Black Toenails

It’s not all that unusual for toenails to take on colors other than their natural hue. However, we hope that if one of your toenails takes on a dark purplish, reddish, brownish, or black appearance it’s because of the nail polish and not from a foot infection or injury!

Unfortunately, toenails can sometimes become discolored for a variety of reasons. If you notice a blackened toenail, whether you have any other obvious symptoms or not, it may be a good idea to keep an eye on it or get it checked out by a professional. While some black toenails are minor annoyances, others can cause significant problems if left untreated.

causes of black toenails

Possible Causes of Black Toenails

By far the most common cause of black toenails is repetitive trauma. This typically occurs as a result of the nail banging against the top of your shoe repeatedly during activity, such as running or other sports. These constant small impacts eventually lead to a bruise underneath the nail. Shoes that are too tight (particularly in the toe box) or too lose (which allows them to slide around) are common culprits.

In other cases, the discoloration could be the result of blood pooling under the nail, also known as a subungual hematoma. This sort of injury could also be the result of repetitive impacts, although it could also occur as a result of a single traumatic episode—a stubbed toe, perhaps, or dropping a heavy object.

Fungal infections can also lead to nail discoloration. Most fungal toenail infections take on a more yellowish appearance, but sometimes the nail turns darker.

The rarest, but by far the most dangerous, possible cause is melanoma, an aggressive form of skin cancer. Early detection and treatment of melanoma is absolutely imperative in order to achieve a good result, so if you notice dark spots under your nail that don’t go away and have no obvious cause, get it checked as soon as you can.

Black Toenail Symptoms

In minor cases due to repetitive trauma, you may not notice anything apart from the discoloration (which may be black or a dark reddish, purplish, or brownish hue). However, there may be significant pain (especially in cases of subungual hematoma), odor, or discharge. The toenail may or may not fall off eventually.

If a fungal infection is at play, common symptoms include nails that are thickened, crumbly, ragged, or warped.

Fixing Black Toenails

Not all cases will require treatment—black toenails with only minor bruising may eventually return to normal after adequate rest.

However, black toenails that are painful or show any signs of bleeding or infection should be checked by a specialist, if only to rule out the need for more aggressive care. A cut that becomes infected or an undiagnosed melanoma can pose major health problems, so you don’t want to take chances.

Pooling blood should be carefully drained to relieve the discomfort and pressure. In some cases, we’ll want to remove the entire nail in order to further examine or treat the underlying problem; in others it may be sufficient to drain the fluid through a small hole in the nail made by a sterile needle. Once you’re home, periodic foot soaks with Epsom salt and application of antibiotic ointment and clean bandages for a period of time may be recommended.

In the rare cases where the discoloration was caused by fungal infections of cancer, we’ll apply treatment protocols more appropriate for those causes.

Preventing Black Toenails

The best treatment is prevention. If you find yourself regularly winding up with black toenails, you might consider if your situation improves by following some of these guidelines:

·         Keep toenails neatly trimmed, straight across corner-to-corner, and not too short.

·         Make sure your shoes offer plenty of space in the toe box.

·         Wear protective shoes, especially when working or moving heavy objects.

·         Try to avoid walking barefoot.

·         Keep feet clean and dry and inspect them regularly.

Whatever may be causing your toenails to take on a darker hue, you can put your mind at ease and get the help you need by setting an appointment with Dr. Keith McSpadden at North Austin Foot & Ankle Institute. A professional evaluation will help you determine if any further action is necessary, and if so, develop the proper strategy to address the problem. You can request an appointment online, or you can give us a call at 512-593-2949.