Understanding and Managing Blue Toenails
Bruised toenails, also known as subungual hematomas, can result from sudden trauma or repeated minor injuries to the toenail. While usually benign, they can sometimes be a sign of a more serious foot condition. Here are three key points for understanding and effectively treating bruised toenails:
Causes of blue nails:
Blue toenails are usually caused by external trauma to the toes. The most common causes are:
1) Direct impact or crushing of the toes, resulting in rapid bleeding and potential pain and swelling.
2) Continuous minor injuries weakening the nail attachments and causing a subungual hematoma.
3) Improper cutting or maintenance of toenails.
4) Impact of heavy objects on the toe.
5) Toe fractures resulting in blood pooling under the nail due to the proximity of the phalanges.
5) Toe fractures resulting in blood pooling under the nail due to the proximity of the phalanges.
(Reference: Kuo, FC, Lin, CY, Lu, HT and Chiu, HY (2020). Traumatic subungual hematoma. Dermatologic Therapy, 33(4), e13548. https://doi.org/10.1111/dth.13548)
Signs and symptoms:
Identifying a blue toenail is relatively simple, especially after a painful shock. The most common symptoms are:
1) Severe pain in the affected toe.
2) Discoloration of the nail, ranging from blue to purple, black and sometimes green.
3) Pulsating sensation in the affected area due to underlying blood circulation.
4) Sensitivity to touch of the toe.
5) Swelling and pain around the nail.
6) Rarely, bleeding around the affected toe.
2) Discoloration of the nail, ranging from blue to purple, black and sometimes green.
3) Pulsating sensation in the affected area due to underlying blood circulation.
4) Sensitivity to touch of the toe.
5) Swelling and pain around the nail.
6) Rarely, bleeding around the affected toe.
(Reference: Nishio, J. (2019). Clinical features and pathophysiology of traumatic subungual hematomas. Clinics in Podiatric Medicine and Surgery, 36(4), 571-580. https://doi.org/10.1016/j.cpm.2019.05.007)
Treatment and prevention:
Immediate care after trauma includes:
1) Rinse the affected toe with cold water for about ten minutes to stop the bleeding and relieve the pain.
2) Take mild pain relievers if necessary.
3) Apply antibiotic cream to prevent infections.
4) If symptoms persist or worsen after a few days, it is advisable to consult a podiatrist. Professional treatment may include draining accumulated blood and treating any underlying problems.
(Reference: Bhosale, SK and Desai, S. (2021). Management of traumatic subungual hematoma. Journal of Foot and Ankle Surgery, 60(6), 1093-1097. https://doi.org/10.1053/j.jfas.2020.12.004)
Conclusion :
Managing blue toenails requires prompt attention, proper care, and preventative measures to ensure foot health and comfort. If symptoms persist or are severe, it is essential to consult a healthcare professional for an accurate diagnosis and treatment.
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