Toenail Trauma: What Happens If You Ignore a Bruise Under the Nail?

Stubbed your toe or dropped something heavy on it?

We’ve all been there—sharp pain, a muttered “ouch,” and then the slow, dark appearance of a bruise under the nail. It’s easy to shrug it off, especially if the pain fades after a day or two. But leaving a bruised toenail untreated can sometimes lead to more trouble than you’d expect.

What Causes a Toenail Bruise?

A bruise under the nail, known as a subungual haematoma, happens when tiny blood vessels under your toenail burst due to impact. The trapped blood creates that purple, blue, or black discolouration you see.

Common causes include:

• Dropping something heavy on your toe

• Stubbing your toe against a hard surface

• Repeated pressure from tight shoes

• Sports injuries, especially in running or football

When a Bruise Is More Than Just a Bruise

Most nail bruises are harmless and grow out over time, but sometimes the damage runs deeper:

• Nail lift or loss – The pressure from pooled blood can separate the nail from the nail bed.

• Persistent pain or swelling – May signal a fracture in the toe bone.

• Infection risk – A lifted or cracked nail can allow bacteria or fungus to enter.

• Hidden injuries – Sometimes a bruise is the only sign of deeper tissue or joint damage.

Possible Complications of Ignoring It

If left untreated, a bruised nail can lead to:

• Long-term nail deformity (thickened, ridged, or misshapen nails)

• Ongoing tenderness and pressure pain in shoes

• Fungal infections if the nail is damaged and vulnerable

• In rare cases, a chronic subungual haematoma could be mistaken for—or mask—skin cancer under the nail

When to Seek Professional Help

See a podiatrist or foot pain specialist if you notice:

• Severe pain or swelling

• The bruise covers more than 25% of the nail

• The nail is loose or completely lifted

• Discolouration that isn’t improving after a few weeks

• Signs of infection like redness, pus, or warmth

At Birtley Foot Clinic, we can safely relieve pressure under the nail, assess for fractures, and reduce the risk of long-term damage or infection.

Helping Your Toe Heal

While you wait for the nail to grow out (which can take several months), you can:

• Wear roomy, comfortable shoes to avoid pressure

• Keep the area clean and dry

• Avoid picking at or trimming the nail too short

• Protect the toe from further knocks

A bruised toenail might not seem like a big deal, but ignoring it can lead to lasting problems. Getting it checked early is quick, often painless, and can save you months of discomfort. If you’ve got a stubborn or painful nail bruise, book an appointment with a Foot Pain Specialist in Birtley—your future self (and your toenail) will thank you.