Sports-And-Fitness

Bruise under the nail

introduction

In most cases, a bruise develops under the nail as a result of an accident such as: For example, hit with a hammer or pinch a finger in a door.
As a result of the pressure, the small vessels under the nail begin to contract and tear. The escaping blood collects under the nail so that a bluish to black discoloration is visible.

Causes of a bruise under the nail

The causes of a bruise under the nail are many. Most often the injury is due to trauma or external violence. Again, different mechanisms are conceivable here: On the one hand, a hard bump of the fingers or toes can lead to a bruise forming under the nail. On the other hand, a blow or a bruise can cause bruising.

However, an acute event does not always have to result in a bruise under the nail. Sometimes the wrong footwear is enough to bruise the toenail.
The right footwear is therefore very important, especially when doing sports. Shoes that are too tight or too small pinch the toes and make painful bruises more likely. Repeated and continuous stress constricts the toes and exposes them to strong pressure, which can ultimately lead to bruising. But even very sturdy shoes, such as work shoes or hiking boots, can lead to bruises under the nails when they run in.

However, if a bruise cannot be explained by an injury or too tight shoes, there is another possible cause, namely black skin cancer (melanoma). It typically appears as an elongated brown to black colored line under the nail. The occurrence of this phenomenon is also known in medicine as the Hutchinson sign.
If the stain does not go away or fades and exceeds the nail's limits, it should be shown to a dermatologist immediately. The absence of pain in combination with the other signs already mentioned is also suspicious for black skin cancer.

Find out more at: Bruise

Symptoms of a bruise under the nail

A bruise under the nail is particularly painful immediately after an injury. It is tenderness that is strongest in the first few days. A pulsating sensation in the affected nail is also typical.
A large bruise under the nail often causes severe pain as the blood that collects under the nail lifts the nail from the nail bed. This in turn tries to hold and fix the nail. The resulting pressure leads to a pulling, throbbing pain.

The discoloration of the stain varies from black, brown to blue. After a few days, the bruise will gradually fade on its own. As a sign of the healing of a bruise under the nail, other color compositions develop over time.

Depending on the type of injury, damage and bruising may be seen in the surrounding tissue. A very large bruise can cause the nail plate to peel off and lift. In the worst case, the nail will fall off.

In the case of black skin cancer, which can also form under the nail and looks like a bruise, there is no pain. When pressed, it neither changes its color nor hurts. There is also no peeling of the nail plate. The discoloration in black skin cancer does not fade or go away on its own.

You might also be interested in this topic: The symptoms of skin cancer

Pain in the nail

The pain associated with bruising under the nail can vary widely.
They depend on the cause and above all on the size and spread of the bruise. In the case of only slight bumps or injuries, usually slight pain occurs, triggered by pressure. They have a pulling and stabbing character, but are usually not very long-lasting and can easily be restricted by cooling measures. After one or two days, the pain can in many cases only be triggered by exerting external pressure.

If it is a bruise that occurs as a result of major injuries or severe bruises, the pain associated with this accident is significantly more intense. If a lot of blood collects under the nail, a sudden onset, stabbing, throbbing pain develops, the intensity of which increases. This can be explained by the fact that the bruise leads to a lifting of the nail from the nail bed and thus exerts a strong pressure.

The pain only subsides after the pressure is relieved and the blocked blood can drain. As a rule, the nail can still be a little painful for about 4 - 6 weeks under load. The pain can also be triggered by surrounding soft tissue injuries or injuries to the bone that occurred in the course of the accident. Therefore, the pain can be more prolonged with more severe injuries and pain medication may have to be administered that can bring about relief.

Read more on the topic: Pain in the toenail

Accompanying symptoms of a bruise under the nail

The classic symptom of a bruise under the nail is pain.
In addition, in most cases there is swelling and reddening of the affected finger or toe phalanx. The nail turns blue to purple in color relatively quickly when the blood flows under it. In the further course the bruise turns black due to the healing process. Depending on the extent of the bruise, the nail plate rises. In the case of particularly voluminous and space-consuming bruises, this can lead to a complete detachment of the nail.

There is also the risk that other structures, such as the finger or hand bones, but also tendons or muscles, are affected. Such further injuries can occur, especially in the event of impact trauma or falls. It is therefore advisable to have a detailed medical history as well as a functional examination of the affected fingers and toes in order to rule out breaks or sprains.

Loosening of the nail in the event of a bruise

Typically, a bruise will grow out from under the nail over time.Depending on the nature of the nail and the duration of its growth, this process can take several weeks. In the case of particularly severe injuries or bruises, it can also happen that the bruise does not grow out, but the entire nail plate detaches from the nail bed and falls off. Most of the time, the nail only partially loosens and continues to loosen over time, so that it finally falls off.

If the nail has loosened, it must be ensured that no bacteria and germs penetrate the wound and cause infections. In addition, the wound should be kept dry as much as possible, as otherwise the risk of a fungal infection of the nail bed is very high.
In this case you should definitely consult a doctor who can clean the wound and prevent possible infections with the help of ointments and bandages. The failed nail grows back. Regular professional nail care should be performed to aid healing. In this way, complications and deformations in the course of growth can be largely prevented.

Read more on the topic: Nail fungus

Treatment of a bruise under the nail

To relieve the pain that may occur as a result of the injury, it helps to cool the affected area a little first. The cooling not only prevents the injured finger or foot, as well as the surrounding tissue, from swelling, but also causes the small, injured vessels below the nail to contract and thus less blood can escape. This will limit the spread of the bruise.

If you have a small bruise, you have to be patient and wait until the discolored nail grows out. This is only a small visual flaw and takes about 4 - 6 weeks.

If the bruise occurs as a result of severe bruising or entrapment, a large amount of blood may accumulate under the nail. This removes the space between the nail and the nail bed and it can trigger the detachment of the nail.
In this case, a hole must be punched or drilled in the affected nail so that the bruise can drain. However, it must be ensured that this measure is carried out by a doctor under sterile, i.e. aseptic, conditions. It is not advisable to take the pressure off the nail yourself.

After a discharge has been made, the finger should be protected from dirt and pathogens with a bandage and spared for a few days. Further medical check-ups are recommended if infections occur or the affected fingernail comes off completely.

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Piercing the nail

A bruise that builds up under the nail can be very painful. In order to alleviate this quickly and with as little effort as possible, a frequently used therapy option is to prick the nail and let the blood run off through a small hole. The pent-up blood can escape. This relieves the pressure under the nail and provides quick and effective pain relief.

In order to pierce the bruise under the nail, the doctor can use a sterile cannula, with the help of which a hole is drilled in the nail with slight twisting movements. However, it should be remembered that piercing the nail is only useful if the bruises are very fresh and not older than 2 - 3 days. Only then is the blood still thin and can drain well. If the blood has already clotted, drainage through such a small hole cannot be guaranteed.

Ointment for a bruise under the nail

When treating a bruise under the nail, ointments are often used. Arnica ointment is popular to prevent swelling and relieve pain. Arnica is a tried and tested remedy which on the one hand has a very calming effect on the skin and relieves pain and on the other hand strengthens the tissue and promotes healing.

Another type of ointment that can be used is zinc ointment. They are often used in the treatment of wounds, as they support the healing processes that are beginning and, above all, have a cleaning and disinfecting effect. Zinc ointments remove the liquid from the wound surface and thereby prevent existing germs from multiplying further.

Disinfecting solutions and ointments are to be used for first aid, so that existing germs and pathogens are killed and possible infections and inflammations are prevented.

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Cooling a bruise

Immediately after the mechanism of injury, the affected nail should be cooled and elevated. On the one hand, the cold has a pain-relieving effect and, on the other hand, when applied immediately, it enormously reduces the swelling of the nail bed and the surrounding soft tissue.
The cold causes the blood vessels to contract, so that the blood flow and thus also the blood leakage into the surrounding tissue, especially under the nail, are reduced.

Consistent cooling can ensure that a bruise under the nail is less intense and painful. Elevating the affected fingers or toes follows roughly the same principle: Elevating the blood circulation is more difficult and thus also reduced.

Also read: Treatment of the bruise - The PECH rule

What to do if the nail falls off

The bruise will grow out with the old nail after a few weeks. The nail then usually falls off. Basically, you don't have to do anything.
You can cool down for pain relief for the first few days. However, after a few days the pain will go away. The new nail grows back and the nail bed is protected. This process doesn't look pretty to the sufferer, but it's not worrying.

In the event of severe injury, the nail that grows back may be slightly deformed or have a dent. But that doesn't have to be the case. After a few weeks or months, the nail often looks the same as it did before the injury.

In addition, nourishing ointments with additives such as arnica or comfrey can be applied. Soothing nail baths are also recommended.

Bruise under the fingernail

In most cases, a bruise under the fingernail is traumatic. Injuries in the form of bruises or bumps can occur both in everyday life and during sporting activities. Small children in particular often pinch their fingers or the whole hand in doors, drawers or windows.

Often not only the fingernail but also the surrounding tissue is affected. The pain usually starts immediately and is very intense. After timely cooling and immobilization of the fingers, however, they should settle within a few days and only a small bruise remain under the nail, which is only painful under pressure.

Otherwise, depending on the nature of the injury, it is advisable to consult a doctor in the event of prolonged pain, swelling, redness and pain in order to rule out possible accompanying injuries such as a fracture of the finger bone.

In addition, if there are supposed bruises without an adequate course of injury, the malignant skin tumor, a malignant melanoma, should be considered, which can develop under the nail on both the finger and the toes.

Also read: Bruise on the finger

Bruise under the toenail

A bruise under the toenail, like on the fingernails, is mostly traumatic. Often times, the bruise forms from falling objects or after being hit against an edge. It is also possible that another person could step on someone's feet.

Also worth mentioning are bruises under the toenail that result from wearing the wrong footwear. If a shoe that is too tight or too small is worn regularly or for a long period of time, high pressure is exerted on the tip of the toe, which is usually transferred to the toenail. As a result of this irritation, in addition to blistering, small blood vessels can then tear, so that the escaping blood collects under the nail bed and appears as a bruise.

Here, too, as with a fingernail, it helps to cool the toe immediately after an injury and / or to stop wearing the wrong footwear. A bruise under the toenail, like a fingernail, can be due to skin cancer.

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Duration of a bruise under the nail

The duration of the healing process depends not only on the injury that led to the formation of the bruise, but also on the size and extent of the bruise, the involvement of the surrounding tissue and possible accompanying injuries, and above all the nature of the nail and its duration of growth .

Over the course of several days, the bruise will pale and also change its color gradient. Usually it grows out with the nail. This can vary greatly over time, as some nails grow faster than others. On average, it takes about 4 to 6 weeks.

In the case of larger injuries, in which the surrounding tissue structures are also involved and the nail may have fallen off completely, the healing takes significantly longer. Complications are also more common in these cases.

Sometimes the nail may not grow back properly, become deformed, or grow into the nail bed, thereby prolonging and affecting healing. Infection and inflammation of the nail bed can also occur over time and lead to complications that also prolong healing.

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Diagnosis of a bruise under the nail

No special diagnostic tools are required to identify a bruise under the nail. The color of the bruise will vary from brown, black to blue and will fade after a few days. The bruise is usually confined to the nail and hurts when external pressure is applied. A throbbing pain in the finger may also be felt in the first few hours after an injury. The tenderness to pressure is greatest in the first few days after the injury.

Ultimately, a doctor just takes a close look at the nail to determine the bruise. Questions about how the accident happened are also groundbreaking. If the stain has arisen without an external cause and is painless, a possible cause is also black skin cancer, which can develop under the nail. In this case, a dermatologist will do special tests to confirm the diagnosis. This includes, for example, inspecting the spot with a reflected light microscope. If the suspicion of black skin cancer is confirmed, the stain is cut out and examined further.