Toenail trauma is mainly caused by hitting your toenail on something or by your toe. And you may notice a darkness beneath your toenail. Sometimes the nails start to lift off the nail bed. This is because of bleeding under the toenail.
The blood gets between the skin and the underside of the toenail, and there is nowhere to go. Therefore, this can cause dark spots under the toenails and pain. If this happens, you should get it checked by a podiatrist.
Runners and other athletes sometimes have trauma as well. This is from the repetitive pressure of the nail hitting the end or the top of the shoe. Sometimes, this repetitive micro trauma will lead to nail thickening.
Types of Toenail Trauma: From Mild to Severe
It can range from a minor inconvenience to a painful injury that may need medical attention. There are different types of trauma; understanding those may help determine the right treatment.
Subungual Hematoma
This one is the most common type. It occurs when blood collects under the nail due to impact or pressure, like stubbing your toe, dropping something heavy, or pressure from tight shoes. It can cause pain and a dark red or black discoloration.
Nail Bruising
When it happens, you might notice slight tenderness and a purple or bluish tint under the nail. This may cause the nail bed to bruise without bleeding.
Cracked or Split Toenails
Cracks can appear after sudden force or repetitive stress. While minor cracks can heal on their own but deeper splits can expose the nail bed and increase infection risk.
Nail Falling Off (Toenail Avulsion)
In critical cases, the toenail may detach from the toe. The exposed area may be painful and vulnerable to infection.
Nail bed Laceration or Fracture
This is a serious form of trauma where the nail bed is cut to the toe bone, under the nail is fractured. It usually needs professional medical treatment.
How to Treat at Home Safely
Subungual Hematomas may be treated at home. If it doesn’t hurt and if less than half of the nail is discolored, then you may not need to treat it. If the nail falls off on its own, it grows to over time.
What to do if it causes pain?
- You can treat it with ice. Wrap a towel around an ice pack. Press it gently on the injury for 20 minutes each day.
- Elevation,
- light compression, and
- OTC pain relievers for mild bruising.
After an injury, the nail bed usually heals in about seven to ten days. If the injury is serious, it might take up to 12 months for the toenail to grow back completely. A lost fingernail typically takes four to six months to regrow.
When to See a Doctor for Toenail Damage
- An instance of blunt trauma
- The toe exhibits severe swelling or redness
- Discharge appears from under the toenail
- The toenail becomes loose or falls off
- If the injury affects healing or circulation
- If discoloration appears as a stripe
How to relieve bleeding under the toenail
It’s a simple process to relieve the pressure caused by bleeding under the nail. Dr. Andrew Schneider performs a painless procedure where he makes small holes in the toenail. This allows the blood to drain from under the nail.
When you do this procedure soon after the injury, the nail is often able to reattach to the nail bed and continue growing.
Sometimes the injury causes a blister to form beneath the nail. In these cases don’t have to put holes in the toenail to access the blister through the end of the toenail and allow it to drain. Even after draining the blood or blister from under the nail, the toenail will likely be stained underneath.
How can you recover from Toenail Trauma?
At this point, maybe several things will happen. If you do the treatment and are successful in saving the toenail, the nail will just grow out.
The darkened part of the nail will reach the end, and you just clip it. The same goes for those little holes. It takes about nine months for a great toenail to regrow. For the other toenail, it will take about six months.
Sometimes, if the injury is more severe, the nail will separate from the nail bed, and a new nail will start to grow under it. If this happens, it will look like the nail is thick.
When the new nail progresses far enough, the top nail will loosen and ultimately come off. When this happens, it easily comes off with no bleeding and no pain. There is no reason to go to the hospital unless there is pain, bleeding, or pus when the nail comes off.
Cosmetic solution Keryflex
There is a better choice, and that is to use a cosmetic solution. This is safe to use on the toenails and does not damage the new nail growth.
The procedure is called Keryflex. In addition, Keryflex is a cosmetic nail system that gives you a nice-looking nail while your natural nail is recovering. It’s made from a keratin resin, the same material that your toenails are made from. This is flexible. The flexibility of the keyflex will prevent it from digging into your toe, preventing it from forming into an ingrown toenail.
Moreover, A lot of times the nail may look like it has a fungal infection. You can do a test on the nail to see if it’s thickened due to fungus or reacting to the toenail trauma.
In the first place, you have injured your toenail; it’s best to get it checked. If you address it early, it can present lasting problems with the toenail.
What to do while waiting for the nail to grow out?
- Firstly, Most people wear sandals and open-toed shoes
- Acrylic nail
Some people do put an acrylic nail on the toe. Drs don’t recommend this. Acrylic is not meant for toenails. Besides, they are not flexible, and when pressure is applied by wearing shoes, they become even less flexible. And they can dig into the toe. Furthermore, it can cause an ingrown toenail and lead to an infection. The acrylic nail is also damaging the new nail growing beneath it.
Source: tanglewoodfootspecialists, NIH
