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.
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
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.
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
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.
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.
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