Injuries to the toenail and bacterial endocarditis are typically the two major causes of bleeding toenails. Depending on which is actually causing the bleeding to occur, it may or may not be a reason for concern. To ensure that the true nature of toenail bleeding is accurately diagnosed, the toenail in question should be examined by a physician.
Toenail bleeding is often a result of some form of trauma to the nail bed and is called a subungal hematoma. Trauma to the toe can be a result of hitting the foot against a hard object or it may occur when some type of heavy object is dropped onto the toe. Subungal hematomas may also occur when the feet are kept in tight or ill-fitting shoes. In this case the repetitive rubbing of the toenail against the shoe's material may result in bleeding.
When a subungal hematoma causes toenail bleeding, losing the nail becomes a possibility. This may happen if the injury damages over half of the nail. The resulting excess blood may give the toenail a blackened or a purplish appearance. If the amount of blood is significant enough, it may produce enough pressure to push up against the nail bed and dislodge it. If this occurs and the nail falls off it will typically grow back within six months.
A splinter hemorrhage is another type of bleeding that occurs beneath the toenail. This type of bleeding will typically give the impression that there are splinters beneath the plate of the nail. The blood “splinters” are a brown or red color and generally run the length of the nail. There are two potential causes for this type of toenail bleeding, one of which is a foot injury and the other being a condition known as endocarditis.
Bacterial endocarditis is a type of bacterial infection that will generally affect people with weakened hearts more than those with no prior cardiac problems. It is caused by bacteria that enters the bloodstream and it affects the lining and valves of the heart. These bacteria are often found naturally in the body and may be introduced into the blood stream through certain procedures or types of surgery. When bacterial endocarditis is the cause of the splinter hemorrhage, the splintering will usually occurs during later stages of the condition. Lack of foot trauma is also an indication that this type of toenail bleeding may be caused by endocarditis.