Clear, healthy nails are an ideal in society, which is why so much time and money are spent each year keeping many at peak appearance. Yet regardless of whether someone goes the extra mile for pedicures and treatments, it can be troubling to see a once normal nail suddenly grow darkened. A black toenail can result from several different causes, with the proper treatment often depending on the reason for the blackout.
Reasons for a Black Toenail
Minor repetitive trauma is one of the most common causes of black toenails, often as the result of the toes striking the inside of the shoe. Runners who perform at a high frequency and intensity are at a higher risk of having a black toenail, and the condition is even seen as an odd badge of honor in some running communities. The continuous force of the toes sliding up against the shoe causes the bruising or light bleeding that results in the discoloration, and causes no pain in most cases.
More severe trauma, of course, can be an entirely different matter. The force of a heavy object dropped on the toe can cause a pool of blood to accumulate beneath the nail. This is known as subungual hematoma, and the pressure that builds under the nail can cause a severe, throbbing pain in addition to a blackened nail.
Non-trauma causes of a black toenail can include a fungal infection. This can sometimes cause pain, but not the throbbing type that comes with a severe impact. In much rarer instances, melanoma can cause a dark spot to appear beneath a toenail.
Getting Back from Black
If a black toenail is minor, usually from the result of running and/or ill-fitting shoes, the nail may eventually come off and regrow on its own. Treatment may not be necessary, but it is still important to look for signs of infection such as pus, a foul odor, fever, or chills. We also recommend coming in to have a black toenail checked if discoloration covers more than 25 percent of the nail, or you have a spot that has not faded or gone away.
In case of a sudden trauma, do not attempt to drill a hole in your toenail to drain the blood. Not only can this be very painful to do on one’s own, it can lead to further injury and infection if performed incorrectly. Leave this to the professionals. If the injury is severe, the toenail might also be removed to check the underlying nail bed for lacerations or other trauma that would need treatment.
Prevention is always the best treatment for a black toenail. Always wear properly fitting shoes with a wide toe box that doesn’t crowd the front of the foot. If any heavy lifting is in your future, also be sure to wear protective footwear and practice the proper caution. Keeping toenails trimmed short (but not too short) and straight across will also help prevent repetitive trauma.
For help with black toenails, Dr. Sanjay Patel and the staff of Family Foot Care & Surgery are here for you. Schedule an appointment with either of our two offices by calling—203-876-7736 for the Milford location, or 203-288-4055 for the Hamden office—or fill out our contact form to reach us.