A bruised toenail, medically known as a subungual hematoma, occurs when blood collects under the toenail. This common injury typically results from direct trauma, such as dropping a heavy object on the toe or repeatedly hitting the toe against the front of a shoe during physical activity. While often minor, understanding appropriate care for a bruised toenail promotes healing and prevents complications.
Initial Steps for Home Care
Home care for a bruised toenail focuses on reducing swelling, managing pain, and protecting the injured area. Applying R.I.C.E. principles alleviates discomfort and minimizes further damage. Rest the affected foot by limiting activities that place pressure on the injured toe, preventing additional bleeding.
Apply ice to the injured toe for 15 to 20 minutes, several times daily, to reduce swelling and numb the area. Wrap the ice pack in a thin cloth to avoid direct skin contact. Gentle compression, such as a light bandage, can manage swelling, but ensure it is not too tight to restrict circulation. Elevating the foot above heart level, especially during the first 24 to 48 hours, also reduces fluid accumulation and swelling.
Over-the-counter pain relievers, such as acetaminophen or ibuprofen, effectively manage discomfort. Follow dosage instructions. Protecting the toe from further impact is important; wear open-toed shoes or shoes with a wide toe box to prevent pressure. Regularly observe the toenail for any changes in color, swelling, or increasing pain.
Signs to See a Doctor
While many bruised toenails can be managed at home, certain signs indicate professional medical attention is needed. Severe or throbbing pain that does not improve with home care or over-the-counter pain relievers suggests significant pressure under the nail. Pus, increasing redness around the nail, or streaks of redness extending up the foot are signs of possible infection, requiring prompt evaluation.
Consult a doctor if the injury prevents putting weight on your foot or if you suspect a toe fracture. If the toenail appears significantly loose or completely detached from the nail bed, medical assessment is recommended. Injuries caused by something sharp piercing the nail, especially if dirty, also warrant a doctor’s visit due to deep infection risk. A medical professional might drain blood from under the nail to relieve pressure and pain, or perform an X-ray for underlying bone damage.
Recovery and Future Protection
Recovery for a bruised toenail involves the gradual growth of a new, healthy nail, pushing the damaged nail forward. This process can take several months, typically between six to nine months, as toenails grow slowly. The discolored part of the nail will gradually move towards the tip as the new nail emerges from the nail matrix at the base. In some cases, the old nail may detach completely before the new nail fully replaces it.
To prevent future bruised toenails, select properly fitting footwear with adequate toe box space to prevent toes from pressing against the shoe front. Avoid shoes that are too tight or too loose, as both can cause toes to slide and hit the shoe. Wearing protective footwear, such as steel-toed boots, is advisable during activities involving heavy objects or foot impact. Keeping toenails trimmed straight across and not too short helps prevent trauma and ingrown nails, contributing to overall nail health.