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How Do I Treat a Bruised Toenail?

D. Jeffress
D. Jeffress

Bruising underneath a toenail can be caused by the constant pressure of uncomfortable shoes or frequent impacts associated with running, jumping, or kicking a ball. Also called a subungual hematoma, a bruised toenail can become tender as blood and fluid build up in the nail bed. Most bruised toenails can be treated at home by protecting the injured area, wearing tight but comfortable footwear, and avoiding intense physical activity. A toenail that causes discomfort should be assessed by a doctor, who can manually drain blood from the nail bed.

When a bruised toenail is not painful or tender, it does not typically need to be treated. Instead, a person can simply take care to keep the toenail clipped to avoid snagging it on socks or shoes. If the affected nail becomes loose over time, it can be protected with a bandage to prevent it from completely falling off. Even when taking precautions, the nail may eventually separate from the bed due to insufficient blood flow.

A bruised toenail.
A bruised toenail.

It is important to clean and protect the exposed area until a new nail grows into place, a process that may take several months. A person can relieve tenderness and prevent infection by soaking the toe in warm, soapy water once or twice a day. In addition, topical antibiotic creams and ointments should be applied regularly. Accidental injuries can be avoided by wrapping a bandage around the toe and wearing comfortable-fitting shoes.

Treatment options for a bruised toenail are determined based on severity of the injury.
Treatment options for a bruised toenail are determined based on severity of the injury.

When a bruised toenail is accompanied by minor pain, a person can usually alleviate symptoms and shorten healing time with simple home care techniques. Icing and elevating the toe can help to numb the pain and reduce swelling underneath the nail. Over-the-counter anti-inflammatory drugs can also help relieve symptoms. If the bruise persists for a long period of time, and there is no known cause of the injury, it could be a melanoma, so any bruises that occur for a long period of time should have medical attention.

Soaking a bruised toenail in warm water can help to relieve tenderness and prevent infection.
Soaking a bruised toenail in warm water can help to relieve tenderness and prevent infection.

An especially painful bruised toenail can be difficult to treat at home. If possible, a person should visit a podiatrist or emergency room to receive proper medical care. A doctor can inspect the nail and possibly take x-rays to make sure the injury is not accompanied by an underlying bone fracture. After evaluating the severity of the bruised toenail, the doctor can explain treatment options.

A bruised toenail may lead to infection if not properly treated.
A bruised toenail may lead to infection if not properly treated.

In most cases, a podiatrist or trained nurse can relieve symptoms by draining excess fluid and blood. After sterilizing the toe, a professional uses a needle or a cauterizing tool to make a tiny puncture in the center of the bruised area. He or she lightly squeezes the toe, causing fluid to drain from the puncture hole. Once the nail bed returns to a normal color, antibiotics and bandages are applied. Patients are usually instructed to avoid intense activity for several days and return to the hospital if symptoms return.

What Happens if You Don’t Treat a Bruised Toenail?

A bruised toenail that limits mobility may warrant a visit to the podiatrist.
A bruised toenail that limits mobility may warrant a visit to the podiatrist.

While a bruised toenail can look intimidating, even scary, it is typically not a cause for concern. A bruised toenail shouldn’t become a problem if you follow simple, low-maintenance treatment, such as ice and elevation for pain. The pain should resolve quickly, the body will absorb the blood underneath the nail, and the nail will eventually grow out and return to its normal coloration—usually within nine months or so.

However, there can be serious consequences for neglecting to treat a bruised toenail. For one, not treating a bruised toenail can cause unnecessary pain. The pain can also be incredibly intense, even strong enough to inhibit the ability to walk or do other everyday foot activities.

For that reason, the simplest thing to do with a bruised toenail is give it the attention it deserves. Apply ice and elevate your foot, and if the pain becomes excruciating, consider consulting a doctor. 

How Long Does it Take for a Bruised Toenail to Go Away?

The pain from a bruised toenail will resolve relatively quickly, but the visible bruise may persist for longer.

Usually, any pain from the injury will go away in a few weeks, or even less time if you apply proper treatment such as ice, elevation, and rest. 

However, there is also the visual component to consider. The ruptured blood vessels that cause the hematoma will discolor the toenail, leaving a deep red or dark blue impression on the skin. The hematoma will take six to nine months to resolve. During this time, the toenail will undergo the typical growth process: new toenail growth will push the old nail outward, where it can be clipped off. 

The short answer: it takes about three-quarters of a year for a bruised toenail to fully resolve.

Can You Put Nail Polish on a Bruised Toenail?

Because some consider a bruised toenail rather unsightly, there can be the temptation to cover the nail with paint or nail polish, especially for those who often wear open-toed shoes for work. However, it’s also true for everyday life—after all, it’s hard to enjoy pool season when you have to deal with an unsightly toe.

That said, as tempting as it might be to cover the nail with paint, you should avoid doing so, at least for the first few weeks after injuring your toe. To begin with, many cover their toe as a way of ignoring the bruise—but doing so can obscure whether the bruise is worsening. In that way, nail polish could backfire—you apply it to have peace of mind but end up with a more injured toe.

In addition, nail polish may not agree with injured toenails in general. While it is usually safe to wear nail polish, doing so can dry out the layers of skin beneath the toenail, creating conditions for bacteria, mold, fungi, and mildew to thrive. A fungal infection is the last thing you want when you have an injury beneath your toe.

However, after the pain of your bruise has subsided, you may consult your doctor to determine if it is safe to wear nail polish on your bruised toenail. 

Can a Bruised Toenail Have Complications?

Not many complications can arise from bruised toenails, but staying on your toes (pun intended) is still essential. 

The first complication can result from neglect or oversight. In some cases, a subungual hematoma can arise from a very severe toe injury, such as a broken bone or a deep cut, in which case you should consult your doctor immediately.

Another complication can arise from improperly treating a bruised toenail. While doctors are trained in safely draining bruised toenails, it can be dangerous to do so at home. Attempting to pierce a toe at home, outside of the sterile environment of a medical office, can result in infection or even further damage to the toe—putting your toe in an even worse position than when you started.

However, these complications are rare and typically arise from improper treatment. Therefore, being attentive to a bruised toenail and leaving the rest to medical professionals is the best course of action.

Discussion Comments

anon348527

I dance six days a week, very intensely. I have a bruised toenail. Even though it doesn't cause me pain, it will probably never go away because my pointe shoes cause so much friction. It's been four months and it's still the same color and in the same place it was in. The bruised part is really thick now, thicker than my other big toe. The teachers say let it heal but I'm not going to stop dancing because it doesn't hurt, so it probably won't go away. Anyone want to help?

anon328956

I recently did a 10 mile run training for a half marathon and the next day I noticed a blue nail. The next day it was sore and also the big toe had become sore and discolored too.

I did not know what was wrong, but it felt similar to mashing a thumb, so I punctured it at the top of the toe just under the nail and blood and fluid gushed out and for squeezed and removed as much of the blood and liquid as I could.

It has been a few days and fluid is still oozing out and it is still pretty sore but I feel that it was helpful to remove the pressure. I have been soaking it daily and trying to keep it clean.

I am planning to run the half marathon but that is if the tootsies will allow me too. Right now they are pretty sore! I'm buying new running shoes tomorrow that are bigger with more toe space!

anon300189

I ran a half marathon a week ago and ended up with (what I didn't know until now) was bruised toenails. Both of my big toenails were bruised (just a light purple) but they also had 'blisters' under the toenails. I popped the blisters at the tip of the toes with a needle that night and a ton of fluid drained out.

Well, since then, fluid drains from them daily and they are still painful. The fluid does not smell and looks like water. I'm wondering if something is wrong or should I just continue with peroxide and polysporin cleanings.

allenJo

I've heard that you can soak a bruised toenail in Listerine and it will loosen it and help it to come off -- is this true?

NathanG

So here's my gross bruised toenail story -- I once got a bruised toenail from wearing some hard leather shoes on a long walk; the whole thing was completely black. Not having read a useful article like this, I decided to just let it sort of take care of itself. Well, a month or so went by and I was just cleaning my toenails like normal, and then the bruised nail just popped off!

It totally freaked me out, and I have to admit, I almost fainted, even though it didn't hurt -- I was just so grossed out by the whole thing. What had happened was that a new nail had grown underneath the bruised one and pushed it off.

After that I just washed the area with rubbing alcohol every day until the new nail had grown all the way in -- so on the whole, not a painful experience, but not one I'd want to repeat!

MrMoody

@everetra – I can’t relate to your ingrown toenail, but in my case I had suffered from toenail fungus for a long time. I had a lot of black spots underneath my big left toe and my toenail was almost completely removed. I tried the off-shelf-remedies and over time, one finally worked, but it took a combination of using the product and diligently cleaning underneath my toes to keep that gunk from coming back. It’s quite scary to see that stuff underneath your toenail—it almost looks like leprosy or something (what little I know about leprosy).

everetra

A bruised toenail can be a painful thing indeed. I had an ingrown toenail on my right toe some time ago. I didn’t treat it properly as I should, and as a result it got more swollen over time. Finally the ingrown toenail got so bad that it turned into an abscess, which is basically a toenail infection. I tried some compresses and other home remedies. These solutions eased the pain a little bit but didn’t eliminate the problem.

Finally I went to the hospital and they had to perform a surgical procedure. They anesthetized the toe and then cut deep to remove the spurs that were causing the ingrown toenail. They treated the infection and gave me some medicine. I wore a bandage on that toe for some afterwards until it was healthy and normal. However, I had to remember to cut my toenails properly to prevent the problem from returning.

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    • A bruised toenail.
      By: F.C.G.
      A bruised toenail.
    • Treatment options for a bruised toenail are determined based on severity of the injury.
      By: johnnydao
      Treatment options for a bruised toenail are determined based on severity of the injury.
    • Soaking a bruised toenail in warm water can help to relieve tenderness and prevent infection.
      By: Tandem
      Soaking a bruised toenail in warm water can help to relieve tenderness and prevent infection.
    • A bruised toenail may lead to infection if not properly treated.
      By: adam88xx
      A bruised toenail may lead to infection if not properly treated.
    • A bruised toenail that limits mobility may warrant a visit to the podiatrist.
      By: Andrea Arnold
      A bruised toenail that limits mobility may warrant a visit to the podiatrist.