What to Know About Fingernail and Toenail Injuries

June 21, 2021
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Dr. Jerry Williams of Urgent Care 24/7 discusses subungual hematomas.

What does that mean? When you hit your finger with a hammer, and you get the bruise or the collection of blood underneath your nail, and it throbs horribly when you get the injury, or when you stub your toe, that collection of blood or that hematoma, as we call it, underneath the nail is a subungual hematoma. While it’s a pretty innocuous injury, it can be extremely painful, and throbbing and problematic. If you’re watching this video right now, maybe you or a loved one, or friend has an acute subungual hematoma.

There also can be unsightly because it takes a long time for the nail to grow out and for the blood collection to be cleared, and grow out from underneath the nail bed. So we’re going to talk to you about how we treat these hopefully give you some help, and you can actually do this at home, though. It’s not for the faint at heart. So let’s talk about that.

Let’s say you hit your finger with a hammer, and you’ve got an immediate onset of throbbing and you can see the blood collection underneath the nail, actually, what you can do is you can take a needle and heat a needle, like a sewing needle, and heat it and you can actually burn a hole through your nail. That will allow the blood to come up out of the nail and you can express the blood through that hole out from under your nail and you’ll get instantaneous relief from the pressure and the throbbing. Now again, you’ve got to be very careful because you don’t want to burn a hole through your nail and then burn a hole into your nail bed, the scarring your nail bed permanently. Some people actually use a hypodermic needle that is used for injections. They can actually drill a hole into the nail not burn a hole through the nail and allow again, that same relief of the blood out from underneath the nail bed.

Dr. Williams has done these many, many times for patients. When you do that, immediately the blood literally will just squirt out of the hole as soon as you break the whole break through the nail. This gives amazing relief and then we’ll put an antibiotic ointment such as a triple antibiotic ointment petroleum based and cover with a band aid and allow it give it a chance to heal. It can really be a game changer with pain control especially when when when someone gets a subungual hematoma, and it actually makes them much less unsightly.

If you can drain that blood out from underneath the nail bed immediately, you’re not left with that blue black discoloration underneath the nail for four months until it can clear so there’s some cosmetic benefit to route to releasing the blood from underneath the nail allowing it to drain. That is a benefit as well. So that’s subungual hematomas an unpleasant injury. Dr. Williams hopes that’s helpful to you, he looks forward to seeing you again on another medical chat.


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