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Treatment
Recovery
Causes
Dried blood under the fingernail can happen when an injury causes bleeding under the nail. This is medically known assubungual hematoma. These bleeds can result indarkened discoloration, such as black spots, and pressure and pain.
This article will explore the treatment options for a subungual hematoma.
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When to See a Healthcare ProviderIf the affected area continues to collect blood, you’re experiencing extreme pain, or the injury is at the base of the nail, it’s best to see a healthcare provider.Also see your healthcare provider if you have other symptoms like swelling or inability to move the finger or toe. You might have a fracture. If it is continuing to bleed, you may have a laceration which requires sutures. It takes about 48 hours for blood at the level of the nail bed to clot. If you wait longer than 48 hours to see a healthcare provider, drainage may not be possible.
When to See a Healthcare Provider
If the affected area continues to collect blood, you’re experiencing extreme pain, or the injury is at the base of the nail, it’s best to see a healthcare provider.Also see your healthcare provider if you have other symptoms like swelling or inability to move the finger or toe. You might have a fracture. If it is continuing to bleed, you may have a laceration which requires sutures. It takes about 48 hours for blood at the level of the nail bed to clot. If you wait longer than 48 hours to see a healthcare provider, drainage may not be possible.
Nail trephination
Nail trephinationuses hot metal wire, an electrocautery device, or a spinning, large-bore needle to pierce the nail plate for drainage.
Fortunately, the nail plate lacks nerves, so this process doesn’t hurt.
Removing the Nail
If the hematoma covers more than half the nail or the nail injury is deep, your healthcare provider may choose to remove the nail completely.
Before removing the nail, your healthcare provider will numb the area, which is called a digital block, so that it doesn’t hurt to have it taken off.
Keep in mind that it can take several months for a nail to grow back.
After a nail trephination, make sure to follow all instructions from your healthcare provider, including methods of pain relief and caring for the finger or toe. Your healthcare provider may recommend:
Some general advice for caring for your injured nail includes:
Complications of Subungual HematomaIf damage to your nail is extensive, there’s a small chance that your nail matrix may have been damaged. The nail matrix is where your fingernails and toenails form. Damage to the nail matrix may mean that your nail may not grow back or that your nail may look different when it grows.
Complications of Subungual Hematoma
If damage to your nail is extensive, there’s a small chance that your nail matrix may have been damaged. The nail matrix is where your fingernails and toenails form. Damage to the nail matrix may mean that your nail may not grow back or that your nail may look different when it grows.
You may also experience bleeding under your toenail if you wear shoes that are too tight.
When to See Your Healthcare ProviderIf you experience bleeding under your nail, see your healthcare provider as soon as possible. If it’s been less than 48 hours, your healthcare provider or urgent care physician can drain the excess fluid and relieve the pressure.Also see your healthcare provider if you have other symptoms like swelling or inability to move the finger or toe. You might have a fracture. If it is continuing to bleed, you may have a laceration which requires sutures.
When to See Your Healthcare Provider
If you experience bleeding under your nail, see your healthcare provider as soon as possible. If it’s been less than 48 hours, your healthcare provider or urgent care physician can drain the excess fluid and relieve the pressure.Also see your healthcare provider if you have other symptoms like swelling or inability to move the finger or toe. You might have a fracture. If it is continuing to bleed, you may have a laceration which requires sutures.
If you experience bleeding under your nail, see your healthcare provider as soon as possible. If it’s been less than 48 hours, your healthcare provider or urgent care physician can drain the excess fluid and relieve the pressure.
Also see your healthcare provider if you have other symptoms like swelling or inability to move the finger or toe. You might have a fracture. If it is continuing to bleed, you may have a laceration which requires sutures.
Causes and Treatments for a Bruised Toenail
Summary
Subungual hematoma, or bleeding under the nail, can cause discoloration, pressure, and pain.
If you see your healthcare provider within 48 hours, it can be drained to relieve pressure.
If you have other symptoms suggesting a fracture, you experience pain, or the discoloration appears without a known cause, always see your healthcare provider.
Causes of a Loose Toenail or Fingernail
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Osteopathic College of Dermatology.Subungual hematoma.
Bansal A, Choudhary P, Relhan V.Traumatic nail disorders. In: Grover C, ed.Textbook of Onychology. Evangel Publications; 2020:430-447.
Kaiser Permanente.Toenail or fingernail avulsion: Care instructions.
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