Black Toenails

Toenail pain is no fun. If you have black toenails, or subungual hematoma, it’s because you have either sustained a direct trauma to your toenail or because of repetitive motion to your toes. For these reasons people who are very physically active can find themselves with black toenails more often than others.

Why is my Toenail Black?

If your toenail is black it means that there is blood pooling under the nail. There are two reasons that this may happen: because of trauma to your nails (for example, dropping something heavy on your foot) or because of repeated motion to your toes (such as when you are running in shoes that don’t fit properly). Other symptoms that may accompany subungual hematoma may include pain, foul odor, or discharge from underneath the nail. These symptoms may be an indication of infection, so it’s very important to keep an eye out for any changes.

What are the Treatment Options?

In most cases the nail will eventually fall off and a new one will grow back. While the healing process is occurring it’s very important to keep your nail protected and free of infection. This means covering it in a bandage and wearing protective footwear.

In some situations it may be necessary to undergo more invasive procedures. One option is to have your nail partially or completely removed. If there is injury to the nail bed it’s often recommended to have the nail removed so that sutures can be applied to stop the bleeding. Once the nail is removed and the hematoma is taken care of the toe must be taken care of and protected so that infection doesn’t occur.

Another treatment option is to drain the hematoma. A doctor can do this with either a needle or by cauterizing the nail. These treatment options are only used as a last resort because of the fact that usually the nail will simply fall off on its own. It can take months for the new one to grow back and the toe to completely heal.

Preventing Future Trauma

There are steps you can take to prevent any future hematomas from occurring. For instance, always remember to wear shoes that fit. You want a pair that has room in the toe box for a little wiggle, but not so much that your feet are slipping and sliding around. Shoes that are too tight or too loose may lead to many different foot issues, so spend the time looking for the perfectly fitting pair. Also, remember to keep your toenails groomed (not too long or short).

Try to be barefoot as little as possible, and if you are barefoot make sure you are not moving any heavy objects at the same time. If you do happen to be moving heavy objects be sure to wear protective footwear and be as careful as possible. By following these steps you are doing your best to reduce the risks of developing a subungual hematoma.

When Should I Call a Doctor?

If you have a black toenail that just won’t heal or if you notice a foul odor or discharge coming from the nail bed, you should schedule an appointment with Dr. Mitchell Wachtel immediately by calling (978) 794-8406. We can set up an examination with you in one of our three Massachusetts offices and discuss further treatment options with you so that you can be on the road to recovery quickly and easily.