Hematoma

Blood beneath the toenail, or a hematoma, will often present after an injury with the most common complaint being that the nail is darkened and discolored. In an acute injury the blood will likely need to be drained. If the injury was long ago, the nail will need to grow out before the bruise will resolve.

 

Signs and Symptoms

 

  • Black, blue, purple or red discoloration to the toenail

  • Pain with pressure

  • Bloody drainage

  • Swelling to the toe

Diagnosis and Treatment

 

Diagnosis of a hematoma under a nail is through physical exam. If there was a known direct injury to your toe, Dr. Hanawalt will also take an x-ray to evaluate for a broken bone.

Treatment of the hematoma depends on how long it has been there. If the injury was recent, the hematoma will need to be drained. This is performed often without the need for local anesthesia and is usually quick and painless. If the injury is severe enough, the nail may need to be removed. Bruising to the nail that has been present for a few weeks generally needs no intervention and will eventually resolve as the nail grows.