Bruised Toenail: Causes, Symptoms and Effective Home Treatments

Bruised Toenail: Causes, Symptoms and Effective Treatments
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Having a blackened and bruised toenail is rarely a cause for serious concern. An injury to your toe because of running, wearing incorrect footwear, or a trauma can cause bleeding under a toenail that results in the nail turning black. Depending on the severity of the trauma, just a part of the toenail could show signs of bruising or the whole area under the nail could turn black, and eventually the bruised toenail will fall off.

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Along with the bruising under the toenail, it is very common to feel throbbing pain. Sometimes, the pain can be from the injury itself, but on other occasions, the toe can be sore because the bleeding under the nail causes pressure to build up. Some home remedies can help to treat a blackened toenail and speed up the healing time. However, in cases of a severe toenail bruising, a doctor may drain the blood to relieve pressure.

This article explores the various causes of bruised toenails and looks at ways you can easily prevent bruising under a toenail. You will also learn about some easy home remedy treatments to reduce the bruising and help your bruised toenails heal quicker.

Symptoms of Toenail Bruising

The medical name for bruising under the toenail or fingernail is a subungual hematoma. This describes a condition where blood collects under the nail making it appear purple or black. Although it looks like your fingernail or toenail has turned black, it is the tissue under the nail that becomes bruised.

According to Drugs.com, trauma usually causes damage to the nail and tissue underneath resulting in throbbing pain, swelling, and a red, blue or purple bruise as the blood collects. The damaged bruised toenail and surrounding area may also be tender to touch.1

If not treated properly, you could also get bacterial infections in your toenail and possibly a fungal toenail infection. In the end, this can cause your toenail to become thickened or fall off completely.

Causes of Bruised Toenails

Let’s look at the various causes of bruised toenails. Knowing what can cause bruising under a toenail or fingernail can also help you prevent injury to your toes and having black toenails.

Runner’s toenail

Runner’s or jogger’s toenail is one of the most common reasons for blackened bruised toenails. Most runners at some point experience bruising under their toenails. For many runners, it’s their big toe that gets bruised more often.

A report in the British Journal of Sports Medicine found that many long-distance runners have toenail bruising on their longest toe. This happens when the toe pushes against the front of the shoe while running or jogging. The journal reported that around 2.5% or marathon runners in the 1979 New York Marathon showed signs of runner’s toe.2

The report said that it may take several months for bruising under the toenail to heal completely. However, wearing good-fitting footwear and keeping toenails trimmed short can help prevent runner’s toe and damage to the surrounding tissue.

Trauma to toenail

Among non-athletes, the most common cause of having one or more bruised toenails is suffering trauma to the feet. Trauma to your toes can cause intense pain and bleeding in the nail bed. This results in blood pooling under the nail that eventually turns black as the bruise forms.

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Dr. William Blahd on WebMD says that a common reason for injuring your toe is dropping a heavy object on it. Stubbing your toe on a hard surface can also result in a sore toe that develops a toenail bruise.3

Any trauma to your toe that results in a bruise should be examined by a doctor. This is to check for broken bones or serious damage to the tissue in the nail bed. If there is no injury, Dr. Blahd says that the discoloration under the nail and pain should heal on without treatment. However, it may take up to 6 months for a new toenail to grow if the bruised toenail falls off.

Incorrect footwear

Not wearing proper footwear can result in bruising to one or more of your toes. There are a few reasons why improper footwear can cause toenail bruising. One reason is wearing shoes that are too small and this causes repeated injury to your toenail bed (similar to runner’s toenail).

Wearing incorrect footwear at work can also lead to bruised toenails. For example, the Canadian Centre for Occupational Health and Safety says that footwear that doesn’t protect the feet properly can put you at risk of injuries to your toes and feet. This could be from a heavy object falling on your feet or sharp objects puncturing the soles of the shoes.4

To prevent footwear damaging your toes and causing them to bruise, you should always wear appropriate footwear. Harvard Medical School recommends wearing shoes that aren’t too tight and making sure the toe box is large enough not to press on your toes. It recommends to make sure you have about a half-inch of space between your longest toe and the end of the shoe and to wiggle your toes to make sure there is enough room.5

Long toenails

You can easily get blackened and bruised toenails if they are too long. The toenail could either press repeatedly against your shoe resulting in damage to the nail bed and bruising. Or, you could catch the toenail on an object when walking around barefoot.

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The British Journal of Sports Medicine recommends that toenails should be trimmed short to prevent bruising and damage.2

Certain medications

Although not directly causing blackened toenails, certain medications can thin the blood and make bruising easier. This means that even a relatively small and insignificant injury to a toe could result in severe bruising under the nail causing it to become blackened.

Dr. William Blahd on WebMD says that some medications which increase the risk of bleeding are blood-thinning medications like aspirin, warfarin, or clopidogrel. Also, certain cancer medications and steroids can make you bruise easily.6

If you think that your medication is making your bruise easily, you should speak with your doctor.

Home Remedies for Bruised Toenails

To reduce the bruising under a toenail, it’s important to treat the injury as soon as possible. This can help to prevent blood collecting under the nail and may help reduce the size of the bruise.

Dr. Linda Vorvick on MedlinePlus recommends treating a minor toe injury using an ice pack to promote healing.7 This is what you should do:

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  1. Put some crushed ice in a plastic bag and wrap the bag in a thin towel.
  2. Apply the ice pack to your injured toenail and keep the foot elevated above the level of your heart to prevent toenail swelling and blood coagulating under the nail.
  3. Hold for 20 minutes every 2 hours on the first day to help soothe the throbbing pain and discomfort.
  4. After the first day, apply the ice pack 3-4 times a day to help speed up healing and prevent a bruised toenail.

However, Dr. Allison Harvey on eMedicineHealth says that if a large bruise develops that is more than 25% of your toenail, you should seek medical attention.8

In these cases, if there is a lot of bleeding under the nail and pressure builds up, doctors may drain the blood to alleviate the throbbing pain. They do this by puncturing the nail plate to allow the blood to flow out.

How to Prevent Toenail Bruising

Because bruised toenails can take a long time to heal, you should always try to prevent toenail bruising. Here are some of the best ways to avoid having a bruised and blackened toenail:

  • Always wear shoes that fit well, allow a little room for movement, and make sure they are laced up correctly.
  • Apply ice as soon as possible to any injury to your toes to prevent bruising under the nail and pain.
  • Wear protective footwear if you work in heavy industries.
  • Keep your toenails trimmed short to prevent them pushing on the front of your shoes.

Bruised Toenail – When to See a Doctor

In some cases of a bruised toenail, you should visit a doctor to check for more serious injuries. Also, toenails that have become blackened for no obvious reason could be a sign of a serious medical condition.

Dr. Linda Vorvick recommends seeing a doctor for a toenail injury in the following circumstances:7

  • First-aid remedies for a damaged toenail don’t reduce redness, pain, or swelling
  • You notice pus draining from the wound
  • You have a fever
  • The bleeding won’t stop

In rare instances, black patches that develop on the nail bed could be a sign of cancer. Therefore, if you have a blackened toenail that looks like a bruise and there has been no injury to the nail, you should see your doctor.

Read my other related articles:

Article Sources

  1. Drugs. Subungual hematoma.
  2. Br J Sports Med. 2004;38:498-501.
  3. WebMD. Bleeding under a nail.
  4. CCOHS. Foot comfort and safety at work.
  5. Harvard Medical School. 10 tips for finding the right shoes.
  6. WebMD. Medications that cause bruises.
  7. MedliniePlus. Nail injuries.
  8. eMedicineHealth. Home remedies for nail injuries.
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