What Causes Black Toenails?

What Causes Black Toenails?

When a body part has 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 nail bed 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, but it also generates a tremendous amount of pressure, which leads to intense pain.

What makes a toenail to turn black?

Naturally, toenails are white in color. Discolorations occur by different factors such as nail polish, infection, lack of proper nutrition or trauma.

There are also other causes of toenail discoloration such as nail polish, lack of proper nutrition, injury or trauma. Discolored toenails can be attributed to several different factors, but they usually heal by themselves. 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:

  • An underlying illness or any medical condition – This may include anemia, diabetes, heart disease, or kidney disease.
  • Fungal infections – Usually, fungal infections cause toenails to become yellow. But sometimes fungal infections set in as a result of a buildup of dirt that has been ignored for a long time. Your toenails are especially susceptible to fungal infections because they love to grow on warm and moist surroundings.
  • Melanoma – Subungual melanoma is a type of melanoma (skin cancer) which occurs under the toenail. Streaks of dark color under your toenail may be an indication of subungal melanoma.
  • Trauma – Trauma, usually brought by injury, causes damage to the blood vessels. This results to the discoloration of the toenails. 

What are the symptoms to pay attention to?

Symptoms of a black toenail may include:

  • Discoloration, which may be reddish, purple, brownish or black
  • Pain
  • Foul odor
  • Discharge from underneath the nail

Although symptoms are not always present, there is a wide range of symptoms which can occur. The  pain may be associated with any of the above-mentioned causes especially when there’s a infection.

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, they can be prevented. Here are some tips to help you prevent having black toenails:

  • Keep toenails trimmed properly by cutting them across, but not too straight.
  • 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?

Usually, a black toenail will fall off eventually and a new nail will grow in its place. In this case, you may not to seek medical treatment right away if you don’t feel any pain, or don’t notice any indications that your foot is infected (such as persistently foul odor, discharge, pus, etc.).

If the blackened toenail is left untreated, this can lead to a bone infection which requires prolonged IV antibiotic medication. It can even lead to incorrect re-growth of new nails or worse, amputation. If you have grown concerned towards your discolored toenails, call your doctor and make an appointment immediately.

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?
  • Does my toenail change its colors as it heals?
  • Are there any other symptoms that I should expect that indicate that treatments are not working?
  • How long should I wait to contact you for a follow-up?
  • How long will it take for my nail to get back to its normal shape and color?
  • Should I opt for artificial toenail if my nail won’t grow back in a way that I like?
  • What are the chances that this problem may occur again?
  • Would I be able to drain blood at home?
  • Do I need to worry about anything malignant?
  • Are there any topical or oral medications to prevent black toenails?

How are black toenails diagnosed?

In most circumstances, a visit to your podiatrist will be simple and for reassurance only. He or she will check to ensure that you that your affected toenails won’t have any fractures, any underlying infections or won’t need any more medical intervention.

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 your discolored toenail is caused by trauma, it depends on the type, how severe the injury is, and how much of your toenail is discolored. If the discoloration is severe, your podiatrist may decide to extract the affected nail to examine any open cuts, or examine any exposed bone.

If your blackened toenail is not a cause of outside factors or injury and you have noticed that it has discolored persistently, your podiatrist or doctor will have to order certain tests which may include biopsy.

Black Toenail Treatment Options

In some cases, you don’t have to seek medical treatment especially if your discolored toenail is a result of a trauma. In such cases, your black toenail will eventually fall off on its own or grow out.

But if you are still unsure, you should consult your podiatrist immediately. He or she will determine what has caused your toenails to darken, and how severe the discoloration has become.

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 is removed and then cleaned to prevent the clotting of blood (hematoma).
  • 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. Usually, it takes months for an affected toenail to completely heal and grow back pretty much to the way it once was, as toenails have a tendency to grow about 3 millimeters a month.