Black toenails: Causes and how to get rid of them

If you have a black toenail, you’re one of many. This is a common problem, especially in the older generation,

If you have a black toenail, you’re one of many. This is a common problem, especially in the older generation, however isn’t always caused by stubbing your toe or dropping something on it, though that is the main reason.

It is referred to as a subungual hematoma, which simply means there is a collection of blood underneath the nail.

This can not only cause the nail to become discoloured, it also generates pressure, leading to intense pain.

In these cases, medical treatment is advised.

Black toenails can also be caused by a fungal infection, or in rare case they may indicate underlying melanoma.

Why is my toenail black?

There are several ways your toenail could turn black, including:

  • Injury or trauma to the nail or affected toe
  • Fungal infection
  • Repeated trauma from running or bare foot
  • Ill-fitting or tight shoes
  • Malignant melanoma (very rare)

When should I see the doctor?

Often a black toenail will eventually fall off and grow back on its own. If there’s any extreme pain, pus, discharge, foul odour, accompanied by fevers and chills, you may need to seek medical treatment right away.

Generally, any time the discolouration covers 25 per cent or more of your nail, you should see your doctor, as this may mean the nail bed has been lacerated or there is bone exposed.

In such cases, it is more likely that the nail bed is severely lacerated or that there is exposed bone under the nail.

Treatment options

In most cases, the black toenail will eventually fall off on its own or grow out. You should make an appointment with a podiatrist if you are concerned.

If the nail bed has been lacerated it will have to be washed out and possibly sutured. If the hematoma only needs to be drained to relieve the pain and pressure, there are three ways your podiatrist can do this:

  • Removal: The nail will be removed and the area will be cleaned.
  • Needle: A sterile needle can be used to create a small hole in the nail to allow the fluid to drain.
  • Cautery: A battery-operated device burns a hole in the nail until the blood begins to drain.

You may be advised to soak your foot with Epsom salt and lukewarm water twice daily for ten to fifteen minutes at a time, after which an antibiotic ointment and a dry, sterile bandage will be applied.

Can black toenails be prevented?

Here are some tips to help you prevent black toenails:

  • Keep toenails trimmed properly, not too short and straight across.
  • Wear properly fitting shoes.
  • Try to avoid walking barefoot.
  • Keep feet and nails clean and dry.
  • Always wear clean socks and shoes.
  • Treat any nail problems during their early stages.

Tell us, has this information helped you?

  1. I have this at the moment. The black strip is down one side and the nail has lifted on that side. I have managed to trim the nail and now the nail has split across. Hopefully old nail will grow out and I can see new nail coming through. I bet you are all thinking – too much information. lol

    • Sitting in Kalgoorlie smiling Debbie. During my last visit here in January 2015 a large can of dog food rolled out of the back of the Patrol and landed on my big toe. All year I carried a black toe nail. It finally grew out almost 12 months to the day this year.

    • Joan Pennington You made me laugh. I would have said more than that. I actually don’t know what I did to deserve mine.

    • Debbie Bryant glad I made you laugh
      I think I might have told porkie pies , as to what was really said Ha Ha 😎

  2. Another condition, which looks and feels similar, at least when the nails fall off, is Yellow Nail Syndrome.. Although this is considered rare, if you suffer from a lung problem get it checked out as that is what it is most often associated with. It seems to be related to the lymphatic system, and makes you susceptible to chronic sinusitis and pneumonia. There is no known cure, but at least you won’t waste money on anti-fungal treatments and the such like.

  3. I dropped something on my foot and the toenail went black it slowly grew out with a nice new nail underneath.

  4. I remember as a youth being “yorked” on the big toe by a fast bowler. Instant agony. I awoke the next day in great pain, barely able to walk and with a toenail as black as soot. The only doctor I could get to see on that day was an old doctor who was better known for the time he spent in the bar and not in his surgery. Examining the toe and the nail he said.”I can fix that.” Taking a paper clip from a container on his desk he half straightened it. He then fired up a small methylated spirit burner and held the paper clip in the flame. When the paper clip was obivously heated to the temperature he desired he grabbed my foot and plunged the paperclip through the toe nail. Instant agony and almost instant relief. I walked out of surgery as if I’d never had the injury.

    • Just over 31 years ago at 8 months pregnant, I had a train door slammed on my thumb nail. After 3 days of throbbing pain, I went to my doctor, where a nurse did the same (only with a large sterile needle) & the relief was instant. After all the blood & pus came out, she told me that was the first time she’d ever done that procedure!

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