Common toenail injuries include bleeding under the toenail (subungual hematomas) and tearing off part or all of the toenail (toenail avulsions).
Bleeding under the toenail has been called "tennis toe," "runner's toe" or "skier's toe" because it occurs more commonly in these sports.
Bleeding under the toenail usually occurs from the toenail repeatedly making contact with the shoe. This causes bleeding under the toenail from a shearing force that can separate the toenail from the nail bed (skin holding the nail to the toe). This often happens because shoes are too tight or because toenails are too long. It can also happen if a heavy object strikes the toenail.
Torn nails usually occur when the nail catches on something and is pulled off.
Blood underneath a toenail can be painful, especially if the injury occurred from an object directly striking the toenail. Because of the underlying blood the nail will turn reddish to brown to bluish black. Eventually the nail may fall off.
A torn toenail is also painful.
The toenail should be clipped short so it does not make contact with the shoe. Shoes with a bigger, wider area for your toes should be worn.
If the blood underneath the nail is causing a lot of pain your healthcare provider may drain the blood by making a hole in the nail by drilling with a needle or using a sterile heated paperclip or heating tool.
A partially torn nail is usually taped down until a new nail has begun to form and then it is trimmed away.
Sometimes a nail that is severely damaged may be removed by your healthcare provider. If a nail is removed or falls off, put a topical antibiotic ointment on the nail area and cover it with a bandage until a new nail grows in.
Take an anti-inflammatory such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
Although toenail injuries are not serious, they can be painful. You may return to your normal activities as soon as you can tolerate the pain and are wearing shoes that do not make the pain and discomfort worse.
Wear proper fitting shoes. Be sure to keep your toenails trimmed.
