Managing Bruising and Nail Changes After a Toe Injury

Bruising from stubbing a toe?

About a month ago, while jogging in the morning, I accidentally kicked the ground with the second toe of my right foot.
That evening, I noticed bruising, but by noon on the same day, the toe no longer hurt.
Since then, I have been able to exercise normally, and touching the bruised area does not cause pain.
However, the bruised area now covers about 75% of the entire nail, and the bruised part has caused the nail to protrude somewhat (it is noticeably swollen compared to the normal toenail).
I would like to know how to handle this situation.
Thank you.

Mr. Lin, 30~39 year old female. Ask Date: 2023/05/31

Dr. Wu Yuxin reply Dermatology

In principle, no special treatment is needed; the bruised area will be naturally pushed out as the nail grows.

Reply Date: 2023/05/31

More Info

Managing bruising and nail changes after a toe injury can be a concern for many individuals, especially when it comes to the appearance and functionality of the toenail. Based on your description, it seems that you have experienced a significant bruise under your toenail (subungual hematoma) due to an injury sustained while jogging. The fact that you are not experiencing pain and can perform normal activities is a positive sign, but the persistent discoloration and swelling of the nail are worth discussing further.

Understanding the Injury
When you injure your toe, especially in a manner that causes bruising, blood can accumulate under the toenail. This results in a subungual hematoma, which can cause the nail to appear dark and swollen. The extent of the bruise you described, covering about 75% of the nail, indicates a considerable amount of blood accumulation. The swelling and protrusion of the nail can be attributed to the pressure from the blood underneath, which can cause the nail to lift away from the nail bed.

Treatment Options
1. Observation: Since you mentioned that you are not experiencing pain and can engage in normal activities, it may be appropriate to simply monitor the situation. Subungual hematomas often resolve on their own as the body reabsorbs the blood over time. The discoloration will gradually fade, and the nail will eventually grow out.

2. Nail Care: Maintain good hygiene by keeping the area clean and dry. Avoid any unnecessary trauma to the toe, as this could exacerbate the condition. If the nail is lifting significantly or if you notice any signs of infection (such as increased redness, warmth, or discharge), it is essential to seek medical attention.

3. Pain Management: If you experience any discomfort, over-the-counter pain relievers such as acetaminophen or ibuprofen can be used. However, since you are currently pain-free, this may not be necessary.

4. Medical Intervention: If the nail continues to protrude or if you develop pain, it may be necessary to consult a healthcare professional. They may consider draining the hematoma if it is causing significant pressure or discomfort. This procedure involves creating a small hole in the nail to relieve the pressure from the accumulated blood.

5. Nail Growth: As the nail grows out, the area of bruising will likely move towards the tip of the nail. It may take several months for the nail to fully grow out and for the appearance to normalize, depending on the rate of your nail growth.

6. Monitoring for Complications: Keep an eye on the nail for any changes. If you notice any signs of infection or if the nail begins to separate from the nail bed, it is crucial to seek medical advice promptly.

Conclusion
In summary, your current situation with the bruised toenail appears manageable, especially since you are not experiencing pain. Monitoring the injury while maintaining proper care is advisable. If you have any concerns about the appearance of the nail or if symptoms change, do not hesitate to consult a healthcare professional for further evaluation and management. Remember, nails grow slowly, and it may take time for the nail to return to its normal appearance.

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