What Causes Black Toenails?
When a body part is a different color than normal, this can be a clear indication that something is wrong. Such is the case with having black toenails. In this condition, the soft tissue in your nailbed has either become bruised, started bleeding, or is possibly displaying a sign of cancer.
This condition not only causes the nail to become black or discolored, it also generates a tremendous amount of pressure, which leads to intense pain.
What makes a toenail turn black?
Naturally, toenails are white in color. Sometimes, discolorations can occur from nail polish, nutritional deficiencies, infection or trauma. Black toenails are attributed to a variety of causes, some of which resolve on their own. If your nail doesn’t get better, you will need to see your doctor to rule out a more serious cause of black toenail.
What causes black toenail?
A black toenail may be caused by:
- Underlying medical condition – This may include anemia, diabetes, heart disease, or kidney disease.
- Fungal Infections – While these often look white or yellow, fungal infections can sometimes cause black toenails from debris buildup. Your toenails are especially vulnerable to fungal infections because they thrive on moist and warm environments.
- Melanoma – This is the most serious type of skin cancer. This often appears as a dark brown misshapen spot, and these spots can also occur underneath nail beds.
- Trauma – Usually caused by an injury, trauma to the toenail can cause the blood vessels beneath a nail to break. The resulting bleeding underneath the nail appears black in color.
What are the symptoms to pay attention to?
Symptoms of a black toenail may include:
- Discoloration, which may be reddish, purple, brownish or black
- Foul odor
- Discharge from underneath nail
Although symptoms are not always present, there are a wide range of symptoms which can occur. In this case of an underlying infection, there may be pain associated with redness, swelling, foul odor and discharge.
Due to the blood collection which causes the nail to separate from the nail bed, the nail comes loose and falls off on its own within days of the trauma.
Can Black Toenails be prevented?
Yes, it can be prevented. Here are some tips to help you prevent having black toenails:
- Keep toenails trimmed properly, not too short and straight across
- Wear properly fitting shoes. Shoes should offer a wide enough toe box which your toes are not pressed against one another
- Wear footwear that will protect your feet
- Be careful when moving heavy objects
- Try to avoid walking barefoot since this can make your toes and feet susceptible to injury or trauma
- Keep feet and nails clean and dry
- Always wear clean socks and shoes. Let shoes air out between uses.
- Treat any nail problems during their early stages
- Talk with a podiatrist about additional prevention tips
When to see a doctor?
Often, a black toenail will eventually fall off and regenerate on its own. You may not need to seek medical treatment right away if pain or signs of infection, such as pus, discharge, foul odor, fever, and chills are not present.
If left untreated, this condition can lead to a bone infection which will require long-term IV antibiotics and a possible amputation of the digit. If you are concerned, you should call your doctor and make an appointment.
Here are some questions you may want to ask your doctor about black toenails:
- How likely is it that my black toenail will fall off and regrown without treatment?
- Will my toenail change other colors while it is healing?
- What other symptoms should I watch for that may indicate treatment is not working?
- How long should I wait to contact you for a follow-up?
- How long will it take for my nail to return to its normal shape and color?
- Are there any options for cosmetic nails if my nail does not grow back the way I like?
- What are the chances of this problem recur?
- Can I try to drain the blood at home?
- Do I need to worry about anything malignant?
- Is there any oral or tropical medication that I can take or apply to the nail to prevent further discoloration?
How are black toenails diagnosed?
In most circumstances, your visit to your podiatrist will be simple and for reassurance only. Your podiatrist will check to make sure you have no open or closed fractures of the affected toe, no underlying infection, and no need for further intervention.
If trauma was involved, depending on the type and severity of the injury and what percentage of the nail is discolored, you podiatrist may decide to remove your nail in order to examine the nail bed for lacerations and exposed bone.
If you have not been injured and have noticed progressive discoloration, your doctor will need to order specific tests, possibly including a biopsy.
Black Toenail Treatment Options
In some cases, medical treatment is unnecessary, especially if minor trauma was involved. In these cases, the black toenail will eventually fall off on its own or grow out. If you are in doubt, however, you should make an appointment with a podiatrist. Your podiatrist will determine the cause and severity of the problem, which will determine the treatment he or she recommends.
If your doctor does not see a need for medication or drainage, the nail may be left alone to heal on its own. On the other hand, if the injury is cause for concern a local anesthetic will be administered and the nail will be removed for examination of the nail bed.
If a laceration is present it will have to be washed out and possible 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, thereby removing the hematoma. In some instances, the nail may be replaced on the nail bed as a protective barrier.
- Needle – A sterile large-gauge 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.
After treatment, you should expect the hole to remain in the nail until it grows out.
Your recovery time will depend on the severity of the injury, the type of treatment used and how well you respond to treatment. On average, black toenails can take up to a few months to completely heal and return to normal, as nails tend to grow at a rate of approximately 3mm a month.