Black Toenail
A black toenail or Subungual Hematoma is a common problem resulting from direct trauma or impact to the toe.
It can also be caused by repetitive rubbing against the inside of a shoe, for example in the case of long distance runners, which is frequently known as 'Jogger's Toe'.
Signs & Symptoms
- Throbbing pain in the toe due to increased pressure under the nail.
- Toenail appears black due to blood between the nail and the nail bed.
- The nail may loosen from the nail bed and eventually fall off.
Treatment for a Black Toenail
There are two main treatments for a black toenail: Trephining or nail removal.
- Trephining is the process of making a hole in the nail, using a heated instrument to pass easily through the nail. The purpose of trephining is to relieve the pressure and pain under the toenail. The nail is then covered with a small dressing to prevent infection.
- Nail removal is used in more extreme cases where the nail becomes misshaped or disrupted by the hematoma, or if there is a more serious underlying injury such as a fracture of the toe. Anaesthetic is not usually supplied, but sometimes nerve blocks are used.
Subungual Hematomas usually heal by themselves with little incident (other than the pain), but can become infected or disrupt the nail.
