Bruising Under the Nail: Causes and Care Tips - Dermatology

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Bruising under the nail, often referred to as a subungual hematoma, can occur due to trauma or injury to the nail bed. In your case, it seems likely that the heavy object you mentioned caused the discoloration you are observing on your left big toe. The purple or blue color you see is a result of blood pooling under the nail due to damaged blood vessels, which is a common response to trauma.


Causes of Bruising Under the Nail
1. Trauma: The most common cause, as you've experienced, is direct trauma to the nail. This can happen from dropping something heavy on your toe, stubbing it, or any other impact.

2. Nail Bed Injury: Sometimes, the injury can be more severe, involving the nail bed itself, which may lead to more significant complications.

3. Underlying Conditions: In rare cases, certain medical conditions that affect blood clotting or blood vessel integrity can lead to bruising without obvious trauma.


Symptoms to Monitor
- Color Change: Initially, the bruise may appear red, then turn purple or blue, and eventually fade to yellow or green as it heals.

- Pain: While you mentioned that it does not hurt much, any increase in pain could indicate a more serious injury.

- Swelling: Look for any swelling around the nail or toe.

- Nail Changes: If the nail begins to lift or separate from the nail bed, or if you notice any signs of infection (such as increased redness, warmth, or pus), you should seek medical attention.


Care Tips
1. Rest and Elevation: Avoid putting pressure on the affected toe. Elevating your foot can help reduce swelling.

2. Ice Application: Applying ice wrapped in a cloth for 15-20 minutes every hour can help reduce swelling and pain.

3. Pain Management: Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage any discomfort.

4. Observation: Keep an eye on the bruise. If it starts to change color significantly, becomes more painful, or if you notice any signs of infection, consult a healthcare professional.

5. Nail Care: Avoid trimming the nail until it has healed, as this can lead to further injury or infection.


When to Seek Medical Attention
- If the bruise covers a large area of the nail.

- If you experience significant pain that worsens over time.

- If you notice any signs of infection, such as increased redness, warmth, or discharge.

- If the nail begins to lift or if you have difficulty moving the toe.


Conclusion
In most cases, a subungual hematoma will heal on its own without the need for medical intervention. However, it is essential to monitor your symptoms closely. If you have any concerns or if the condition worsens, do not hesitate to reach out to a healthcare provider for further evaluation. Taking these precautions can help ensure that your toe heals properly and that you avoid any potential complications.