Don’t Ignore Black Spots Under Toenail


When a pedicurist talks about black toenails, they are probably convincing you to try the latest nail polish color. If you are a runner, however, the term refers to an injury that makes your toenail ugly and could cause you a lot of pain. Runners are particularly susceptible because repetitive motion can jam the toes into the front of the shoe, especially if you run up and down hills a lot. Anyone can get a black toenail–something as simple as dropping your toolbox on your toe, or stubbing it on your bedpost when you get up to use the bathroom, can cause it. If you have this injury, it’s best to have it checked out at My Chicago Foot Expert.

Subungual Hematoma Is the Name, Pooling Blood Is the Game

When your toe experiences any trauma of this sort, the tissue under the nail can be damaged and start to bleed. It is the blood pooling beneath the nail that gives it the dark color – from red or blue to purple, brown or black. As the blood blister grows, pressure builds up under the nail and can cause excruciating pain. If the injury is severe, the nail bed can be damaged as well, which may prevent the replacement nail from growing out correctly. Some trauma can crush the toe down to the bone, which brings a new set of serious problems, including a possible bone infection. If the blood spot covers 25% or more of the nail, it is important to have Dr. Stavros Alexopoulos take a look, to be sure there aren’t more serious problems to be addressed.

How to Treat Black Spots Under Toenail

If the blood spot is very small and not painful, you may not need any special treatment for it other than to cushion it from further harm during the healing process. Eventually, the new nail will push the dark, injured nail out. For anything larger, though, it is best to have us examine it.

We may need to use a sterile procedure to drain the blood if it is causing you a lot of pain. Larger spots can often mean the nail has been separated from the bed and should also be evaluated. Although it may eventually fall off on its own, a new toenail may take up to 6 months or more to grow out. If the nail bed was damaged as well, it may not have a normal appearance. For severe injuries, we may need to remove the nail to repair the nail bed with stitches, rather than let nature take its course.

Things You Can Do to Prevent the Injury

If you work in a dangerous environment, steel-toed shoes are a great benefit. Runners should also make wise shoe choices–use lacing techniques that allow your toes enough room to prevent them from rubbing against the shoe. Cushioned socks can provide comfort as well as a small amount of protection. It’s also important to keep your toenails trimmed properly: straight across and not too short. Don’t forget to avoid going barefoot in any place that can harm your toes.

If you do notice discoloration when you remove your shoes, be sure to have the problem investigated promptly. Ask the staff at My Chicago Foot Expert for more ways to prevent black toenails. You can reach our office on West Foster Avenue by calling (773) 561-8100, or request an appointment on our contact page. We specialize in foot problems faced by athletes, and we re eager to put our experience to work for you!

My Chicago Foot Expert
2740 West Foster Ave., Suite #107
Chicago, IL 60625
Phone: 773-231-7296
Fax: (773)561-5208
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