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, 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.

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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.

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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:

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  • 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.

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