Toenail trauma: What is subungual hematoma?

Toenail trauma such as subungual hematoma occurs if the toe is stubbed on hard surfaces or a heavy object is dropped on the feet. This results to the formation of a subungual hematoma where blood is trapped under the toenail. This provides the affected toe a reddened, black or purplish discoloration.

A subungual hematoma is typically caused by blunt trauma from a heavy object or constant friction from rubbing against the shoe.

Those who engage in prolonged running or walking are susceptible to a subungual hematoma due to increased shoe friction.

What are the signs of a subungual hematoma?

A subungual hematoma can vary from a small spot beneath the nail to a wide area of discoloration. Depending on the amount of blood under the nail, it might come loose. In some cases, the nail remains intact and blood fades as the nail grows.

subungual hematoma

A subungual hematoma is typically caused by blunt trauma from a heavy object or constant friction from rubbing against the shoe.

In case the subungual hematoma is large and triggers pain, medical care is required to lessen the pressure under the nail.

When to consult a doctor

If the following are present, a doctor should be consulted:

  • If the toenail was subjected to blunt trauma
  • Drainage from under the toenail
  • Trauma to the nail results to significant pain, swelling or redness of the toe
  • Loose nail
  • Presence of underlying conditions such as diabetes, neuropathy, peripheral arterial disease or those that affect circulation or healing
  • Discoloration appears as a linear streak or stripe throughout the length of the nail

Quick Note / Disclaimer

The material posted on this page on a subungual hematoma is for learning and educational purposes only. To learn to recognize the signs and how it is managed, register for a first aid and CPR course with Vancouver First Aid.

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