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toenail is black and blue

by Brooke
(Pennsylvania)

At the end of June, I stubbed the toe next to my big toe. Right where the nail begins to grow. It's now September, and it's still black and blue at the top. It doesn't hurt or bleed or anything, it's just ugly. What should I do?


ANSWER

Hi Brooke,

When there is trauma to a nail such as in your case of stubbing it, what happens is there may be bleeding underneath the nail as the result of the nail being jammed back into the toe, thus lifting the nail slightly and causing it to bleed.
In more severe cases there can be so much bleeding that pain can ensue as well as the possibility of infection.
Your case is the more common situation. We also see this in runners, tennis players, basketball players, etc. where the constant jamming of the toe into the sneaker causes the same effect.
Here is what I would recommend.
If the toes does not hurt leave it alone. Nails can take months to fully grow out. What you should be seeing is a gradual movement forward of the discoloration with clear nail behind it.
Eventually the discolored nail will grow forward and will be replaced by normal nail.
Now, if for some reason this does not occur with you then you will need to have the nail examined by a podiatrist.
Since there was a history of trauma, it is same to assume that the discoloration was the result of the trauma, however, in some cases discoloration of the nail can be due to a growth on the nail bed.
So over time if the nail does not improve, the nail may have to be removed in order for the doctor to examine the nail bed to make sure there is nothing abnormal going on.
Again, because of the history of trauma, I do not think there is a growth on the nail bed, but the trauma may have damaged the growth plate of the nail and that may have to be explored as well.
It is now about three months since the trauma. I would give it another two months or so. If the nail does not appear to be improving then it might be time for a podiatrist to take a look at it to make sure there is nothing else going on.
Because the problem is occurring underneath the nail there is nothing you can really do for it on your own, other than applying nail polish to cover the discoloration.
As a side note, if you eventually have to seek medical care make sure you remove any nail polish prior to the visit.

Marc Mitnick DPM
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