A bruised toenail also called ‘subungual hematoma’ which means bleeding under the nail. This occurs due to any damage caused to the underlying soft tissues, nail bed or the bones.
They can occur due to various reasons, and their severity depends on the part that has been affected.The general misconception that must be corrected is that these nails do not have blood vessels.
Thus the bleeding is not caused by the nail, but because of the damage to the skin that is present underneath it.
It can be extremely painful, for its size but otherwise is not a serious condition.This condition results from a traumatic injury caused due to various activities.
It is also known as runner’s toe, tennis toe or skier’s toe, which happens due to the repetitive thrusting of the long toe. (Against the shoe)
Parts Of A Nail:
Before we get into depth about this condition, let us understand in brief the basic structure of our nail.
The nail unit consists of the nail plate, matrix, nail fold, nail bed, lunula, cuticle, and hyponychium.
- The nail plate is simply known as the nail, consists of keratin and does not contain any nerves or blood vessels.
- The matrix is the foundation and the sole structure for the growth and the formation of the nail plate. It contains keratin cells for the development of nails.
- The proximal nail fold is that part of the skin that adheres to the newly formed nail plate and later becomes the ‘cuticle.’
- Cuticle, known as ‘eponychium ‘is formed from the proximal nail fold. It protects the nail fold from microbial invasion and infectious agents.
- Lunula is a crescent-shaped zone present at the base that represents the extension of the nail root.
- Hyponychium is the thickened part of the skin present below the edge of the nail plate.
- Nail bed extends from the lunula to hyponychium and supports the nail plate along its outline.
- Free edge is that part of the nail that is not attached to the skin or the nail bed.
The varied color and the texture of your nail are indications of any underlying ailment.
For example, people suffering from psoriasis may have small pits on the surface of their nails, somewhat resembling oil spots. Brownish stripes may be indicative of AIDS or melanoma under the nailbed.
Any injury to the nails can be very painful, including the toenails.
Causes Of Bruised Toenail:
Listed below are the most common causes of a bruised toenail.
Trauma caused by a blunt object, for example, a man who stubbed his toe may end up with a bruised toenail. When a person slams his toe against a hard substance, the impact induces bruising of the skin under the toenail.
ii. Other activities such as running or dancing:
Running or dancing involves repetitive use of a toenail causing repetitive trauma and leading to bruises. Runners while training intensely can bruise their toenail due to repetitive trauma the toenails are subjected to.
iii. Accidents, which can include those of sports or vehicular or any others:
While playing sports like football, when a player kicks the ball, he exerts pressure over his toenails thus inducing bruises.
iv. Walking barefoot:
People who walk barefoot have higher chances of sustaining injuries as their skin may come under direct contact with sharp or hard objects, thus causing injuries internally within the nail.
v. Hiking or climbing along a rugged terrain:
Hiking along uneven terrains causes trauma to your toes, leading to rupturing of your blood vessels and thus bleeding within your nails.
vi. Hurting your toe while closing a door:
Sometimes, when the door slams against your toe, it causes bleeding under the toenail due to the impact and induces toenail bruise.
vii. Dropping a heavy object on your toe:
Dropping heavy items, by accident can lead to internal injuries within your nail, making it appear bluish-black due to the bursting of blood vessels.
viii. Use of anticoagulants:
Few anticoagulants, such as warfarin have been known to induce such conditions.
ix. Wearing smaller shoes:
Smaller shoes reduce the space available for your toenails, inducing a lot of stress to them and causing a blackened toenail.
x. Long untrimmed nails:
Nails can be a nuisance and pain if they aren’t cut regularly. Long nails can reduce the space available in your shoes and can cause stress due to the thrusting of the nails against the shoe.
xi. Internal infections:
Internal infections play an important role in the formation of a bruised toenail. Pus pockets, formed due to infections can lead to bruises within the toenails. Fungal infections cause the hardening and blackening of your toenail. Thus it leads to the bruising of your nail.
xii. Hot weather increases the chances of getting one:
Temperature also influences the chances of bruising your toe. More the temperature means more pressure, thus more flow of fluid thus increases the chances of rupturing of a blood vessel in a toenail.
How Does Bruised Toenail Occur? A brief On Jogger’s Toenail:
In basic terms, bruised toenails occur when we apply the excess amount of pressure/weight onto the tips of our toes. This can be due to any physical activity such as dance, sports, etc.
Ideally, we must try spreading our weight over many toes as possible. The more tapered your toes are, the more likely you are going to suffer from this ailment.
The most common type of this condition caused by running, otherwise known as ‘jogger’s toenail’ is due to the injury of the soft tissues under the toenail. This results in damage to blood vessels leading to blood leakage internally.
Let us consider this activity in particular and understand how this happens.
The repeated impacts that the toenails are subjected to while running are the main reason for bruised toenails.
After every impact on the ground, there is usually a short period when your foot remains in motion even when your shoe stays at rest.
The foot consequently slides in the forward direction, leading to a forceful impact on it followed by more stress as you push your legs off the ground.
This is common in runners and highly competitive runners training for marathons, at high intensity.
The nail injuries are not much painful, but it may cause blackening and thickening of the nails.
Using inappropriate shoes without enough padding, longer time running or downhill running can worsen this condition helping to form a bruised toenail.
The injuries will heal on proper rest, medication, and reduced training intensity and repetitive trauma.
Symptoms Of Bruised Toenail:
The symptoms of a bruised toenail vary from person to person and can be mild or intense. They can be:
- A cut in the nail bed
- Bluish-black discoloration: caused by rupturing of blood vessels, and leakage of blood into soft tissues.
- Throbbing pain caused by pressure of the blood that is collecting between the nail and nail bed
- Tenderness and swelling of the affected toenail.
- Sometimes, even a fracture of the bone underlying the region.
NOTE: few of these symptoms can also indicate other ailments.
- Splinter hemorrhages occurring near lunula may be indicative of endocarditis.
- Darkened areas or discolorations under a nail can indicate tumors if it stays in the same spot.
- It can even indicate fungal growth. Fungal infections turn the nail darker and thicken the nails.
Severe bruises to your nails need immediate assessment and treatment by a doctor. If you experience the following symptoms, you need to visit your doctor/podiatrist right away:
- Severe pain that doesn’t go away with painkillers
- Fever, tingling sensations of the toe
- Blue or grey discoloration near the toenail
- Bleeding in other areas such as nosebleed, bloody urine, and stool
- Sore, redness and open wound developing in the affected area
Consequences Of Bruised Toenail:
Bruised toenails are painful and can limit your productivity. They can be as simple as this or may lead to more serious complications if not taken care of, properly. It can end up as an ugly sight if not treated immediately.
Warm moist shoes provide a suitable environment for bacterial growth. Few infections associated with this include Paronychia, felon, etc. Fungal growth is one more important consequence of watching out for.
If the bruised toenails are not treated soon, there are chances that your nail might fall off from the nail bed.
Besides, if the bruised toenail occurred due to a severe blow you also may have broken bones and serious damage to tissues or nail beds.
Diagnosis And Treatment Of Bruised Toenail:
Your doctor will examine your injury and most likely take an X-ray to confirm or rule out a fracture or other injuries (In case of a severe blow). Sometimes even a dermoscopy or biopsy is performed to examine the nail.
In most cases, your doctor will reduce the symptoms by draining blood and excess fluids. First, your doctor will sterilize your toe and make a tiny puncture in the bruised area. Then, this area is lightly squeezed to release excess fluid and blood.
Removal of the nail is also carried out if your nail has been partially removed from its position.
Once the nail returns to normal, your doctor will suggest a few antibiotics and cover your wound.
Home Remedies To Get Rid Of Bruised Toenail
1.Wear Proper Shoes
Consider wearing open shoes till the toenails heal. Also wear shoes bigger than your regular size to allow more room for your toenails.
2. Proper Rest
Take rest and do not strain your injured toenail by walking long distances.
3. Take Care
Cut your toenails as short as possible and make sure the edges are flat than curved to avoid ingrown nails.
Keep your foot elevated to reduce the throbbing sensation.
Make a splint for the affected toenail. Do not pull out the nail if it has been detached partially from the nailbed.
Wear bandages to cover the wound. Keep the affected area dry and clean to prevent further infections.
4. Epsom Salt
Soak your feet in warm salt/Epsom salt water, thrice a day. This can ease the pain effectively. Follow it up with a topical antibiotic cream to avoid infections.
You can also place your affected toe in a buck
et full of ice water to reduce inflammation. This stops bleeding as well as avoids blue-black discoloration of your nails. Follow it up with antibiotic cream.
6. Fuller’s Earth
Fuller’s earth helps reduce inflammation and keeps the affected area cool. Mix it with rose-water and prepare a paste. Apply this mixture to your entire toe. This will also help to reduce the pain.
7. Mustard Oil
Mustard oil has heat inducing properties that reduce inflammation. Massaging mustard oil around the affected toe helps relieve the pain.
8. White vinegar
White vinegar can help restore your skin’s pH. Mix one part of white vinegar with two parts of warm water, and soak your toenails in this solution for 15 minutes; rinse it off and dry the area thoroughly.
Mouthwash contains several compounds and alcohol that can treat bacterial and fungal infections. Soak your foot with this for 30 minutes, rinse it and dry it off gently.
Turmeric is a natural antiseptic and an antibiotic. Its healing properties reduce the swelling and chances of further infection. Apply a paste of turmeric on the affected area topically to reduce the symptoms.
11. Lemon juice
Lemon juice is another such antibiotic and antiseptic that can be applied on the toenail for about 30 minutes and rinsed with warm water. Don’t forget to dry the area thoroughly.
12. Lavender oil
Lavender oil has antiseptic properties that can ward off any infections on the bruised toenail. Mix few drops of this to any choice of carrier oil and apply using a cotton ball to the affected area. Leave it for 10 minutes and rinse thoroughly and pat dry.
13. Oil of oregano
Oil of oregano has numerous properties. Its antiseptic, antibacterial, antiviral, analgesic, and antifungal properties can do wonders for the treatment of bruised toenails. Mix 2 drops of this oil in one teaspoon of any choice of carrier oil and apply this onto the affected area. Leave it for 30 minutes and rinse thoroughly. Don’t forget to keep the area dry.
14. Orange oil
Orange Oil has antifungal properties that can treat infected toenails. Apply this oil using a dropper to your toes and toenails. Mix it with carrier oil or dilute it if you have sensitive skin. Leave it for around 30 minutes; wash it off and pat dry.
15. Apple cider vinegar
Apple cider vinegar is mildly acidic and can kill bacteria and fungi preventing your toenails from further bacterial or fungal infections. Mix equal parts of water and apple cider vinegar and soak your toes for 30 minutes daily. After a few weeks, you will notice the improvement in your toenail injury.
16. Tea Tree oil
Tea Tree oil has antiseptic properties which can heal your bruised toenail. Mix a few drops of tea tree oil along with one teaspoon of coconut or olive oil and use a ball of cotton to apply on the affected area. Leave it for 20-15 minutes; scrub it with a toothbrush gently at the affected area.
Arnica is a homeopathic, natural substance heals bruises. It is an anti-inflammatory that speeds up the time taken by the wound for healing. It can be applied as a cream or gel to the sore muscles.
18. Aloe Vera Gel
Aloe Vera gel is applied to the area can reduce infections and cool the area.
19. Coconut oil
Coconut oil has been widely used for dermal infections and can reduce the symptoms of a bruised toenail.
Honey is an antibacterial agent and speeds up the healing of the wound by applying it to the wound.
(NOTE: The above three remedies must be considered if there is no formation of pus and only after consultation with a doctor.)
If the symptoms last longer than a few days or a week in spite of these remedies, you must fix an appointment with the doctor immediately.
The prominence of the big toenail can make it susceptible to stress and thus cause bruises. You can manage it with proper treatments as suggested above.
Bruised Toenail Healing Time:
The exact amount of time taken to heal the wound depends on the severity of the bruise and how it has occurred.
In case the bruised toenail comes off the nail bed, make sure not to pluck it as it might lead to several other complications and infections. This will increase the time taken by it for healing. Let it fall by its own.
It might take several months for another nail to grow back at its place. So keep the area clean and protect the nailbed with a bandage.
Generally, after falling off, most toenails grow back in 3-6 months, so there is no need to worry, especially if your wound has healed well.
If the bruised toenail doesn’t fall off right away, protect the area. Give it enough time to heal on its own. In time a new toenail will slowly grow in the area of the bruised toenail.
As it has been stated rightly, prevention is always better than a cure. You can always prevent future incidents of a bruised toenail. The following points will help reduce such incidents from happening:
- Toe pads and gel pads provide extra cushioning top your toes, thus helping in the prevention of bruises.
- Keep your toenails short and cut them regularly.
- Always buy shoes that fit properly.
- For running, choose shoes bigger than your regular size to prevent toenail bruises
- Wear the right type of socks to avoid odor and slipping of feet inside the shoes, as they can cause infections and bruises.
Even after taking all the precautions if you end up getting a black toenail or an injury, you must meet the doctor soon.
How To Keep Your Nails Healthy?
Toenails are made up of tough proteins. They grow as fast as your hair does. They require about 3-6 months to completely grow back to normal. Once the nail cells die, they do not grow back.
The texture and color of your toenails are indicative of your overall health.
Toenails, just like any other part of your body must be well taken care of. Given below are a few home treatments to keep your nails healthy:
- Cut your nails straight to avoid the growth of ingrown nails.
- Cut slices of lemons and rub them against your nails, especially in the nail beds. This can help strengthen them.
- Get nail services and treatments from professionals. Maintain them neatly and regularly.
- Avoid clippers that have been used by others to cut your toenails.
- Eat fresh food consisting of plenty of fruits and vegetables every day.
- Avoid smoking, as tar and nicotine can accumulate under your nails when you smoke.