A subungual hematoma involves bleeding beneath the fingernail or toenail typically caused by a crush injury. Generally, it causes severe agonizing pain as blood accumulates under the nail.
Furthermore, subungual hematoma can be caused by slamming the door of a car or house door on a finger, dropping a heavy object such as dumbell on the toe, stubbing a toe on a hard surface and hitting a finger with a heavy object such as a hammer.
Symptoms of subungual hematoma
- At first, a severe and throbbing pain as blood accumulates between the nail and the nail bed.
A severe and throbbing pain as blood accumulates between the nail and the nail bed. - Dark discoloration such as maroon, red or purple black under or an area of the nail.
- The tip of the finger or toe is swelling along with tenderness.
- A black toe or finger nail will eventually fall off and a new one regenerates, but if there is pain and indications of infection such as foul odor, drainage of pus, chills and fever, seek medical help immediately.
- Lastly, if discoloration covers 25% or more of the nail, seek medical help immediately.
Causes
- Subungual hematoma can be due to a fungal infection
- Injury or trauma to the affected toe or nail
- Wearing ill-fitting shoes
- Repeated trauma caused by running or athletic activities
- Sometimes, it can be caused by malignant melanoma
Sometimes, the nail bed is severely lacerated or a bone is already exposed under the nail. If this condition is not properly treated, it can result to infection of the bone called osteomyelitis that necessitates long-term IV antibiotics and a possibility of amputation.
Treatment
- Apply an ice pack for at least 10 minutes at a time to lessen the swelling and bleeding. Generally, avoid applying the ice pack directly on the skin to prevent frostbite that can worsen the condition. Wrap the ice pack with a cloth or towel before applying on the area.
- Elevate the affected area above the level of the heart to minimize swelling and bleeding as well as lessen the accumulation of fluid on the affected area.
- Take the prescribed anti-inflammatory medication such as ibuprofen to lessen the pain and inflammation. In addition, the pressure and pain usually settles in a few days and blood drains on its own.
- If bleeding covers 25% of the nail, seek medical help since the blood under the nail requires drainage. The doctor injects a local anesthetic to the toe or finger nail and a hole for easy drainage of the blood.
FACT CHECK
https://www.healthline.com/health/subungual-hematoma
https://www.webmd.com/skin-problems-and-treatments/bleeding-under-nail#1
https://www.emedicinehealth.com/subungual_hematoma_bleeding_under_nail/article_em.htm