Ow, ow, ow, bloody ow…!
About fifteen minutes ago, a can of soda fell off the top shelf of the fridge and landed smack on top of my big toe. I’ve iced it down and have quelled the urge to kill every soda drinker in the house, but the lower half of my big toenail is now a lovely shade of dark purple. Interesting. I’ve heard that injuries that result in a black toenail sometimes mean the loss of the toenail. Is that common?
I don’t know how common it is but it certainly happens. I’ve lost a few toenails from ill-fitting climbing shoes and also from long distance running. If it happens gradually (as opposed to trauma ripping the nail off) it’s not really painful although it is as you might imagine a bit gross.
Keep an eye on it, see a doctor especially if the nail starts loosening or coming off. In the past I’ve had one time where a podiatrist just clipped the big toenail right off - it didn’t hurt at all, the nailbed underneath was not sensitive, I had to keep it clean (using amongst other things a bit of bleach scouring powder at the doctor’s suggestion) and applied Lotrimin to keep fungus from growing. I’ve dealt with the loss of the smaller toenails myself with no problems (treat as any open wound - keep it clean, bandaged, etc).
I had that happen when I was five, I slammed a door on my toe. It turned black pretty fast and afterwards it only hurt a little. After about a week I could see it shifting because a new nail was growing under it. It took a few weeks but eventually it just kind of lifted off, didn’t hurt at all, and I had a nice new toenail under it. It freaked me out to look at it while it was black, though. Haven’t done it since (see, I did learn something!) but the thought of it kinda squicks me out.
Hope you don’t have any problems with it.
Like Valgard, I have lost my fair share of toenails due to running. Hasn’t happened in a couple of years, so perhaps I have found the perfect shoe.
Based on my own observations…
It seems that a running related black toenail is basically one giant blister that is under the entire nail, down to the base. After a day or so of throbbing, the nail just starts getting loose like a loose tooth and one day I simply rip it out. I have found that there really is no way to keep a black nail that was caused by running.
A “trauma-induced” black nail is a different creature altogether. These usually have a black area that does not cover the entire nail.
The question of whether the nail will fall off depends much on whether the black extends below the base of the nail, where new growth happens. If it doesn’t, then you should be able to keep trimming off the black as the nail grows. Just make sure you don’t catch the nail when you put on a pair of jeans.
I’ve never had a nail turn black and not had it fall off eventually (although in one case it took quite a while). These were all trauma-induced (stubbing, mostly).
Morning and renewing the litany of “ow, ow, ow”.
Most of the nail is black this morning and throbbing, so I’m guessing there’s a nice amount of blood trapped under there, well down to the base. Think I’ll be having a couple of ibuprofen with breakfast.
Thanks for the advice, all. If this thing isn’t feeling better by tomorrow, time for a trip to the doc.
Nails grow out along a soft nailbed to which the hard part of the nail is attached. Blunt injury can cause bleeding between the nailbed and the nail, loosening the nail. If this is extensive enough, the nail will eventually dislodge and either fall off on its own or be so loose it can be readily pulled away.
A new nail will grow out unless the germinal cells themselves are seriously injured. As long as the nailbed is not seriously disrupted (and this usually only happens with sharp trauma, the new nail will be normal.
Sometimes enough blood is trapped underneath the nail to create additional pain because of the pressure of the blood pooling under there. In those cases, a trephination through the nail–OK; a hole, but trephination sounds fancier–might relieve some of the pain. This can be done with a small drill or a heated point. While it seems that a hot point–a paper clip or a cautery, e.g.–might be painful, in good hands the point cools from the pool of blood as soon as it penetrates the nail. This hole lets the blood out, decreases the pressure and can provide symptomatic relief.
I usually leave the nail in place for a while, and even secure it with a bandage because it gives the initially tender nailbed a chance to harden up a bit before facing the cruel outside world. For nails that are ripped off traumatically, we usually trim them up a bit, clean them, and replace them (temporarily) back into the germinal groove. This helps the healing a bit by protecting the nailbed as well as preventing distortion of the germinal center line (so the new nail doesn’t grow in crooked).
Do you mean, the nail fell off (as in, you don’t have a nail any more) or the black part fell off?
I got a couple squished fingers as a kid, where the nail turned purple (basically, from the blood trapped underneath), but I fully recovered.
It sounds like it bled underneath the toenail. The bad part now is even when it’s healed up, you’re going to have to wait till the toenail grows out before the black/blue blood will no longer show.
I did this just last year. And it took a full year for the toenail to grow and for the blood (black/blue color) not to show.
Naw, save yourself a trip to the doc and the cost. Just get an electric drill with a small bit and drill a few holes in the nail to relieve the pressure. Be strong! 
The nail itself fell off.
Good information so far, though I’ll say the hole-in-the-nail thing is not universally accepted.
One more thing: Don’t rush the loss of the nail. It’s terribly tempting to yank it off when it seems ready, but don’t do it! Keep the end of the nail cut close, so your socks and bedsheets don’t snag it. Be patient! If you rush the removal, you’ll end up doing it twice, and that’s a waste of time. :smack:
The entire nail falls off. I lost my pinky toenail while playing soccer in my sneakers and kicking the goal post.
I was sitting in the bath tub and suddenly saw my toenail floating by. :eek: I was about 9 at the time and was super-bummed out because I thought I was going to have a naked pinky toe forever. It grew back though.
I used to do ballet, and dancing on pointe resulted in NUMEROUS bruised toenails, a lot of which fell off (but we carry our whole body weight on the tips of our toes, so the bruising is more severe than what you would get by just dropping a can of soda on it). We would usually just wrap the toe with paper tape to keep the nail in place until it detaches. The method using a heated paperclip that Chief Pendant described was also used… although, it has to be done pretty quickly after getting the bruise (before the blood dries up).
I wouldn’t consider it particularly controversial.
Appropriate candidates present within 24 hours or so and have clear elevation of the nail casued by pooled subungual blood. It’s not enough just to have a subungual ecchymosis (bruise)–you want to be confident there is a pool of blood and that the pressure from this blood is increasing the pain.
If you choose your patients correctly, there is significant relief. I never had any complications–or complaints–from doing this with my patients.
*“Nail trephination was performed using electrocautery, and all patients reported relief of pain after the procedure. Follow-up was achieved in 45 of 48 patients with a total of 47 SUH. Average follow-up period was 10.3 +/- 4.3 months. By patient history, average time for the nail to grow back was 4.0 +/- 2.6 months. No complications of infection, osteomyelitis, or major nail deformities occurred in any patients treated by nail trephination, regardless of SUH size or presence of fracture.” * e.g.
Everyone else has good information and advice but some toenails can take a LONG time to grow back. I lost my big toenails twice while running and it took about 9 months each time for them to fully recover. It didn’t hurt much or cause any problems though. I always assumed that nails grew from back to front but they don’t. Lost nails grow up from the nailbed so you have some type of toenail very soon. They just look kind of screwy for a while.
You most likely have a subungual hematoma—bleeding between the nail plate and underlying nail bed. If you feel confident as a bathroom surgeon, try the trephination technique, as Chief Pedant described. A heated paper clip works as well as anything and is unlikely to introduce infection. Remember that the blood, being under pressure (which causes the pain, in most cases), may likely squirt out, sometimes a considerable distance once you breach the nail plate. So have a 4 x 4” gauze handy and don’t wear your expensive white suit during the procedure. Put a dollop of topical antibiotic and a dressing, under mild compression, on the wound and keep it dry for a couple of days. If pain persists, have the toe X-rayed for possible fracture of the distal phalanx (no big deal unless it extends into the joint). You’ll probably lose the nail and it will take a couple of months to grow back (toenails typically take twice as long to grow as finger nails). If you did considerable trauma to the nail matrix (from whence nails grow), you may be stuck with a deformed nail—but, that’s unlikely.
It’s not nearly as painful as it was this morning, but the front of the nail is definitely being lifted off of the nailbed from the blood beneath. That was quick. I’m not squeemish about trephaning-- I’ve been helping to patch up critters for a while, so no issues with blood. About how long do you need to heat the paperclip, though? I’ve tried it a couple of times already and it’s not making any impression on my nail.
In my experience, you just use a lighter until it is extremely hot and changes color.
Annnd done. That was painless. Alas, no spurting, just a steady trickle for a few seconds. Feels a bit better though.
…I should definitely feel weirder updating people about the status of my gnarly toenail.