Why Is My Toenail Black and Thick? Causes and Solutions - Dermatology

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When you notice that your toenail has become black and thick, it can be concerning and uncomfortable, especially if it is accompanied by pain and swelling after activities like jogging. There are several potential causes for these symptoms, and understanding them can help you determine the best course of action.

One of the most common reasons for a black toenail is a condition known as a subungual hematoma. This occurs when there is bleeding under the nail, often due to trauma or injury, such as stubbing your toe or wearing tight shoes. The blood collects and causes the nail to appear black. If the hematoma is large, it can also lead to increased pressure under the nail, causing pain and discomfort.

Another possibility is a fungal infection, which can cause the toenail to thicken and discolor. Fungal infections often lead to changes in the texture and color of the nail, making it appear yellow, brown, or black. If the nail is thickening and becoming discolored without any known trauma, a fungal infection could be the culprit.

In some cases, a black toenail can be a sign of a more serious condition, such as melanoma, a type of skin cancer that can develop under the nail. While this is less common, it is crucial to monitor any changes in the nail's appearance, especially if you notice other symptoms such as changes in the surrounding skin or persistent pain.

Given your situation, where the toenail has changed color and thickness, and you are experiencing pain and swelling, it is essential to seek medical attention. A healthcare professional can perform a thorough examination, possibly including imaging studies or a biopsy, to determine the exact cause of your symptoms.
In terms of treatment, if the issue is due to a subungual hematoma, the doctor may need to relieve the pressure by draining the blood from under the nail. If a fungal infection is diagnosed, antifungal medications may be prescribed, either topical or oral, depending on the severity of the infection.
For prevention, wearing properly fitting shoes that provide adequate space for your toes can help reduce the risk of trauma. Keeping your feet clean and dry can also help prevent fungal infections. If you are prone to toenail issues, regular foot care and monitoring any changes in your toenails can be beneficial.

In summary, a black and thick toenail can result from various causes, including trauma, fungal infections, or more serious conditions like melanoma. It is crucial to consult a healthcare professional for an accurate diagnosis and appropriate treatment. Ignoring the symptoms may lead to worsening conditions, so timely intervention is key to maintaining foot health.