How To Heal A Bruised Toenail

If you’ve ever stubbed your toe and ended up with a bruised, black and blue toenail, you know how painful it can be. A bruised toenail not only looks bad, but it can throb and ache for weeks. Luckily, there are several steps you can take to help your bruised toenail heal faster and reduce pain in the process.

In this comprehensive guide, we’ll walk through everything you need to know about treating a bruised toenail and nursing it back to health.

If you’re short on time, here’s a quick answer to your question: Apply ice right after injury to reduce swelling and pain. Bandage the toe to protect it. Soak the foot in warm water with Epsom salt. Apply antibiotic ointment daily. Take over-the-counter pain medication as needed.

If the toenail falls off, let the new nail grow in naturally.

What Causes a Bruised Toenail

Common Causes of Toenail Trauma

Toenails can easily become bruised and discolored from repeated trauma. Some of the most common causes of toenail bruising include:

• Stubbing your toe – Stubbing or jamming your toe, especially into hard objects like furniture or door frames, can cause blood vessels under the nail to rupture and lead to bruising.
• Ill-fitting shoes – Shoes that are too tight, narrow, or short can put excess pressure on the toenails and cause bruising over time. High heels and pointed toe styles are common culprits.
• Ingrown toenails – When the edges of the toenail grow into the surrounding skin instead of over it, it causes irritation and inflammation that can lead to bruising.
• Dropping objects on your feet – Heavy objects like books or weights that land on the toenails can instantly cause bruising and blood vessel damage.
• Pedicures – Overly aggressive filing, trimming or pushing back the cuticles can injure the nail bed and cause bruising around or under the nails.
• Toenail fungal infections – Fungal infections that get under the nail can cause it to detach and become bruised underneath.
• Sports injuries – Certain sports like football, soccer, tennis, and running carry a higher risk of trauma directly to the toenails.

In most cases, toenail bruising is the direct result of blunt force trauma damaging the blood vessels underneath the nail. The toes are especially vulnerable to injury because the nails extend beyond the fleshy tip of the digits.

Why It Bruises and Turns Colors

When the tiny blood vessels under the toenail are damaged, blood leaks out and pools within the surrounding nail bed tissue. This causes the nail itself to change colors as the trapped blood oxidizes and breaks down.

At first, a bruised toenail may appear red, blue, or purple as fresh blood accumulates underneath. Over the next few days, those colors will fade to brown, black, or greyish-yellow as the bruise progresses through the healing stages.

The discoloration may start at the point of impact on the nail and spread outward over time. In severe cases, the entire nail can become bruised, detached and discolored. It takes around 6-12 months for a bruised nail to fully grow out and be replaced with healthy new nail tissue.

If a hematoma, or pocket of clotted blood, forms under the nail, it can create pressure and throbbing pain until it is drained. Seeking prompt medical treatment for a bruised toenail can help relieve these uncomfortable symptoms.

With proper care and protection of the sensitive toenails, most minor bruises will heal on their own. However, severely damaged nails may fall off completely. Consulting a podiatrist can help determine the right treatment to promote proper regrowth.

Treating a Bruised Toenail – First 48 Hours

Apply Ice to Reduce Swelling

One of the best ways to treat a bruised toenail in the first 48 hours after injury is to apply ice to reduce swelling and pain. Wrap some ice cubes or a cold pack in a thin towel and gently press it against the bruised toe for 10-15 minutes every few hours.

The cold temperature constricts blood vessels and inhibits inflammation. Icing the toe helps minimize pain, redness, and swelling during the initial healing phase. Just be careful not to apply ice directly on the skin, as it can cause frostbites.

Elevate the Foot

Keeping the bruised toenail above the level of your heart is another effective way to curb swelling in the delicate tissues of the injured toe. Gravity will naturally pull excess fluid away from the toe when it is elevated. Try propping your foot up on a pillow when you are sitting or lying down.

The higher you can elevate the foot, the better. Leave it elevated as much as possible in the first 48 hours after bruising the toenail.

Take Over-The-Counter Pain Medication

Most bruised toenails are accompanied by throbbing pain and tenderness, especially when any pressure is applied to the nail. Taking an over-the-counter nonsteroidal anti-inflammatory drug like ibuprofen (Advil, Motrin) or naproxen (Aleve) provides relief by reducing inflammation and pain signals.

Follow dosage instructions carefully. You can alternate the OTC meds with acetaminophen (Tylenol) for additional pain management in the acute injury phase.

Bandage the Toe

Bandaging and buddy taping the bruised toenail protects it from further injury as it begins to heal. Carefully place a small bandage or piece of gauze over the nail, being cautious not to press on the tender tissues underneath.

Then use medical or athletic tape to gently secure the injured toe to the adjacent toe for stability and support. The buddy taping helps limit mobility of the bruised nail, which reduces pain and chance of reinjury. Leave the bandage on for a few days, changing it daily.

Caring for a Bruised Toenail – After 48 Hours

Soak the Foot in Warm Water

After a couple of days, the bruising and swelling should start going down. Help speed up the healing process by soaking your foot in warm water for 10-15 minutes a few times a day. The warmth increases blood flow, reducing swelling and soothing pain (source).

You can make a warm foot soak by mixing a tablespoon of Epsom salts in a large basin or bucket of warm water. The magnesium in Epsom salts may help alleviate soreness.

Apply Antibiotic Ointment

It’s important to watch for signs of infection as the nail heals, which can include increasing pain, redness, foul odor, and green or yellow drainage. If you notice infection setting in, clean the area gently with mild soap and apply an over-the-counter antibiotic ointment like Neosporin twice a day.

The antibiotics will fight bacteria and help prevent the nail infection from worsening (source).

Trim Loose Nail Pieces

Around 2-3 days after the initial injury, you may see the bruised part of the nail start to detach from the nail bed as new nail grows underneath. Use sterile nail clippers to gently trim off any loose pieces of toenail, being very careful not to pull at nail still attached.

Removing dead nail tissue facilitates healing and prevents torn nails from snagging on socks.

Protect the Toenail

To protect the healing nail from further impact over the next several weeks, consider wearing open-toed shoes or sandals if weather permits. If you must wear closed-toe shoes, cushion the nail by placing a small piece of cotton or soft gauze under and over the nail before putting on socks and shoes.

Also avoid any athletic activities that could result in stubbed or jammed toes until the bruised nail fully heals.

Signs of Infection

When a toenail is bruised, it’s important to watch for signs of infection as the area heals. An infection can lead to serious complications if left untreated. Monitoring for infection warning signs allows prompt medical care if needed. Here are main symptoms that signal a bruise is becoming infected.

Increased Redness and Swelling

As a bruised toenail starts mending, some redness and puffiness around the nail is normal initially. But if the redness spreads and swelling worsens or persists beyond a few days, an infection may be brewing. The skin near the nail may become hot and increasingly tender to the touch.

The cuticle area in particular is prone to infection, so keep an eye on that region.

Pus Draining from Nail

Perhaps the surest sign of infection is discharge of fluid or material from the fingernail. Yellow, green or bloody pus draining from the cuticle or out from under the nail signals bacteria have invaded. Likewise, any foul-smelling discharge is a red flag for infection.

Do not squeeze or puncture the nail if you see exudate, as this can worsen the infection. Rather, promptly seek medical assessment.

Foul Odor

Along with observable discharge, a bad or rotten odor around the toenail can indicate infection. Bacteria release waste products that smell unpleasant. “If it smells bad, it probably is bad” is a good rule of thumb. The stench is often described as an ammonia-like or stale scent.

Trust your nose – if the nail starts to stink, infection is likely brewing.

Fevers or Chills

Systemic signs like fevers and chills can accompany a localized skin infection. If the toenail area is reddened, swollen or oozing, and is coupled with an unexplained temperature over 100°F or fatigue and body aches, bacteria may have entered the bloodstream.

Monitor for flulike symptoms that emerge in tandem with increased nail irritation. Seek prompt medical evaluation for systemic symptoms, as antibiotic treatment may be needed.

Catching an infected nail early is key, as complications can arise rapidly. Left untreated, infection can destroy the nail bed and lead to permanent nail loss. Surgery or intravenous antibiotics may be necessary if neglected.

But prompt oral antibiotic therapy typically arrests infections before they progress. So be vigilant for signals of infection like increased swelling, secretions, odor and systemic symptoms. Call your doctor promptly if any suspicion of infection sets in.

According to recent statistics, toenail injuries become infected more often than fingernails (https://www.aafp.org/afp/2017/0615/p786.html). Reasons include thicker nail density, slower nail growth, and greater exposure to bacteria from shoes and socks.

So vigilance with toenail wounds is especially important.

When to See a Doctor

If Infected

If the bruised toenail becomes infected, it’s important to see a doctor right away. Signs of an infected toenail include increased pain, redness, swelling, warmth around the toe, and pus or discharge coming from the nail.

An infected toenail can quickly spread to the rest of the foot and become serious, so prompt medical treatment is essential. The doctor will likely prescribe oral antibiotics to clear up the infection. They may also remove part or all of the nail to allow drainage and healing.

Don’t try to treat an infected toenail yourself at home – see a podiatrist right away.

If Entire Nail Falls Off

It’s quite common for an entire bruised toenail to fall off within 1-2 weeks after a trauma like stubbing or dropping something on the toe. The nail bed under the nail often remains intact, so a new toenail will regrow over the next several months.

However, if the entire toenail falls off and the nail bed is damaged, prompt medical care is recommended. The open nail bed is prone to infection. The doctor can properly clean and dress the open nail bed to prevent infection while the new nail grows in.

They may also prescribe antibiotics as a preventative measure.

If Pain Persists for Weeks

While moderate pain and soreness is normal with a bruised toenail, severe or worsening pain that persists for several weeks is not typical. Most bruised toenail pain improves within a couple weeks. Lingering, severe pain may indicate an underlying fracture or lasting damage to the nail bed.

See a podiatrist if toenail pain persists for more than 2-3 weeks after the initial injury. The doctor can perform x-rays to check for a fracture and determine if further treatment is needed.

For Cosmetic Correction

If a bruised toenail heals but leaves behind a misshapen, discolored or uneven nail, you may want to consider cosmetic correction. A podiatrist can safely remove the damaged part of the nail and shape the nail for a better aesthetic appearance.

This is considered a minor procedure and is typically performed under local anesthesia in the doctor’s office. While not medically necessary, it can greatly improve the look of the nail. Many patients opt for cosmetic correction of a bruised toenail if it looks significantly abnormal but is not causing discomfort.

Letting the Nail Grow Back

Be Patient

When you bruise your toenail, it’s important to be patient and give it time to grow out. Rushing the healing process can lead to more damage. Here are some tips for being patient as your nail recovers:

• Understand that it can take 6 months or longer for a bruised nail to grow out completely. Don’t try to rip off the damaged part of your nail – this will likely lead to more pain and prolong healing.
• Focus on keeping the nail and toe area clean and protected as the new nail grows in under the bruised area. Gently wash with soap and water.
• Wear open-toed shoes or sandals as much as possible to avoid pressure on the tender nail bed.
• Resist the urge to pick at the bruised nail. Picking can introduce bacteria and lead to infection.

Remember, patience is key. Letting your nail grow out on its own timeline is the safest way to ensure proper healing.

Keep Nail Groomed

Even though you’re letting your bruised toenail grow out, it’s still important to practice good nail care. Proper grooming can help the nail heal cleanly and prevent jagged edges or ingrown toenails.

• Use nail clippers or an emery board to gently file off any ragged edges as the new nail grows in.
• Clip nails straight across to avoid painful ingrown edges.
• Smooth rough surfaces with an emery board to prevent snagging on socks or further injury.
• Clean under nails daily with mild soap and water to prevent debris buildup.
• Apply an antiseptic ointment and bandage if area is tender or swollen.

Routine grooming removes dead nail tissue and encourages healthy regrowth. But be very gentle – no aggressive cutting or tearing. Let the bruised nail come off naturally.

Apply Vitamin E Oil

Applying vitamin E oil to the nail bed may help a bruised toenail heal. Vitamin E has antioxidant properties that can help repair damage. It also moisturizes the nail and cuticle to prevent painful cracking.

• Look for vitamin E oil at your local pharmacy or health food store. Make sure it’s designed for topical use.
• Use a clean cotton swab or finger to apply a small amount of oil directly onto the nail 1-2 times per day.
• Massage gently into the nail bed and cuticle area to increase absorption.
• The oil may help reduce throbbing pain and sensitivity as the new nail grows in.

You can also find vitamin E in some cuticle creams and nail strengtheners. Using these specially formulated products may be more effective than plain oil.

While vitamin E likely won’t speed healing, it can support the growth of a healthy new nail after bruising occurs. Be patient and diligent with application for best results.

Conclusion

With some simple at-home care, most bruised toenails will heal on their own over time. Try to keep pressure off the toe and keep it clean while the damaged nail grows out. See a doctor right away if you notice signs of infection. Otherwise, be patient and let the nail grow back naturally.

With proper care, your bruised toenail can return to normal.

Treating a bruised toenail may seem difficult, but just remember RICE – rest, ice, compression, and elevation. Keep the toe protected and let the bruised nail grow out over time. With diligent care, your toenail should heal and regenerate completely, good as new!