Symtoms, Prevention And Treatment Of Black Toenails

There are number of reasons why you might experience black toenails. Usually, if your toenail is dark or black it is because of an injury or trauma. When you drop something heavy on your foot or kick something very hard or otherwise damage your toenail, this can result in a subungual hematoma, which is a bruise or collection of blood beneath the toenail.

Anyone can get a black toenail from trauma, but naturally people who are involved in athletic sports (see our article on footcare for tennis players) or those who go barefoot or wear open-toed sandals are more prone to them. Conversely, you may have a black toenail because your shoes are too tight. Wearing improperly fitted shoes can cause damage to your toenails.

In addition to being caused by trauma, fungal infection can also cause black toenails. This is very common among people whose immune systems are compromised. In very severe cases, a black toenail may be a symptom of a darkly pigmented malignant tumor known as a melanoma.

In this article you will learn:

  • What does it mean when your toenails turn black?
  • What causes toenails to thicken and turn black?
  • What does a black spot on my toenail mean?

Black toenail symptoms

Here are the symptoms you may experience when you have a black toenail:

  • Your toenail will be discoloured (e.g. brown, purple, red or black)
  • You may notice a foul odor emitting from your toenail
  • There may be a discharge from beneath the nail
  • You may be experiencing a great deal of pain

You may have any or all of these symptoms, or you may experience none of them. When blood is trapped underneath your toenail, it causes the toenail to darken. If your toenail is simply bruised and not infected, there will not be a discharge or foul odor. A black toenail can be quite painful because of the trauma, collection of blood and the resulting pressure.

Is a doctor’s appointment necessary?

It’s not always necessary to see your doctor about a black toenail. If your toenail is injured due to trauma, the nail may fall off on its own within a few days. This happens because the toenail has become separated from the nail bed and the pressure of the collected blood beneath it forces it off. If it does not hurt and there is no discharge or foul odour, you may wish to try treating it as you would any wound by keeping it clean and covered.

In many cases, it is best to see your doctor so that he or she can examine the injury and provide treatment to ease the pain. More often than not, your doctor or podiatrist will rule out serious problems and send you on your merry way greatly assured. When your doctor examines your black toenail, he or she will check it to be sure there are no fractured bones or infection present.

You should know that your nail is quite likely to grow back crooked or otherwise abnormally. Additionally, understand that if over one quarter of the nail is black, you should see a doctor because this may mean that there is exposed bone or a severe laceration beneath your toenail. You do not have this treated, you might contract a bone infection. This can result in lengthy treatment with intravenous antibiotics and even amputation of your toe.

Generally speaking, it’s always better to be safe than sorry. If you are worried about your black toenail, you should definitely call your doctor.

Depending upon the type of injury you have experienced and the amount of your toenail that is affected, your doctor may recommend removing the toenail. This will enable him or her to examine the nail bed thoroughly for serious lacerations and/or exposed bone.

If your toenail gradually becomes dark for no apparent reason, your doctor may need to order some tests and perhaps perform a biopsy to check for cancer. He or she will also ask you quite a few questions to try to determine the cause of the damage. Your doctor will also review your own medical history and your family medical history to determine possible causes of your problem.

When you talk with your doctor or your podiatrist, be sure to answer all of his or her questions honestly and completely. It is also smart to ask a few questions of your own to be sure you understand the entire situation. Here are a few important things you should ask when you discuss black toenail treatment and prevention with your doctor or podiatrist.

  • Are there pills I should take or medications I should use to speed the recovery of my black toenail?
  • Should I be concerned that this black toenail indicates the presence of cancer?
  • Are there cosmetic solutions if my toenail does not grow back normally?
  • How long must I wait for my toenail to grow back normally?
  • Should I be alarmed if my toenail changes colours as it heals?
  • Is it possible for me to drain the collected blood myself?
  • Will my black toenail fall off and grow back by itself?
  • Are there any symptoms I should be watching for?
  • When should I check back with you?
  • Is this problem likely to recur?
  • Is nail removal always necessary?

Black toenail treatment

If your doctor determines that you do not need any medical intervention, he or she may simply decide to leave the nail alone and let it heal. Alternately, your doctor may decide to simply drain the collected blood to relieve the pressure and the pain. Basically, black toenail treatment can be done in three different ways:

  1. Cautery: Your doctor may use a battery operated instrument to burn a hole in the toenail so that the blood can drain
  2. Lancing: Your doctor may lance the nail using a large gauge, sterile needle
  3. Nail removal: It may be best to simply remove the whole nail and clean the nail bed. Sometimes, your doctor may decide to place the nail back on the nail bed to protect it.

If you do need to have your toenail removed, the procedure will be performed under local anesthetic. Once the toenail has been removed, your doctor will examine the nail bed for laceration and apply stitches as needed.

After your treatment is complete, you will simply wait for your toenail to grow out so that the drainage hole will grow away. Don’t be surprised if your nail does not grow back normally. The sooner you see your doctor after noticing nail discolouration, the better your chances of normal or near normal nail regrowth will be.

Follow-up care

When you leave your doctor’s office, you must be sure to follow his or her advice closely. For example, you may need to soak your feet in Epsom salt water a couple of times a day for 10 or 15 minutes. Following your soaking treatment, you must apply antibiotic ointment and cover your damage toenail with dry sterile bandaging.

The amount of time it takes to recover will vary depending upon the severity of your injury and the intensity of your treatment. Generally speaking, complete regrowth of injured toenails can take several months because toenails grow quite slowly at a rate of about 3 millimetres monthly.

Smart habits will help you avoid black toenails

Once your toenail has healed, you will surely want to avoid a recurrence of this painful and bothersome experience. Adopt these smart habits to avoid injury to your toes and nails:

  1. Attend to nail damage and problems as soon as you notice them. Remember to trim your toenails correctly. Trim them straight across rather than contouring them at the corners once a day
  2. Wear protective footwear that covers your toes. Always wear shoes that fit correctly. The toe box should be large enough to provide ample room to wiggle your toes freely
  3. Alternate your shoes from one day to the next so that they will have plenty of time to air out in between uses. Don’t go barefoot because this leave your toes wide open for injury
  4. Take great care when moving heavy items

By attending to your injury promptly, you can expect successful recovery from a black toenail. By adopting the habits suggested here, you can prevent repeating the experience!

Disclaimer: does not provide medical advice, treatment or diagnosis.

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