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Black spot under toenail

by Liz
(Leeds, West Yorkshire, United Kingdom)

dark spot under nail

dark spot under nail

dark spot under nail
black spot under nail

Some weeks ago I spotted a black spot under my toenail. First I though it might be a mole, as I am prone to getting new very often. Today I was taking my socks off and noticed that a second one appeared almost next to it. Both spots seem quite symmetric, and I do not have any type of discomfort. Could this be some type of nail infection?


RESPONSE

Hi Liz,

Sitting on the other side of the internet, I cannot pretend to know exactly what those black spots under your toe nail actually are, but I will give you some insight and what you can do about them.

The majority of spots that occur underneath a nail are harmless. In most cases it is dry blood usually from some sort of trauma to the nail bed. The trauma does not have to be as severe as dropping something on your toe or someone stepping on it. In many instances it is from repetitive micro trauma such as wearing a shoe with a narrow toe box thus creating too much pressure on the nail and it starts to bleed underneath. If you happen to be athletic, that too can create this type of micro trauma.

In many instances it can be mild bleeding from an irregularity on the nail bed, again usually from nail irritation.

Another very common cause of discoloration underneath a toe nail can be from fungus. I enlarged your pictures as best I could and it appears that the nail surrounding the two dark spots is discolored, which certainly may be fungus.

The third cause of discoloration under a nail bed is from a growth growing on the nail bed. This can range in most cases from a mole to a granuloma (which is scar tissue from irritation), all the way up to a skin cancer.

So now we know it could be any number of possible conditions, again most of them harmless, but keeping in the back of our mind that there is possibility of a more serious problem.

Here is my recommendation. Do nothing right away. Mark where the discoloration is today, relative to the skin on the side of the nail. Wait two months and see if the discoloration, both of them, grow forward, leaving no residual discoloration in the original spots.

The reason I recommend this is because the majority of harmless discolorations under a nail will grow forward as the nail grows. Eventually the discolorations will be at the end of the nail where it can then be cut away. That's the end of that.

Now, if the discoloration does not grow forward, there is a very good chance that there is a growth on the nail bed. Again, most of these are not serious problems, but at that point I would recommend seeing a doctor to have the nail removed to see what kind of growth may be on the nail bed. If the growth is suspicious it may have to be removed and biopsied. Although not common, skin cancers particularly melanoma can occur underneath a nail and this needs to be ruled out.

If during this two month period the discoloration appears to be getting larger, even if it may appear to be growing forward, that too would be a warning sign that there may be some sort of growth on the nail bed and it should be investigated.

Marc Mitnick DPM
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Oct 05, 2017
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How can I submit a question and photo?
by: Sandy

Im so sorry to bother u but i cannot sleep i am so worried its 12 43 am and i just noticed small black gray spots through out my toes im so shook i have two small children and cant run to the er to check it out please help me. Im scared
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Most nail discolorations are either from fungus or from bleeding underneath the nail and are harmless.
At your leisure go see a podiatrist or a dermatologist and have them checked out. Do not waste your time in the ER.

Marc Mitnick DPM

Sep 29, 2017
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Black dot under toenail
by: Brian

I have a small black dot under my nail on big toe looks like picture on this site. I also have a tremendous amount of pain on the whole outside of that same foot. Any ideas what that could be?

Sep 20, 2017
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My theory
by: Sally

I noticed a few years ago the same black spots under my big toe nail. I know it sounds crazy but I stick a pin into it, after a few seconds I took the pin out and the spot shot across my nail out of sight! Not sure if related but I do wonder as I get terrible pain in my joints. Just as one joint eases, another flares up. Could this be the little black horror passing around my body causing pain and discomfort? I've had blood tests done but nothing has ever shown up.. Just as the pain from my right knee subsided, I'm now in agony with my left shoulder (I struggle lifting my head up and down). Not sure what to do???

Aug 29, 2017
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Black spot
by: Dolly

Almost 3 weeks ago I wore shoes that squished my toes together. As a teacher I worked in them the whole day. A day later I noticed a black spot in the left corner of the nail, around where my toes were squished together.

Now the spot seems to be growing. Should I be concerned?
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My guess is it is just some bleeding under the nail and should grow forward. If it does not grow forward, or continues to get larger then I would recommend having a doctor look at it.

Marc Mitnick DPM

Feb 04, 2017
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Black spot and black line
by: Heidi

I have had a black line going diagonally across a middle toe in my left foot. I have kept an eye on it for about a year. For almost that entire time it remained stationary. About a month ago it appeared to have moved towards the top of the nail. I thought it was growing out. Then last night I took off my nail polish and noticed there is now a new, much larger black spot (the older one is a line) on the bottom of the toenail. Should I be concerned? The nail Is healthy sans the black spot and line and there is no discomfort of any kind.
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An enclosed picture would have been helpful, but the smart move here would be to have a podiatrist or a dermatologist take a look at it. In most cases it is nothing, BUT, you never know.
Go have it looked at by a doctor.
Marc Mitnick DPM

Feb 04, 2017
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Such a helpful forum
by: Heidi

Great content.


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Thanks for the kind words.

Marc Mitnick DPM

Apr 18, 2016
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Dark spots and discolored toenail
by: Frank

Hello I had a question about this same thing. I have two spots in the center of my toe nail (bigger than the one in the picture on this page) and just recently I noted overnight it seems to now have discolored the majority of the right side of my toenail. I've had the spots for a couple months but recently I've experienced more pain in the nail especially because I've been paying more attention to it. If I upload a picture here could you possibly lend a hand and let me know if this is serious or not. Im really concerned.

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The better move would be to see a local podiatrist or dermatologist as pictures can be deceiving.
Additionally, in my practice, I sometimes have to actually cut away a piece of the nail to see what is going on underneath.

Marc Mitnick DPM

Jan 15, 2015
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Two big toenail have black dot exactly same
by: Nhung - Vietnam

My sister yesterday take out her sock and show me her two feet will black dot quite same without hurt or conflict. We quite nervous when think about heart desease or skin cancer. We will keep eyes on it for some weeks. Let's look. Now it is middle of winter, hope that it result from wearing shoses.

Jan 06, 2015
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Reply
by: Liz

Hi! It did turn out the be a couple of small bruises under the toe nail, probably cause by some new running shoes I got. After a couple of months they grew out and I had no further issues.

Jan 05, 2015
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spots
by: Anonymous

Did you ever find out any more? I have 4 or 5 of these on the sole of my foot, but recently got into running so I wonder if that's the cause.

Oct 13, 2014
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I also have black dot...
by: Courtney

What did you ever find out about your black dot? I have had one under my toenail for about 1-2 months. It it something to worry about????? I have had some tenderness and pain with it as well.

Oct 07, 2014
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help?
by: Anonymous

hi was this ever looked further into? I have almost the exact same

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