Bruising underneath a toenail can be caused by the constant pressure of uncomfortable shoes or frequent impacts associated with running, jumping, or kicking a ball. Also called a subungual hematoma, a bruised toenail can become tender as blood and fluid build up in the nail bed. Most bruised toenails can be treated at home by protecting the injured area, wearing tight but comfortable footwear, and avoiding intense physical activity. A toenail that causes discomfort should be assessed by a doctor, who can manually drain blood from the nail bed.
When a bruised toenail is not painful or tender, it does not typically need to be treated. Instead, a person can simply take care to keep the toenail clipped to avoid snagging it on socks or shoes. If the affected nail becomes loose over time, it can be protected with a bandage to prevent it from completely falling off. Even when taking precautions, the nail may eventually separate from the bed due to insufficient blood flow.
It is important to clean and protect the exposed area until a new nail grows into place, a process that may take several months. A person can relieve tenderness and prevent infection by soaking the toe in warm, soapy water once or twice a day. In addition, topical antibiotic creams and ointments should be applied regularly. Accidental injuries can be avoided by wrapping a bandage around the toe and wearing comfortable-fitting shoes.
When a bruised toenail is accompanied by minor pain, a person can usually alleviate symptoms and shorten healing time with simple home care techniques. Icing and elevating the toe can help to numb the pain and reduce swelling underneath the nail. Over-the-counter anti-inflammatory drugs can also help relieve symptoms. If the bruise persists for a long period of time, and there is no known cause of the injury, it could be a melanoma, so any bruises that occur for a long period of time should have medical attention.
An especially painful bruised toenail can be difficult to treat at home. If possible, a person should visit a podiatrist or emergency room to receive proper medical care. A doctor can inspect the nail and possibly take x-rays to make sure the injury is not accompanied by an underlying bone fracture. After evaluating the severity of the bruised toenail, the doctor can explain treatment options.
In most cases, a podiatrist or trained nurse can relieve symptoms by draining excess fluid and blood. After sterilizing the toe, a professional uses a needle or a cauterizing tool to make a tiny puncture in the center of the bruised area. He or she lightly squeezes the toe, causing fluid to drain from the puncture hole. Once the nail bed returns to a normal color, antibiotics and bandages are applied. Patients are usually instructed to avoid intense activity for several days and return to the hospital if symptoms return.
What Happens if You Don’t Treat a Bruised Toenail?
While a bruised toenail can look intimidating, even scary, it is typically not a cause for concern. A bruised toenail shouldn’t become a problem if you follow simple, low-maintenance treatment, such as ice and elevation for pain. The pain should resolve quickly, the body will absorb the blood underneath the nail, and the nail will eventually grow out and return to its normal coloration—usually within nine months or so.
However, there can be serious consequences for neglecting to treat a bruised toenail. For one, not treating a bruised toenail can cause unnecessary pain. The pain can also be incredibly intense, even strong enough to inhibit the ability to walk or do other everyday foot activities.
For that reason, the simplest thing to do with a bruised toenail is give it the attention it deserves. Apply ice and elevate your foot, and if the pain becomes excruciating, consider consulting a doctor.
How Long Does it Take for a Bruised Toenail to Go Away?
The pain from a bruised toenail will resolve relatively quickly, but the visible bruise may persist for longer.
Usually, any pain from the injury will go away in a few weeks, or even less time if you apply proper treatment such as ice, elevation, and rest.
However, there is also the visual component to consider. The ruptured blood vessels that cause the hematoma will discolor the toenail, leaving a deep red or dark blue impression on the skin. The hematoma will take six to nine months to resolve. During this time, the toenail will undergo the typical growth process: new toenail growth will push the old nail outward, where it can be clipped off.
The short answer: it takes about three-quarters of a year for a bruised toenail to fully resolve.
Can You Put Nail Polish on a Bruised Toenail?
Because some consider a bruised toenail rather unsightly, there can be the temptation to cover the nail with paint or nail polish, especially for those who often wear open-toed shoes for work. However, it’s also true for everyday life—after all, it’s hard to enjoy pool season when you have to deal with an unsightly toe.
That said, as tempting as it might be to cover the nail with paint, you should avoid doing so, at least for the first few weeks after injuring your toe. To begin with, many cover their toe as a way of ignoring the bruise—but doing so can obscure whether the bruise is worsening. In that way, nail polish could backfire—you apply it to have peace of mind but end up with a more injured toe.
In addition, nail polish may not agree with injured toenails in general. While it is usually safe to wear nail polish, doing so can dry out the layers of skin beneath the toenail, creating conditions for bacteria, mold, fungi, and mildew to thrive. A fungal infection is the last thing you want when you have an injury beneath your toe.
However, after the pain of your bruise has subsided, you may consult your doctor to determine if it is safe to wear nail polish on your bruised toenail.
Can a Bruised Toenail Have Complications?
Not many complications can arise from bruised toenails, but staying on your toes (pun intended) is still essential.
The first complication can result from neglect or oversight. In some cases, a subungual hematoma can arise from a very severe toe injury, such as a broken bone or a deep cut, in which case you should consult your doctor immediately.
Another complication can arise from improperly treating a bruised toenail. While doctors are trained in safely draining bruised toenails, it can be dangerous to do so at home. Attempting to pierce a toe at home, outside of the sterile environment of a medical office, can result in infection or even further damage to the toe—putting your toe in an even worse position than when you started.
However, these complications are rare and typically arise from improper treatment. Therefore, being attentive to a bruised toenail and leaving the rest to medical professionals is the best course of action.