Subungual hematoma is a common toenail injury caused by blood accumulation following trauma. Although usually benign, a toenail hematoma can become painful and signal more serious issues. Recognizing symptoms and understanding causes and treatments is essential for proper care.
Symptoms of a hematoma under the toenail
Subungual hematoma typically occurs after a toe trauma and manifests through clear signs such as:
- Sharp pain in the affected toe
- Discoloration of the nail (blue, purple, or black)
- Pulsating or throbbing sensation
- Touch sensitivity and swelling
- Nail lifting and painful adjacent toes
Though often only a cosmetic issue, toenail hematomas can lead to complications such as partial or total nail detachment, infections including nail fungus, distorted nail growth, or an ingrown toenail. Persistent hematomas require consultation with a doctor or podiatrist.
Similar conditions
Darkening of the nail can arise from other foot problems resembling a hematoma, such as:
- Nail fungus
- Benign or malignant tumors
- Plantar warts
- Diabetic foot ulcers
- Horn under the nail
Due to the similarities, a podiatrist’s evaluation is recommended for diagnosis.
What can cause a subungual hematoma
Subungual hematomas arise mostly from trauma to the foot, including:
- Toe crushing or impact by heavy objects
- Repeated microtraumas to the nail
- Improper nail cutting or care
- Prolonged standing
Blood accumulation under the toenail can also be due to a phalanx fracture, requiring medical assessment.
Subungual hematoma prevention
Preventing toenail hematomas involves reducing trauma risks, such as:
- Wearing well-fitting supportive shoes without toe compression
- Limiting use of sandals and high heels
- Using protective footwear like steel-toe boots in hazardous jobs
- Regular, proper toenail maintenance
- Ensuring shoes are properly tied and reducing barefoot time
How to relieve a hematoma under the toenail quickly
To temporarily ease the pain of a subungual hematoma:
- Apply ice to reduce swelling
- Take painkillers as needed
- Soak feet once or twice daily in saline water
- Apply antibiotic cream with a protective bandage on the nail
Treatments available at the clinic
Most hematomas heal naturally but persistent pain requires treatment. A podiatrist focuses on foot care to drain blood and may recommend a digital x-ray if a fracture is suspected. Antibiotics may be prescribed to treat infection.
PiedReseau – Learn more
For further information on toenail hematoma, visit the PiedReseau website. However, nothing substitutes an in-person podiatrist consultation. Protect your feet—they are precious!