Expert Foot & Ankle Treatment from Michigan’s #1 Podiatrist - Balance Foot & Ankle Specialist
Board Certified Podiatrists
Expert Foot & Ankle Care
Black Spot Under The
Toenail or Fingernail
Welcome to the Complete Guide for a Black Spot under the Toenail or Fingernail!
What Is a Black Spot Under The Toenail?
A black spot under the toenail or fingernail can have a few major causes. The most common cause of black under your toenail is due to bleeding that can come from dropping something onto your toe, getting stomped on or even closing the door on your finger. In athletes it can also be caused by repetitive rubbing against the inside of a shoe, for example in the case of long distance runners, it is frequently referred to as ‘Jogger’s Toe’. If you have definitely not had any friction against the tips of your toenails, but you have instead been exposed to f moisture- then it is likely a Pseudomonas infection. If you have not experienced any of these situations then you may be at risk for melanoma. Read the guide below for more information.
Runner’s toe– Runner’s toe occurs if the toenail is rubbing against the front of the shoe; even if it is not really painful, blood could accumulate in the form of leakage or blistering under the nail. This page is dedicated to treating runner’s toe.
A blood clot forms when blood thickens and clumps together in a deep vein, usually in the lower leg or thigh. This condition—deep vein thrombosis (DVT)—can restrict normal blood flow and lead to serious complications, including pulmonary embolism if the clot travels to the lungs. Risk factors include prolonged immobility, surgery, smoking, obesity, and underlying medical conditions. Prompt diagnosis and medical care are crucial, especially when symptoms like pain, warmth, or swelling are present.
Toenail fungus– If your nails gradually become thick, discolored and crumbly under the border then read our comprehensive guide to toenail fungus.
Melanoma– If you have an unusual streak of black pigment that is pain free and just appeared over a without any incident- it is essential that you read our guide to black streaks in your nail.
The Following Guide is for the Most Common Cause
Bleeding under the Toenail or Fingernail
Signs & Symptoms
- Throbbing pain from blood building up under your nail. Even slight irriation can be runner’s toe.
- Usually the big toe or the second toe.
- Black, blackish red or bruised toenail.
- Loose toenail at the far end of the toe.
Who is at Risk
-1 in 100 develop runner’s toe from shoe friction while running, but it is much more common in marathon runners and ultra marathon runners.
-Up to 55% of Marathon runners can develop runners toe in their running career.
When to Seek Treatment for pain under the toenail
If over 25-50% of the nail is involved there is a high chance of a broken toe or finger, there is also a chance that the cut under the nail may become infected and would need antibiotics.
Treatment for a Pain under the Toenail or Fingernail
Bleeding under the Toenail or Fingernail
Home Treatment
- In the minor cases with slight irritation, the pain will resolve in 1-2 days without treatment.
- Ice for 15mins, this helps with pain but also helps the injury heal faster in the long run. Wrap ice into a towel (or something frozen) and hold it for 15 mins until you are numb to the cold and the pain. This improves bloodflow, healing and decreases inflammation
- Elevation- keep the arm or leg above your heart early on.
- Pain medication- Anti-inflammatory
- If the nail bed is detached- cut off the loose part of the nail.
- To prevent infection, use an antibiotic ointment like bacitracin, neosporin or triple antibiotic. This is very important, the toes and fingers are very likely to develop an infection compared to the rest of the body.
- Clip the toenail to prevent further rubbing & cover it with a thick bandaid or duct tape.
What can a Podiatrist do?
- X-ray for a fractured finger or toe- very possible if over 25% of the nail is damaged.
- Check for a cut or tear underneath the
- Draining the blood
- The toenail can be numbed with lidocaine so that the nail can be punctured with a drill or a hot needle pain free. The blood is drained and as the pressure drops the nail should be pain free.
- Nail removal
- If over 25-50% of the nail is destroyed, the skin under the nail should be inspected for a cut or infection. Lidocaine injection numbs the toe and this can all be done pain free.
- Stitches that are absorbed by the skin in the next few weeks are used to close the skin underneath the fingernail and toenail.
- If there is an infection, then antibiotics will need to be prescribed
For more on a Black Spot under the Toenail or Fingernail: Subungual Hematoma
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FAQ About Black Spot Under Toenail
A black spot under a toenail is most commonly caused by bruising (subungual hematoma) from repeated pressure or minor trauma, such as tight shoes or sports activity. Other causes may include fungal infection, pigment changes, medication effects, or less commonly, melanoma. A podiatric evaluation helps determine the exact cause.
Many black spots are harmless bruises that grow out with the nail. However, a spot that appears without injury, changes in size or color, has irregular borders, or does not move as the nail grows should be evaluated promptly by a podiatrist to rule out more serious conditions.
A bruise under the toenail typically:
Appears after pressure or injury
May be tender initially
Moves forward as the nail grows
If the spot does not move, is painless, or continues to darken, it’s important to have it examined by a foot and ankle specialist.
Yes, certain fungal infections can cause dark discoloration, especially when debris builds up under the nail. Fungal nails are often thickened, brittle, yellow or brown, and may have an odor. Proper testing is needed to confirm a fungal cause before starting treatment.
You should schedule a podiatry visit if the black spot:
Appears without known injury
Does not improve or move with nail growth
Is painful, bleeding, or infected
Changes in size, shape, or color
Occurs if you have diabetes or circulation issues
Balance Foot & Ankle Specialist provides expert evaluation in Howell and Bloomfield Hills, Michigan.
Treatment depends on the cause. Options may include:
Monitoring as the nail grows out
Draining pressure from a nail bruise
Treating fungal infections
Biopsy or referral if a serious condition is suspected
Early evaluation ensures the safest and most effective care.
Professional Podiatry Care—Right at Your Door
Get expert foot and ankle care without leaving home. Our podiatrists provide compassionate, convenient home visit services across Michigan for patients who need care where they’re most comfortable.
Dr. Tom Biernacki, DPM is a board-qualified podiatrist and foot & ankle surgeon serving Southeast Michigan at Balance Foot & Ankle Specialists. A Michigan native, Dr. Biernacki earned his undergraduate degree from Michigan State University and his Doctor of Podiatric Medicine (DPM) from Kent State University College of Podiatric Medicine. He completed a three-year comprehensive surgical residency in foot and ankle surgery in the Detroit metro area.
Dr. Biernacki specializes in the treatment of heel pain, bunions, hammertoes, diabetic foot care, sports injuries, flatfoot correction, and minimally invasive foot surgery. He is dedicated to providing evidence-based, patient-centered care that helps people of all ages stay active and pain-free.
He sees patients at multiple convenient Metro Detroit locations and is committed to community education through the MichiganFootDoctors.com resource library. Dr. Biernacki is a member of the American Podiatric Medical Association (APMA) and the Michigan Podiatric Medical Association (MPMA).