Have you ever noticed a toenail getting discolored or turning black? It feels urgh! You may be scared or pukish at such a sight. However, it is important to be aware of the causes and complications and have some knowledge of the treatment and prevention of black toenails.
Read on to learn more about what a black toenail means and how can you protect yourself from having one.
What Does a Black Toenail Mean?
A black toenail can be described as a black or a purplish hue around or beneath the toenail surface. The condition, medically known as subungual hematoma, usually stems from an injury or trauma to the nail.
The discoloration or darkening of the nail results from bleeding or blood pooling happening under the nail following some injury like stubbing or dropping a heavy object on the toe. The blood trapped beneath the nail dries and clogs causing it to turn dark or black.
There can be other reasons for a black toenail, such as infection or nutritional deficiencies. Whatever the cause, black toenails can often be painful. Let’s get into the details of the problem.
Symptoms
There are certain common symptoms accompanying a black toenail that characterize it:
- Pain and discomfort
- Nail thickening and splitting
- Swelling and bruising
- Discoloration and lifting from the nail bed
- A brittle or loose nail
- Possible bleeding
If the condition worsens or the area becomes infected, there can be some severe symptoms including redness, odor, or discharge.
Causes
Subungual Hematoma or a black toenail can be caused due to several underlying reasons resulting in discoloration and/or pain:
1) Trauma
The most common cause of a black toenail is injury or trauma. You may have experienced this when you accidentally drop something heavy on your toe or cause an injury after stubbing it. This trauma causes the blood vessel to break underneath the nail resulting in bleeding which eventually darkens and makes the toenail turn black.
2) Runner’s Toe
If you wear shoes regularly, you may have noticed your second or third toenail turning dark especially if the shoe is excessively tight or loose or even if the nail is too long. Tight shoes keep the toes compressed and can cause the nail to pinch resulting in bleeding between the nail plate and the nail bed. Conversely, wearing a loose shoe can cause your toe to bump or rub against it as you move causing repetitive trauma.
Also if you are a runner or take long walks regularly in your shoes, your feet may swell during this, creating pressure causing the blood to clot underneath your nail surface that may lead to darkening. Also, if your big toe is too big and bends inside the shoe, or if your toenails are too long, that can cause trauma.
3) Malignant Melanoma
A more serious and rare condition that causes the toenails to turn black is called malignant melanoma or ‘subungual melanoma’. It is a highly dangerous type of skin cancer that causes discoloration of or underneath the nail bed and can become serious if left untreated.
4) Fungal infections
Though fungal nail infections are usually green, yellow, or white looking, they can sometimes result in debris buildup causing a black toenail. Fungal infections, usually caused by organisms called ‘dermatophytes’, occur in toenails because your feet are often in moist and sweaty environments. Your toenails are prone to such fungal infections if you have a cut or a crack near the nail. If you have diabetes, heart, kidney, or vascular diseases, or simply a weak immune system, your toenails would be more vulnerable to these fungal buildups and infections.
5) Ingrowth
If you have ingrown toenails, the nails would be growing into the surrounding skin leading to bacterial infections. This can cause darkening or discoloration of the nail in some cases.
Complications and Risk Factors
Certain factors can result in the risk of developing a black toenail:
1) Repeated trauma
If you are a clumsy person and keep banging your feet and stubbing your toes now and then, this can be a risk factor for you and may cause a black toenail after repetitive trauma on it.
2) Wrong footwear
If you were ill-fitting shoes for longer times or regularly, the continuous rubbing or compression on the toes may cause harm to your toenail.
3) Underlying conditions
If you have a particular health condition that affects blood circulation or causes clotting or thickening of the blood, it may result in blood vessels getting ruptured underneath your nailbeds causing discoloration and vulnerabilities.
The possible complications due to black toenails can be more dangerous than you’d imagine and can cause permanent damage:
- The nails may grow back out thickened or misshaped.
- If caused by bleeding beneath the nail, the toenail is more than 50% discolored, it may lead to fractures or lacerations.
- If the black toenail is due to trauma or injury and the damage is sustained by the nail matrix, it may result in improper regrowth or failure to regrow the nail altogether.
- If the darkening is due to melanoma, it may spread to the surrounding skin or even other parts of the body.
When to See a Healthcare Provider?
In most cases of toenail injuries, treatment is not required and it heals naturally. Later on, a new and perfectly healthy nail replaces the discolored and damaged nail over several months. However, in some cases, where the symptoms or causes are serious or you see the damage getting increased, it is advisable to consult a healthcare provider and get a proper diagnosis and treatment.
Contact a doctor in case:
- You feel a strong and uncontrollable pain in the toenail.
- Discoloration appears slowly and increases gradually.
- There is an injury to the nail base or under the nail bed.
- The infection or discoloration is spreading to the surrounding skin or the cuticle.
- More than half of the nail is black.
- You have diabetes or any other vascular disease.
Diagnosis and Tests
If you experience any of the potential causes and symptoms and observe a black or discolored toenail along with pain and other symptoms, consider getting it diagnosed by your healthcare provider. Guide your doctor about any health conditions, recent toe injuries, or regular habits to help in the right diagnosis and treatment.
Depending on your symptoms, causes, and the condition of the black toenail, the doctor may prescribe some diagnostic tests:
- Lab analysis or microscopic examination of the nail sample.
- Blood test in case of any underlying health condition of nail infections.
- X-ray to study and evaluate the bone structure underneath the nail bed.
There is nothing to fear. Usually, the doctor will diagnose and treat the problem on its own. Only in the case of not understanding the precise cause of the problem or seeing any serious prospective issue will the healthcare provider get one of these tests done to prescribe the appropriate course of treatment.
Treatment
If the black toenail is caused by a small injury or runner’s toe and if you aren’t feeling any pain and discomfort, you may let time heal the issue. However, you may try some home remedies to treat the problem:
1) Cold compress
To prevent further injury, avoid moist conditions and direct contact with ice. Instead, use a cold compress or wrap the ice in a cloth and apply it to the affected area. Gently compressing the injury with this will also help in treating bleeding or blood clots.
2) Elevation
Keeping the foot elevated helps in painful toenails due to swelling or pressure. Choose to do this for resting the feet from a long walk or running in ill-fitting shoes.
3) OTC Medication
If you are experiencing pain or discomfort in your toenails, the healthcare provider may prescribe over-the-counter medicines to alleviate the problem.
In case the discoloration is due to any other serious reason, the doctor will diagnose properly and get some tests done if needed and will prescribe treatment and medication accordingly including oral antifungals, antibiotic ointments, soaks, or even surgical removal of the infection or the nail.
Prevention
Prevention is better than cure especially when the cause of the problem is ignorance or carelessness. And it is particularly better than the scary treatment options that may make things painful for you. Though you cannot prevent accidental causes, be careful when it comes to preventing or minimizing injuries and infections:
1) Maintain hygiene
Prevent fungal infections and bacterial buildup by maintaining proper foot hygiene. Always keep your feet clean and dry and avoid sweaty or moist conditions. Keep your toenails trimmed and avoid sharp corners at all times. In case of breakages, properly shape and file the nails for any cracks or sharp edges. Indulge in regular manicures at home or professional salons to maintain your nails and the surrounding skin.
2) Invest in good footwear
Always wear comfortable and good-quality shoes and other footwear including socks. Make sure your shoes are well-fitted especially when indulging in brisk walking, running, or exercising. Protect toes during sports, traveling, or trekking.
Wrapping Up
A black toenail can be alarming, but understanding its symptoms, causes, and treatment options can help you address it effectively. Whether it’s due to trauma, fungal infection, or other underlying issues, seeking proper medical advice is crucial. Remember, prevention is key, so taking care of your feet and nails is essential. If you do experience a black toenail, don’t panic. With the right treatment and care, your toenails can heal, and you can get back to flaunting your healthy, happy feet.
So, stay informed, stay proactive, and step forward with confidence, knowing that you have the knowledge to keep your toenails looking and feeling their best. Here’s to healthy toenails and happy feet!
