A bruised toenail, medically known as a subungual hematoma, occurs when blood collects underneath the toenail plate. This condition typically arises from direct trauma to the toe, such as dropping a heavy object on it or forcefully stubbing the toe against a hard surface. Repetitive friction from ill-fitting footwear during activities like running or hiking can also lead to the development of a bruised toenail. The pressure from the accumulated blood can cause discomfort and a visible discoloration, ranging from red to dark purple or black, beneath the nail.
Immediate Home Care
Immediate attention to a bruised toenail can help manage pain and reduce swelling. Applying the R.I.C.E. method, adapted for a toe injury, is recommended. Begin by resting the affected foot to prevent further injury.
Applying ice to the injured area can help reduce swelling and numb the pain. Wrap an ice pack or a bag of frozen vegetables in a thin cloth and apply it to the bruised toenail for 15 to 20 minutes at a time, several times a day during the first 24 to 48 hours. Elevating the foot above heart level also minimizes swelling by promoting fluid drainage. Prop your foot on pillows while resting.
For pain management, over-the-counter pain relievers such as acetaminophen or ibuprofen can be effective. Follow dosage instructions. Keeping the injured area clean is also important to prevent infection, especially if the nail bed or surrounding skin is compromised.
Knowing When to See a Doctor
While many bruised toenails can be managed at home, certain signs indicate the need for medical evaluation. Severe or throbbing pain that persists despite home care measures suggests significant pressure buildup under the nail. Signs of infection, such as increasing redness, warmth, swelling, pus discharge, or a foul odor emanating from the toe, warrant medical attention.
If the toenail appears damaged, is partially detached, or is lifting from the nail bed, a doctor should assess the injury. An inability to comfortably bear weight on the affected foot or walk normally also suggests a serious injury. Individuals with underlying health conditions, such as diabetes or peripheral vascular disease, should seek medical advice for any foot injury, as their healing processes may be compromised. In some cases, a medical professional may need to drain the blood from under the nail, a procedure known as trephination, to relieve pressure and pain.
Understanding the Healing Process
The healing process for a bruised toenail is gradual and involves the growth of a new, healthy nail. The discolored blood trapped beneath the nail will not disappear but will slowly grow out with the nail plate. This can take several months, as toenails typically grow at a rate of about 1 millimeter per month.
Often, the pressure from the accumulated blood can cause the damaged nail to detach. This is a normal part of healing, with a new nail growing in underneath. During this period, it is important to protect the toe from further injury.
Wearing comfortable, roomy shoes that do not press against the affected toe can help prevent further trauma. Avoiding activities that put direct pressure on the toe, such as certain sports or prolonged standing in tight footwear, also aids healing. The complete replacement of a toenail can take 6 to 12 months, depending on individual growth rates and the extent of the initial injury.
Preventing Future Bruises
Preventing future bruised toenails involves adjustments to footwear and foot care practices. Ensuring that shoes fit properly is a key preventative measure. Shoes should have adequate toe room, allowing toes to wiggle freely, especially for prolonged standing, walking, or running.
Trimming toenails correctly reduces trauma risk. Nails should be cut straight across, not too short, and never rounded at the corners, as this can lead to ingrown toenails and increased injury risk. Using appropriate protective footwear during activities where the feet are vulnerable to impact, such as engaging in sports or moving heavy objects, can reduce the likelihood of a bruised toenail.