Nail bruise (subungual hematoma)

About Nail bruise (subungual hematoma)

A bruise (hematoma) that develops under the fingernail after trauma to the finger. Bruises develop when small blood vessels under the nail tear or rupture. Blood leaks into tissues under the nail and causes the black-and-blue color. The blood becomes trapped under the nail and with time causes increasing pain and pressure.

Symptoms

Bluish-purple discoloration under the nail, pain that increases with passage of time, throbbing pain, finger swelling.

Tests & Diagnostics

A history and physical exam will be performed. An x-ray may be done to identify an associated fracture.

Common tests: X-ray.

Path 2 — Over-the-Counter Options

OTC sleep aids and supportive treatments

Path 3 — Prescription Options

Prescription medications

Conventional treatment summary

Drainage of the hematoma by drilling or burning a hole in the nail is the standard treatment. Pain can be treated with acetaminophen (Tylenol) or nonsteroidal anti-inflammatory medications/NSAIDs (ibuprofen/Motrin or Advil, naproxen/Naprosyn or Aleve). A finger guard may be applied to prevent further injury during the healing process.

Medical specialties

Internal Medicine · Orthopedic Surgery · Dermatology · Hand Surgery · Pediatrics · Family Practice · Podiatry · Foot and Ankle Surgery

This page is educational content, not medical advice. Always consult a qualified clinician for diagnosis and treatment of Nail bruise (subungual hematoma).