Many people enjoy painting their nails, but when nails are changing color without any polish, you probably should get it checked out. A yellowish tint usually indicates a fungal infection, but when nails become blackened, brown, or purplish, there’s a good chance you’ve suffered an injury known as black toenails.

An Injury Under the Nail

Although there could be more than one possible cause, by far the most common is trauma to the toe. In such cases a black toenail may also be known as a subungual hematoma, which simply means that blood is pooling underneath the nail.

Frequent runners and athletes are often targets of this kind of injury, especially if they’re wearing shoes that are too tight. It may also be the result of a single significant trauma, like dropping a heavy object on your toe.

A color change isn’t the only symptom of blood pooling under the nail. All that extra fluid places pressure on the nail and surrounding tissues, sometimes leading to significant pain. You may also notice swelling, odor, or discharge, particularly if there is an infection. If the injury is serious enough, the toenail may fall off entirely within a few days of the injury.

Other Possible Causes Of Subungual Hemotoma

In more rare cases, a black toenail may be the result of something other than trauma. Although fungal infections of the toenail typically have their own distinctive symptoms, in some cases they can produce blackened nails, often accompanied with odor and discharge. A variety of other medical conditions or health problems could also be at play here.

The most serious possible cause is malignant melanoma, the most severe form of skin cancer. Although cases of black toenails related to melanoma are very rare, the condition can be fatal, especially when not diagnosed and treated in the early stages. That’s why it’s important to see an expert about your black toenails—you want to rule out any chance that it could be cancer.

Don’t Wait for Complications to Strike!

Not every case will require treatment—more minor injuries may heal on their own. However, if the discoloration covers more than 25% of your toenail, you notice any signs of infection (such as pus, odor, discharge, fever, or chills), or have any reason to suspect cancer (such as there being no obvious initial injury), you should get help right away. If left untreated, a bad subungual hematoma can lead to a severe bone infection, or even amputation.

Tackling Treatment

If your doctor decides medical treatment is necessary, the most common procedure is draining the nail to relieve the pressure from the pooling blood. This usually involves making a small hole in the nail using a needle or cautery device. Rarely, we may need to remove the entire nail to allow greater draining or examine the nail bed for signs of significant laceration. We’ll also prescribe antibiotics if there’s any sign of infection.

After the procedure, we may give you some additional instructions for home care. Twice-daily foot soaks (10-15 minutes with Epsom salt and lukewarm water), followed by application of an antibiotic ointment and a sterile bandage is often recommended.

Carolina Podiatry Group has been helping patients in and around the Charlotte area with toenail problems and injuries such as black toenails for years, and can help you find the best possible treatment for your condition. To schedule an appointment with us in Lancaster, Rock Hill, or Indian Land,  SC, dial 888-569-9559 today.

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