The sudden appearance of blood beneath an acrylic nail can be alarming. This bleeding indicates that the delicate tissue of the nail bed has been compromised, causing blood vessels to rupture. Because the acrylic covering makes the injury less immediately visible, the pain and discoloration are signals that the underlying nail unit requires attention to prevent complications.
Identifying the Source of the Bleeding
The majority of bleeding under an acrylic nail stems from physical trauma that damages the nail bed, resulting in a subungual hematoma. This injury occurs when a sudden, blunt force, such as jamming the finger or hitting the nail, causes blood to pool between the nail plate and the sensitive nail bed tissue. Because the acrylic forms a rigid cap, the impact transmits force directly to the underlying tissue, trapping the blood and creating pressure that causes throbbing pain.
A second common mechanism involves the lifting and separation of the acrylic from the natural nail plate. As the artificial nail separates, it can snag on objects, forcibly tearing the natural nail away from the nail bed, a process called onycholysis. This tearing ruptures small blood vessels, leading to bleeding and an open pathway for bacteria or fungi to enter the space. Separation often occurs several weeks after application as the natural nail grows out, weakening the acrylic’s seal.
The third cause relates directly to the application or maintenance process, specifically excessive filing or drilling. Aggressive use of electric files, particularly near the cuticle or during infills, can inadvertently damage the nail bed tissue. This mechanical trauma can cause immediate or delayed pinpoint bleeding. Damage from over-filing weakens the integrity of the natural nail, making it more susceptible to tearing later on.
Immediate Care and Next Steps
The first action upon noticing bleeding is to stop the flow by applying light, sustained pressure with a clean cloth or gauze. Elevating the hand can also help reduce the blood pressure in the finger, aiding in coagulation. Once the bleeding has subsided, the area must be thoroughly cleaned with water and an antiseptic solution to minimize the risk of bacterial contamination.
Assessing the status of the acrylic is the next step. If the nail is significantly lifted, dangling, or causing intense pain, the acrylic should be removed to relieve pressure and inspect the wound. Removal must be done carefully, usually by soaking the nail in pure acetone or by gently filing the lifted area down until it can be detached. Never attempt to forcefully pry or pull the acrylic off, as this can cause catastrophic damage to the nail bed.
After removal or if the acrylic remains firmly attached, apply a thin layer of antibiotic ointment to the wound and cover it with a clean, breathable bandage. If the wound is a subungual hematoma that covers a large portion of the nail, or if the pain is severe and throbbing, seeking professional medical assistance may be necessary for safe drainage and pressure relief.
Signs That Require Medical Attention
While many minor nail injuries heal on their own, certain symptoms indicate a more serious complication. Throbbing pain that continues to worsen after 48 hours, especially if accompanied by increased swelling, is a warning sign. This persistent, heightened pain can signal excessive pressure from a large hematoma or the beginning stages of an infection.
Other indications for a doctor’s visit include the presence of pus or foul-smelling discharge beneath or around the nail, which suggests a bacterial infection. Spreading redness or warmth extending from the nail fold into the surrounding finger tissue is also concerning.
A fever or red streaks emanating from the injury site are signs that the infection may be spreading systemically and require prompt medical intervention. If the bleeding is profuse or does not stop after ten minutes of direct pressure, a healthcare provider should be consulted immediately.
Preventing Future Nail Trauma
Future protection relies on both proper application techniques and modification of daily habits. When acrylics are applied, the nail technician should avoid overly aggressive filing or drilling of the natural nail plate, especially near the cuticle and side walls. Ensuring the acrylic is applied with a complete seal prevents moisture from becoming trapped between the layers, which can promote lifting and create an environment for infection.
Timely maintenance appointments, typically every two to three weeks, are important to prevent the acrylic from significantly lifting as the nail grows out. Addressing small areas of lift quickly prevents them from becoming snag hazards that can lead to a traumatic tear of the nail bed. Consciously avoiding using the hardened acrylic nails as tools—such as scraping, prying, or opening cans—will reduce the risk of impact or leverage trauma.