nail, nail lifting or onycholysis, and nail splitting down the middle. Onycholysis is when the nail starts to lift and detach from the nail bed, often causing white discoloration. Nail splitting can be a sign of advanced melanoma.
If you notice any of these signs, it is important to seek medical attention early. A dermatologist will examine your nails and may perform a biopsy to determine the presence of nail melanoma. Treatment options may include surgery to remove the affected part of the nail, chemotherapy, or, in advanced cases, amputation of the affected finger or toe.
While nail changes can be harmless, they can also indicate underlying health issues. Therefore, it is always advisable to consult a healthcare professional if you notice any significant or persistent changes in your nail's color, texture, or shape.
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Fungal infections
A fungal nail infection, also known as onychomycosis or tinea unguium, is a common condition that many people develop at some point in their lives. It occurs when a fungus that is normally present in your fingernails or toenails overgrows. While it is not usually serious, it can be unpleasant and difficult to treat.
Fungal nail infections may not cause any obvious symptoms at first. However, as the infection progresses, it can lead to discolouration of the nail, which may turn white, black, yellow, or even green. The nail may also become thickened, distorted, and brittle, making it difficult to trim. In addition, the infection can cause pain or discomfort, particularly when using or placing pressure on the affected finger or toe.
Toenails are more frequently affected by fungal infections than fingernails because fungi prefer warm, dark, and moist environments like the feet. Wearing shoes and socks can provide the ideal breeding ground for fungus to grow. Additionally, walking barefoot in places like communal showers, locker rooms, and gyms can increase the risk of contracting a fungal nail infection.
Fungal nail infections can be treated at home with over-the-counter ointments, creams, and polishes. Keeping your nails clean and dry can also help prevent and manage the infection. However, for more severe or persistent infections, antifungal medication may be necessary. This can come in the form of tablets or a special paint applied directly to the nail. It is important to note that treatment for fungal nail infections may take several months to show results, and the nail may not always return to its original appearance.
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Certain medications
Fingernails turning black can be caused by melanonychia, which occurs when pigment cells called melanocytes deposit melanin, a brown-coloured pigment, into the nail. This results in the appearance of brown or black stripes on the nail as it grows out. Melanonychia can be caused by medication, specifically melanocytic stimulation from drugs such as zidovudine, psoralens (PUVA), hydroxyurea, and other chemotherapy drugs.
Melanonychia can also be caused by trauma, nutritional deficiencies (such as deficiencies in vitamin B12, vitamin D, and protein), and other health conditions. It is important to consult a doctor if you notice any discolouration or stripes on your nails as it may indicate an underlying health issue. In the case of medication-induced melanonychia, a doctor may change your medication or advise you to stop taking it for a period of time if possible. For medications that cannot be stopped, melanonychia may be a side effect that you will eventually get used to.
It is worth noting that drug-induced nail disease is quite rare, except in the case of chemotherapy agents, and is generally more common in older individuals and those taking multiple medications. The signs and symptoms of drug-induced nail disease depend on the specific drug and may affect a single nail or all the fingernails and sometimes toenails. In addition to melanonychia, certain medications can cause nail pigmentation in the form of brown or black transverse and/or longitudinal bands, known as splinter haemorrhage. Drugs that can cause splinter haemorrhage include EGFR inhibitors, sunitinib, imatinib, and sorafenib.
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Frequently asked questions
Black fingernails can be caused by a number of factors, including trauma or injury to the nail bed, fungal infections, certain medications, underlying health conditions, and vitamin deficiencies. It is important to consult a doctor or dermatologist if you notice discolouration, as it may indicate an underlying issue.
If your black fingernail is accompanied by symptoms such as throbbing pain, swelling, or other nail deformities, it is advisable to seek medical attention. If the bleeding covers more than 25% of the nail, a doctor may need to drain the blood from under the nail.
Black fingernails can be caused by factors other than physical trauma, such as fungal infections, certain medications (especially antifungals and chemotherapy drugs), vitamin B12, vitamin D, or protein deficiencies, and underlying health conditions such as melanoma or melanonychia.
Melanonychia is the appearance of brown or black bands on the nail, which can be caused by melanocytic activation or proliferation. It can be benign or cancerous, and treatment may involve surgical removal of malignant tissues.
Proper nail care involves keeping the nails clean and dry, avoiding harsh chemicals, and protecting them from trauma. Regular moisturization of the nails and cuticles can prevent dryness and brittleness, and contribute to optimal nail health.
