Caleb Foster
A throbbing finger nail can be caused by a variety of issues. One common cause is a subungual hematoma, which occurs when blood collects under the nail, typically due to a crush injury. This can cause throbbing pain and may require medical attention if severe. Another possible cause is paronychia, a bacterial or fungal nail infection that can result from trauma, irritation, or underlying skin conditions. Ingrown nails, hangnails, and subungal tumors are also potential causes of throbbing finger nails. Proper diagnosis and treatment are important to ensure the issue resolves without complications.
| Characteristics | Values |
|---|---|
| Cause | Trauma, irritation, or infection |
| Symptoms | Throbbing pain, swelling, redness, pus, fever, severe pain |
| Diagnosis | Self-diagnosis or doctor's examination |
| Treatment | Antibiotics, antifungals, steroids, drainage, nail removal, elevation, ice, pain relievers |
| Healing Time | Acute: 5-10 days, Chronic: several weeks |
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What You'll Learn
Subungual hematoma (blood under the nail)
A throbbing fingernail can be a symptom of a subungual hematoma, which is a collection of blood under the nail. This is usually caused by an injury to the nail, such as a crush injury or blunt trauma, and can result in a fracture. Subungual hematomas can cause severe throbbing pain due to the pressure of blood collecting between the nail and the nail bed. The affected area may also be swollen.
If you have a subungual hematoma, you can ice and elevate the area to reduce swelling and take over-the-counter anti-inflammatories like aspirin, ibuprofen, Advil, Motrin, or naproxen to reduce minor pain. If the pain is severe, your doctor may perform a procedure called decompression or trephination to relieve the pressure and pain. They may numb the affected finger or toe and use a heated wire (electrocautery device) or carbon laser to burn a hole, allowing the blood to drain.
In some cases, a subungual hematoma may indicate a more serious injury. If there is a large area of bleeding under the nail, the nail bed may be injured, and the entire nail may need to be removed and replaced with stitches. If you have broken bones or serious damage to the nail bed and/or surrounding tissues, seek immediate medical attention.
It is important to note that a darkened area under the nail without any history of injury could indicate other possible causes, such as nail-unit melanoma. Therefore, if you experience any unusual symptoms or are concerned about a subungual hematoma, it is always best to consult with your doctor for a proper diagnosis and treatment plan.
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Paronychia (nail infection)
Paronychia is a bacterial or fungal skin infection that develops around the nail. It is caused by biting or chewing nails, or working conditions that require hands to be frequently wet or exposed to chemicals. It can also be caused by an ingrown toenail. Acute paronychia develops quickly and can be treated at home by soaking the affected finger or toe in warm water several times a day. It can also be treated with antibiotics to kill the infection.
Chronic paronychia, on the other hand, has a slower onset and can take weeks for treatment to be effective. It is often caused by irritant dermatitis, a condition that makes the skin red and itchy. It is also more common in people with diabetes or vascular disease. In cases of chronic paronychia, a doctor may prescribe antifungal medication such as clotrimazole or ketoconazole. They may also need to drain any pus from surrounding abscesses.
To diagnose paronychia, doctors will usually perform a physical examination and consider the patient's medical history. They may also take a sample of any pus present and send it to a laboratory to test for the presence of specific bacteria or fungi.
To prevent acute paronychia, it is important to take good care of your nails by avoiding injuring your nails and fingertips, keeping your nails trimmed, and avoiding biting or picking at your nails.
To avoid chronic paronychia, it is crucial to keep your hands dry and protect them from harsh chemicals. Wearing gloves when working with water or chemicals is recommended. Additionally, changing socks daily and alternating between different pairs of shoes can help keep your feet dry and reduce the risk of infection.
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Ingrown fingernail
An ingrown fingernail occurs when the sharp edge of your fingernail grows into the skin on the side of your finger. It is more common in teenagers and adults over 50, as these populations experience changes in fingernail thickness. Nail brittleness is also more common with age.
If home remedies do not help, or if an infection develops, medical treatment may be necessary. In some cases, a doctor may recommend non-invasive medical procedures, such as placing a piece of tape on the affected area or removing a portion of the nail using special tools or chemicals. In rare cases, surgery may be required to remove the entire nail.
It is important to note that people with diabetes, neuropathy, or circulation problems should not try to treat ingrown nails at home and should seek medical advice instead.
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Hangnails
- Soak the affected finger in clean, warm water for 10 to 15 minutes.
- Massage vitamin E oil, petroleum jelly, or mineral oil very gently into the area.
- Using sanitized nail clippers, small scissors, or cuticle cutters, gently trim the hangnail close to the skin. Avoid tearing the skin, as this can cause further damage and increase the risk of infection.
- Apply a fragrance-free moisturizing cream or antibacterial ointment to keep the skin around your nails moisturized and prevent infection.
- Bandage the area if it is sore or bleeding to protect it from infection until it heals.
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Subungal tumours
Subungual tumours are growths that develop in the subungual space, which is the area underneath the nail plate. They can be benign or malignant and often present with pain, tenderness, and cold sensitivity. Due to their location, subungual tumours cannot be detected through ocular inspection or palpation, making diagnosis challenging. Imaging techniques, such as 18 MHz high-frequency ultrasound with CDFI (Colour Doppler Flow Imaging) and magnetic resonance (MR) imaging, play a crucial role in the detection, diagnosis, and management of subungual tumours.
Benign subungual tumours can have various appearances before surgery, ranging from pinpoint tenderness with no nail abnormality to tender implantation dermoid tumours with nail deformities. Surgical excision is the treatment of choice for benign subungual tumours, and proper surgical technique is critical to ensure complete tumour removal and prevent nail deformities. In some cases, a transungual approach with nail removal may be necessary.
Malignant subungual tumours, such as squamous cell carcinoma and malignant melanoma, are more serious and require prompt medical attention. These tumours often exhibit nonspecific clinical manifestations, making imaging and pathological findings crucial for accurate diagnosis and treatment planning.
Overall, subungual tumours can vary in terms of their pathology and clinical presentation. Imaging techniques and surgical interventions are essential tools in the diagnosis, treatment, and management of these tumours to ensure optimal patient outcomes and prevent potential complications.
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Frequently asked questions
A throbbing pain in your fingernail could be caused by a subungual hematoma, which is when blood collects under the nail, usually due to an injury. It can be very painful and cause throbbing due to the pressure of the blood collecting between the nail and the nail bed.
If you have a throbbing fingernail, you should seek medical attention to rule out any serious causes. Your doctor may recommend keeping your hand or foot elevated above the level of your heart to reduce throbbing and taking prescription pain relievers or over-the-counter pain medicines such as ibuprofen or naproxen.
There are several other potential causes of throbbing pain in your fingernail, including paronychia (nail inflammation), ingrown nails, hangnails, and subungual tumors. These conditions can be caused by trauma, irritation, infection, nail biting, or exposure to irritants such as detergents and other chemicals.
