Caleb Foster
A blood blister under a toenail, medically known as a subungual hematoma, is a common injury. It occurs when blood vessels under the nail bed break and leak blood, which gets trapped and causes throbbing pain. While this injury usually isn't dangerous, it can be extremely painful. The pain typically subsides in a few days, but the nail takes much longer to recover. The discoloured nail will eventually grow out, fall off, or need to be removed, and a new toenail can take 6 months to a year and a half to regrow.
| Characteristics | Values |
|---|---|
| Medical term | Subungual hematoma |
| Other names | Blood blister under the nail, runner's toe, tennis toe |
| Cause | Injury to the blood vessels under the nail bed |
| Symptoms | Severe throbbing pain, nail discoloration (reddish purple, blue, black, or brown) |
| Treatment | Decompression or trephination to drain blood and relieve pressure |
| Healing time | 4–6 months for a fingernail, 6 months to 18 months for a toenail |
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What You'll Learn
Subungual hematoma
The pressure of the pooled blood under the nail causes pain and throbbing. This can be treated by draining the blood through a procedure called trephination or decompression. This procedure can be performed using a cautery device, which uses a heated wire or carbon laser to burn a hole in the nail, or a needle. Trephination is a quick and painless procedure, and the heated tip of the wire is cooled by contact with the hematoma, preventing injury to the nail bed. After the procedure, the finger or toe will need to be bandaged and elevated, and cold compresses may be required.
If the area of bleeding is very small, a subungual hematoma may not require medical treatment. Ice can be applied to the area to reduce swelling, and over-the-counter anti-inflammatories can be taken to relieve minor pain. If the bleeding covers a large area of the nail surface, the nail bed may be injured, and a doctor may need to remove the nail and use stitches to repair the nail bed.
In most cases, the nail will fall off on its own after several weeks as the pooled blood separates it from its bed. A new fingernail can regrow in as little as eight weeks, but a new toenail may take up to six months to fully regrow. If there has been damage to the nail bed or surrounding tissues, the new nail may take longer to grow back and may not look normal.
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Toenail trauma
A blood blister under the toenail, medically known as a subungual hematoma, is usually the result of some form of injury to the blood vessels under the nail bed. This could be caused by a heavy object crushing the toe, or by engaging in sports with a lot of stop-and-start action, such as tennis, soccer, or basketball. Subungual hematomas can also occur in runners and hikers, especially those who often run or hike downhill.
The first symptom of a subungual hematoma is typically throbbing pain in the nail area, caused by the pressure of blood pooling under the nail bed. This is followed by nail discoloration, which starts out as reddish-purple and eventually turns dark brown to black as the blood clots. While subungual hematomas are very painful, they usually aren't dangerous unless there is accompanying damage to the nail bed or surrounding tissues.
To relieve the pressure and pain caused by a subungual hematoma, a doctor may perform a procedure called decompression or trephination, which involves creating a small hole in the nail to allow the blood to drain. This procedure is typically done within 48 hours of the injury, before the blood starts to clot. After the procedure, the affected toe will need to be kept bandaged and elevated, and cold compresses may also be recommended.
In most cases, subungual hematomas will heal naturally over time, even without drainage. The body will break down and absorb the blood under the nail, although this can take several months for a toenail to fully regrow. During this time, the discolored nail will eventually grow out or fall off and be replaced by a new, healthy one. However, if there is damage to the nail matrix or underlying tissues, the nail may not grow back or may grow back with a different shape.
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Nail loss
A blood blister under the toenail, also known as a subungual hematoma, is usually caused by vertical pressure to the toenail, such as dropping something on your toe. The upper layers of skin separate from the underlying layers, creating a space for blood or fluid to collect and form a blister. This condition can be extremely painful due to the pressure exerted by the pooled blood or fluid.
To relieve the pain, it is necessary to release the fluid or blood from the blister. This can be done by drilling a hole in the nail or piercing the skin adjacent to the nail with a sterile scalpel blade or hypodermic needle. These procedures are generally considered easy and painless when performed with the appropriate equipment and under proper medical supervision.
If left untreated, the pressure from the pooled blood can cause the nail to separate from its bed, leading to nail loss. The affected nail will usually fall off on its own after several weeks. A new toenail may take about six months to fully regrow, and there is a possibility that the new nail may not look normal.
It is important to note that nail loss due to a blood blister is typically not a cause for concern unless there is also damage to the underlying nail bed or surrounding tissues. In such cases, the regrowth of the nail may take longer, and proper medical care should be sought to ensure optimal healing.
To prevent toenail blisters, it is crucial to wear properly fitted shoes and avoid situations where the toes are repeatedly pushed back, such as having long toenails or wearing shoes that are too small.
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Discoloration
Subungual hematoma is the medical term for bleeding under a toenail or fingernail, which can cause the nail to become discoloured. This discolouration typically starts as a reddish-purple hue and darkens to brown and black as the blood clots. The discolouration will grow out as the nail regrows, which can take anywhere from 4 to 18 months, according to the American Academy of Dermatology. In some cases, the discoloured nail may fall off or need to be removed and replaced by a new, healthy nail.
The blood blister under the nail is caused by an injury to the blood vessels under the nail bed. For example, blood vessels can break and leak blood when a heavy object crushes a toe or when a person repeatedly jams their toes into the toe box of a too-tight shoe. Subungual hematomas can also occur in runners and hikers, especially those who often run or hike downhill.
While subungual hematomas are very painful, they usually aren't dangerous unless there is broken bone or damage to the nail bed or surrounding tissues. To relieve the pain, a doctor may perform decompression or trephination, which involves creating a small hole in the nail to allow the blood to drain and relieve pressure. This procedure is typically done within 48 hours of the injury before the blood starts to clot.
It's important to note that nail discolouration can also be a symptom of other conditions, such as subungual melanoma, which can look similar to a subungual hematoma. Therefore, it is essential to seek medical advice for proper diagnosis and treatment.
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Drainage
A blood blister under a toenail is called a subungual hematoma. It is usually caused by a crush injury to the nail. As blood collects under the nail, it causes throbbing pain and the nail may eventually fall off.
If you are experiencing a subungual hematoma, you may opt to have the blood drained to relieve the pain. This procedure is called decompression or trephination. Before draining the blood, your doctor will numb your toe with a nerve block. They will then use one of the following methods to create a small hole in your nail to allow the blood to drain:
- Cautery: A heated wire (electrocautery device) or carbon laser is used to burn a hole in the nail. The heated tip of the wire is cooled by contact with the hematoma to prevent injury to the nail bed.
- Needle: A needle is used to make a hole in the nail.
After the procedure, your doctor will bandage your toe. You will need to keep your toe bandaged and elevated for the first 12 hours. You may also need to use cold compresses during this time. In some cases, your doctor may recommend that you use a splint for up to 3 days until the tenderness subsides.
It's important to note that you should not attempt to drain the blood yourself. Let a medical professional perform this procedure to prevent further injury or infection.
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Frequently asked questions
A blood blister under the toenail is called a subungual hematoma. It is caused by an injury to the blood vessels under the nail bed.
Symptoms include severe throbbing pain, nail discolouration, nail sensitivity, and separation of the nail plate from the nail bed.
A doctor may drain the blood blister, also known as trephination. This procedure involves making a small hole in the nail to allow the blood to flow out.
A new toenail may take anywhere from 12 to 18 months to fully grow back. The new nail may have ridges or other abnormalities.
