bruising underneath the nail

3 min read 13-03-2025

Meta Description: Discover the common causes of subungual hematoma (bruising under the nail), effective treatment options, and preventative measures to protect your nails. Learn when to seek medical attention for severe cases. (158 characters)

Subungual hematoma, or bruising under the nail, is a common injury affecting the fingernail or toenail. This condition occurs when blood collects between the nail bed and the nail itself. It can range from a minor inconvenience to a serious injury, depending on the severity. This article will explore the causes, treatment, and prevention of bruising underneath the nail.

Causes of Bruising Under the Nail

Several factors can lead to a subungual hematoma. The most frequent cause is a direct trauma to the finger or toe. This can happen from:

Impact injuries: Dropping a heavy object on your nail, stubbing your toe, or slamming a finger in a door.
Crushing injuries: Experiencing significant force against the nail, such as during a sports injury.
Penetrating injuries: A sharp object puncturing the nail bed.

Less common causes include:

Underlying medical conditions: Certain medical conditions, such as bleeding disorders or blood thinners, can increase the risk of subungual hematoma. Consult your doctor if you experience frequent or unexplained bruising.
Nail infections: In some cases, a nail infection can cause bleeding and discoloration under the nail.
Nail psoriasis: This chronic skin condition can also lead to bleeding and discoloration.

Recognizing the Symptoms

The primary symptom is a dark discoloration under the nail. The color can vary from red to purple to black, depending on the amount of blood and the time elapsed since the injury. You may also experience:

Pain: The level of pain varies depending on the severity of the bruise.
Swelling: Some swelling around the affected nail is possible.
Tenderness: The nail may be tender to the touch.

Treatment for Bruising Under the Nail

For minor subungual hematomas, treatment often involves simple home care:

Elevation: Elevating the affected finger or toe can help reduce swelling.
Ice: Applying ice packs for 15-20 minutes at a time, several times a day, can help manage pain and inflammation.
Pain relief: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help alleviate pain.

How to Drain a Subungual Hematoma: In cases of significant pain or large blood clots, a doctor may perform a procedure to drain the blood. This is often done by creating a small hole in the nail using a heated needle or a drill. This relieves pressure and reduces pain. This is a quick procedure usually done in a doctor's office.

When to See a Doctor

While many subungual hematomas resolve on their own, it's important to seek medical attention if:

The pain is severe or doesn't improve with home care.
The bruise is large and covers a significant portion of the nail.
You have other symptoms, such as fever, swelling, or redness around the nail.
You suspect a fracture or other serious injury.
The bleeding doesn't stop or reoccurs.
You have a bleeding disorder or are on blood thinners.

Preventing Bruising Under the Nail

Protecting your nails from trauma is the best way to prevent subungual hematomas. Here are some tips:

Wear protective gear: Always wear appropriate protective gear during activities that could potentially injure your nails, such as sports, or working with tools. Consider gloves when doing DIY projects.
Proper footwear: Wear shoes that fit properly to prevent stubbing your toes.
Careful handling: Handle sharp objects cautiously.

Conclusion

Bruising under the nail is a common injury that can range from minor to serious. Understanding the causes, treatment options, and when to seek medical attention can help ensure proper management of this condition. Preventing subungual hematomas through protective measures is key to keeping your nails healthy. Remember, consulting a healthcare professional is crucial for severe cases or if you have concerns.