Understanding Black Toenails

Understanding Black Toenails

A black toenail, medically termed a subungual hematoma, occurs when a portion of the toenail darkens or turns black. This phenomenon is commonly attributed to toenail trauma, such as repetitive impacts against the front of footwear, rigorous physical activities like running, or accidental trauma from heavy objects. The resultant injury induces bleeding beneath the toenail, leading to discoloration.


While typically a result of trauma, black toenails can occasionally stem from underlying medical conditions such as fungal infections, diabetes, or peripheral artery disease. If the discoloration persists without improvement or is accompanied by additional symptoms like fever, redness, or swelling, medical consultation is advised to identify the underlying cause and determine appropriate treatment.


Characteristic symptoms of a black toenail include the presence of black, blue, or purple discoloration on the affected toe, discomfort or tenderness in the injured area, and surrounding swelling. In rare instances, there may also be foul odor and discharge from the affected region. Untreated cases may lead to infection and eventual nail loss.


Treatment options for black toenails include:

  1. Rest and Elevation: Elevating the affected foot and avoiding activities exerting pressure on the toe can alleviate pain and swelling.
  2. Nail Care: Regular trimming and filing of the toenail can prevent further damage and potential infection.
  3. Padding: Application of a soft cushioning pad around the toe helps alleviate pressure and friction.
  4. Antibiotics: In cases of infection, antibiotics may be prescribed to facilitate healing.
  5. Drainage: Severe cases with significant blood accumulation may necessitate drainage to relieve pressure and pain.
  6. Surgery: Surgical intervention to remove the affected portion of the toenail may be warranted in extreme cases.


Preventive measures to mitigate the risk of black toenails include:

  • Properly Fitting Shoes: Ensuring shoes neither constrict nor allow excessive movement of the toes.
  • Appropriate Footwear: Opting for comfortable and supportive running shoes, especially for runners.
  • Protective Gear: Wearing socks or toe protectors during sports or activities posing foot injury risks.

By adhering to these preventive strategies, individuals can minimize the likelihood of developing black toenails and maintain optimal foot health.

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