Black Toenail: Causes, Drainage, and When You Need a Podiatrist

Quick answer: Treatment for black toenail subungual hematoma causes treatment follows a stepwise approach: 1) conservative care first (rest, ice, supportive footwear, OTC anti-inflammatories), 2) physical therapy and targeted exercises, 3) in-office treatments (injections, custom orthotics) if conservative fails at 4-6 weeks, 4) surgery for refractory cases. Most patients resolve at step 1 or 2. Call (810) 206-1402.

Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.

Watch: Dr. Tom explains

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In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your toenail issues, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

Frequently Asked Questions

How long does treatment take to work?

Most patients see improvement in 4-8 weeks with consistent conservative care. Persistent symptoms after 8 weeks need imaging and escalation.

When is surgery needed?

Surgery is reserved for cases that fail 3-6 months of conservative care, structural deformities, or fractures requiring stabilization.

Is this covered by insurance?

Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Custom orthotics often require diabetic or post-surgical justification.

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Get Expert Care at Balance Foot & Ankle

Same-week appointments at our Howell and Bloomfield Township offices. Board-certified podiatric surgeons. Most insurance accepted.

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Balance Foot & Ankle surgeons are affiliated with Trinity Health Michigan, Corewell Health, and Henry Ford Health — three of Michigan’s largest health systems.