A subungual haematoma is the medical term for bleeding and bruising under the nail. They are usually caused by a trauma or injury to the nail unit. An example is, if you slam the door on your fingers or something heavy crushes your toes, this causes the blood vessels to break and leak underneath the nail.
Management and Treatment
Ice should help ease swelling and pain. But if your pain gets worse over the next few hours, you should seek medical care. Your provider may recommend a simple procedure called trephination. This is drainage of the hematoma to relieve pressure.
Bleeding beneath the nail can happen after an injury, such as a heavy object landing on the toe or from chronic rubbing within your shoes. If it covers a large area of the toe or is painful, medical treatment may be needed to relieve pressure and help prevent permanent nail changes.
The trapped blood will eventually be reabsorbed, and the dark mark will disappear. This can take a number of months or years. Subungual hematomas heal more quickly when affecting the fingernail, while subungual hematomas on the toenails heal more slowly. It takes around 6–9 months for the new nail to grow out.
Subungual melanoma appears as dark lines, while hematomas look more like a dark bruise or smudge under the nail. Blood may grow out or appear when you cut your nails if it's a hematoma. Hematomas appear quickly or within hours of injury. Melanoma grows more slowly.
It can take up to 9-12 months for a subungual haematoma on the toenail to fully grow out. However, if there is severe damage to the nail bed, the nail may grow back disfigured or sometimes there is little to no nail regrowth at all.
Subungual melanoma may start as a brown or black streak under a toenail or fingernail. A person may mistake it for a bruise. The main symptoms of subungual melanoma include: brown or black streaks in the nail without any known injury.
A Stage 3 ingrown toenail will usually have even more severe redness and swelling, be very painful, and be accompanied by an overgrowth of skin around the toenail. More severe infection and a fever may follow.
The first toenail change you'll notice in diabetic patients is likely to be discoloration. Most have some yellowing of the nails, though the shade and involvement can vary. Discoloring may start at the distal edge (tip) and run all the way to the root of the nail bed.
Cover the area where your toenail fell off with a bandage. Seek immediate treatment if your entire toenail falls off or the area around your toenail won't stop bleeding.
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