How Do You Treat Black Toenail From Trauma?

Black toenails, often a result of trauma or injury, can be a painful and unsightly condition.

Whether you’ve stubbed your toe, dropped a heavy object on it, or experienced repetitive trauma from ill-fitting shoes or athletic activities, a black toenail can be a source of discomfort and concern.

Fortunately, black toenails can be effectively treated at home in most cases. This article will delve into the causes, symptoms, prevention, and various treatment options for black toenails resulting from trauma.

What are you waiting for? Learn more about black toenail trauma by reading the content below. 

Understanding Black Toenails

Black toenails, also known as subungual hematoma, occur when there is bleeding or bruising beneath the toenail. Trauma or injury to the toe causes small blood vessels beneath the nail to rupture, leading to the accumulation of blood between the nail and the nail bed.

This trapped blood gives the toenail a dark, black, or purplish appearance, which can be quite alarming.

Causes of Black Toenails

  • Trauma: The most common cause of black toenails is trauma, which can result from various incidents such as stubbing your toe, dropping heavy objects on it, or even experiencing repetitive microtrauma from activities like running or playing sports.
  • Ill-fitting shoes: Shoes that are too tight or have inadequate toe space can put pressure on the toenails, leading to trauma and the development of black toenails over time.
  • Running and sports: Athletes, particularly runners and those involved in activities that involve repetitive pressure on the toes are at a higher risk of developing black toenails.

Symptoms of Black Toenails

The primary symptom of a black toenail is the noticeable discolouration of the nail. However, in addition to the visual changes, you may experience the following:

  • Pain and tenderness: The area around the black toenail may be painful and tender, especially when pressure is applied.
  • Swelling: Some cases of subungual hematoma may lead to mild swelling around the affected toenail.
  • Nail separation: In severe cases, the accumulation of blood beneath the nail can cause it to lift or separate from the nail bed.

Preventing Black Toenails

Prevention is always better than treatment, so taking steps to protect your toenails from trauma is essential, especially if you’re prone to black toenails due to your activities or footwear. Here are some preventive measures:

  • Proper footwear: Ensure your shoes fit well and provide adequate room for your toes. Avoid shoes that are too tight, as they can put pressure on your toenails.
  • Protective gear: If you engage in activities that put your toes at risk, consider wearing protective gear such as toe caps or guards to minimize the impact of trauma.
  • Nail care: Maintain your toenails at an appropriate length and avoid cutting them too short, as this can increase the risk of trauma. Keep them clean and well-maintained.
  • Gradual training: If you’re an athlete or participate in high-impact sports, gradually increase your training intensity and duration to allow your toenails to adapt to the stress.

Treatment Options for Black Toenails

If you’ve already developed a black toenail due to trauma, there are several treatment options available, depending on the severity of the condition. Here’s a comprehensive guide to treating black toenails:

Rest and Elevation

For mild cases of black toenails, the first step in treatment is to rest the affected foot and elevate it whenever possible. Elevation helps reduce swelling and can alleviate pain.


Applying ice to the injured area can help reduce pain and swelling. Wrap the ice in a cloth or use an ice pack and apply it to the toe for 15-20 minutes at a time, several times a day. Be sure to avoid direct contact between the ice and the skin to prevent frostbite.

Pain Medication

Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain and inflammation associated with a black toenail.

Follow the recommended dosage instructions and consult a healthcare professional if you have any concerns or underlying medical conditions.


In cases where there is significant pain and pressure due to the accumulation of blood beneath the nail, a healthcare professional may recommend draining the hematoma.

This is typically done by making a small hole in the nail to release the trapped blood, relieving pain and pressure. It’s important to consult a medical professional for this procedure to avoid infection or further injury.

Proper Nail Care

Maintaining good toenail hygiene is essential for preventing infection and promoting healing. Keep the affected nail clean and dry. Avoid wearing tight shoes that may put pressure on the injured toe.

Shoe Modifications

If ill-fitting shoes are the cause of your black toenail, consider changing to footwear that provides more room and cushioning for your toes. Orthotic inserts or padding can also help redistribute pressure away from the affected area.


In rare cases, if there is a risk of infection or if the nail has separated from the nail bed, a healthcare professional may prescribe antibiotics to prevent or treat any potential infection.

Nail Removal

In severe cases where the nail has separated from the nail bed or is causing significant pain and discomfort, a healthcare professional may recommend partial or complete nail removal.

This procedure is typically performed under local anesthesia and involves removing the affected nail to allow for the growth of a new, healthy nail.

Home Care for Black Toenails

In addition to the specific treatment options mentioned above, several home care practices can help promote healing and prevent complications:

  • Keep the affected toe clean and dry.
  • Wear open-toed shoes or sandals to reduce pressure on the injured toe.
  • Avoid tight or ill-fitting shoes until the black toenail has healed.
  • Practice proper nail hygiene by trimming your toenails straight across and not too short.
  • Apply an over-the-counter antibiotic ointment to the injured area if there’s any risk of infection.
  • Be patient; it can take several months for a black toenail to grow out completely.

When to Seek Medical Attention

While many cases of black toenails can be managed at home, there are situations where it’s important to seek medical attention promptly:

  • Signs of infection: If you notice redness, increased swelling, warmth, pus, or worsening pain around the black toenail, consult a healthcare professional.
  • Severe pain: If the pain is severe and does not improve with at-home treatments, see a doctor for an evaluation.
  • Nail separation: If the toenail has completely separated from the nail bed or is partially detached, seek medical care.
  • Recurrence: If you experience frequent black toenails despite taking preventive measures, consult a podiatrist or healthcare provider to address any underlying issues.


Black toenails resulting from trauma can be a painful and concerning condition, but with proper care and treatment, most cases can be managed effectively.

Remember to prioritize prevention by wearing appropriate footwear and taking precautions during activities that pose a risk to your toes.

If you do develop a black toenail, follow the recommended home care and seek medical attention when necessary to ensure a full and healthy recovery.

Your feet deserve the best care, so you can continue to enjoy an active and pain-free lifestyle.

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