A Black Toenail Can Be a Big Problem

by | Jun 10, 2018

Abnormal color change is usually a warning sign of damage. Sometimes the problem is relatively minimal, like a light bruise on the surface of the skin. Other times, the discoloration warns of dramatic problems that need to be addressed, like someone turning blue when choking. A black toenail can signal a variety of changes—some benign, but others more painful and serious.

When Toes Turn Dark

Nails change colors for multiple reasons. The most common culprit for a black toenail is blood under the hard tissue. Damage to the end of the toe causes blood to leak through the nail bed and stain the keratin a dark color. This is also known as a subungual hematoma, or a bruise under the nail. Typically the problem develops from repeated trauma over time, for instance, continually bumping your toes against the front of your shoes. Sometimes, however, it can be the result of one sudden, traumatic injury to the foot, like kicking a solid object or dropping a heavy box on your toe.

This condition is unsightly, but it isn’t always painful. Your nail will turn a darkened color and may eventually pull loose and fall off. However, if the blood pools, it will create painful pressure between your toe and the nail. Sometimes you’ll notice a discharge and foul odor. More rarely, you may have severe damage in the nail bed, like lacerations or even fractured bone. These injuries leave you vulnerable to infections and other complications.


Occasionally a black toenail will be caused by something other than blood. Fungal infections can darken the keratin tissue, especially if debris collects under the nail. A malignant melanoma tumor can also develop under your nail, turning it dark. While this is rare, melanoma is deadly and should always be investigated.







Managing the Condition

To relieve any discomfort, and to avoid risk of infection, you should not ignore a black toenail. Dr. Victoria Melhuish will evaluate your toes to determine the extent of your injury. This will also allow our staff to either diagnose or rule out fungal infections and cancer as the source of the discoloration. We can then help you with the appropriate treatment to restore your toe nails.

If you have blood pooled under your nail, draining the fluid will relieve the pressure and eliminate the pain. Using sterile tools, we will create a small hole in your hard keratin tissue and allow the built-up blood to escape. Your toe will then be cleaned and bandaged to prevent infection. If our team is concerned that you may have more serious issues in the nail bed, you may need to have the tissue removed. Lacerations or exposed bone can then be treated to prevent infections or additional damage.

It will take time for your nails to grow the darkened color out, even once the problem has been treated. To avoid all this, you can take steps to prevent nail injuries. Shoes that are too tight or too short pinch the nails and injure the toes, so wearing footwear that fits properly can help. Try to avoid walking barefoot as well, so your feet stay protected.

If you’ve noticed your nails turning dark without a cause, or suffer from painful, black toenails, have your feet examined to eliminate your discomfort, as well as to check for more serious conditions that could put your feet at risk. Request an appointment or more information from us here at Sierra Foot & Ankle in Carson City, Nevada. You can reach us through our online contact form or by calling (775) 783-8037.

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