A sudden appearance of blood underneath an acrylic nail is a cause for immediate concern, often indicating a subungual hematoma. This collection of blood occurs when small blood vessels in the highly vascular nail bed are injured, causing blood to pool in the space between the nail and the tissue underneath. The presence of an artificial nail complicates this injury because it traps the blood, preventing drainage and creating significant pressure. Understanding the source of the bleeding and taking prompt action is important for relieving discomfort and preventing further complications.
Common Reasons for Bleeding Under Acrylics
The most frequent cause of bleeding under an acrylic nail is physical trauma to the fingertip or toe, such as a blunt force or a crush injury. The acrylic shell, while protective in some ways, can transfer impact directly to the nail bed, or the force of the trauma can cause the acrylic to suddenly lift, tearing the natural nail plate from the underlying bed. Even minor impacts that might go unnoticed on a bare nail can cause bleeding because the rigid artificial nail acts as a lever, magnifying the force applied to the natural nail underneath.
Bleeding can also originate from mechanical trauma sustained during the nail application process. Over-filing the natural nail with coarse hand files or powerful electric drills (e-files) can thin the nail plate significantly, making the underlying nail bed susceptible to injury. Aggressive pushing or cutting of the cuticle, which forms a seal protecting the nail matrix, can also cause micro-trauma and subsequent bleeding.
A less common, yet serious, source of trauma is a chemical reaction or allergy to the products used, which can compromise the integrity of the nail bed. Severe allergic reactions to acrylates or improperly cured products can lead to onycholysis, where the nail plate lifts away from the nail bed, making the tissue fragile and prone to micro-bleeds and separation. The compromised nail structure is much more likely to tear and bleed from minimal physical stress.
Immediate First Aid and Safe Acrylic Removal
The immediate priority when bleeding occurs is to stop the flow of blood and relieve the intense pressure that a subungual hematoma causes. Gently apply clean, direct pressure to the area with gauze or a clean cloth for several minutes to encourage clotting. Elevating the hand above the heart can also help reduce blood flow to the injured digit, which helps control swelling.
Once the bleeding is controlled, the safe removal of the acrylic nail is necessary to assess the injury and prevent infection. If the acrylic is firmly attached and the pain is severe, it is best to seek professional medical attention, as drainage may be necessary to relieve pressure. If the injury seems minor, the acrylic can be gently removed by soaking the entire finger in pure acetone, which dissolves the bond, allowing the acrylic to lift without tearing the nail bed.
Never attempt to forcefully pry, pull, or clip the acrylic off, as this can severely worsen the laceration to the nail bed. After the artificial nail is removed, thoroughly clean the exposed nail bed with clean, lukewarm water and a mild antiseptic solution. Cover the injury with an antiseptic ointment and a sterile, breathable bandage, changing the dressing daily or whenever it becomes wet or soiled.
Recognizing and Managing Infection Risks
An open wound under an acrylic nail creates an environment highly susceptible to infection, as the artificial nail can trap moisture and debris against the injured tissue. Signs of a localized bacterial infection include increased redness and swelling around the nail folds, throbbing pain, and the presence of pus or a foul odor. Red streaks extending from the injury up the finger or a fever are signs that the infection is spreading and warrant immediate medical care.
Fungal infections, or onychomycosis, are often caused by trapped moisture and tend to present as chronic issues like nail discoloration, thickening, and separation of the nail plate from the bed. Bacterial infections can appear more acutely and are often characterized by significant pain, swelling, and sometimes a green or black discoloration, particularly with Pseudomonas aeruginosa.
If the pain is unmanageable, the swelling is rapidly increasing, or you notice signs of systemic illness like a fever, seek professional medical attention. A healthcare provider can diagnose the infection and determine if the underlying nail bed laceration requires repair or if the hematoma needs draining. For simple lacerations and minor infections, home care is often sufficient, but any concern about the severity of the injury should prompt a medical consultation.
Preventing Nail Bed Trauma During Manicures
Preventing injury starts with careful selection of a licensed and experienced technician. Ensure that the salon uses sterilized tools, as improperly cleaned instruments can introduce bacteria and fungi that compromise the nail bed. A gentle approach during the filing and preparation stage is crucial, as aggressive use of e-files can thin the natural nail plate and make it highly vulnerable to trauma.
Speak up immediately if you feel a burning sensation, sharp pain, or discomfort during any stage of the application process. Maintaining your acrylics with timely fill appointments is important, as neglecting the growth gap can increase the chance that the acrylic will lift and snag, causing a traumatic tear to the natural nail.