Bleeding under the nail

Bleeding under the nail or subungual hematoma is often caused by crush injuries. Bleeding under the nail is usually a mild condition that can be treated at home unless you suspect that there might by a bone injury or damage involving the nail bed or surrounding tissues. Bruising, swelling, strains and sprains are topics covered in St Mark James training courses. To learn via “hands on” techniques on how to recognize and manage these minor or major emergencies enrol in a class.

Common causes of bleeding under the nail include:

  • Slamming the finger or toe against a hard surfaceblood under the nail
  • Dropping a heavy object on the toe
  • Hitting the finger against a heavy object
  • Stubbing the toe on a hard object

It is important to note that bleeding under the nail can also be serious because a darkened region under the nail may be an indication of a tumor, therefore, you should not assume that it is subungual hematoma. Seek medical attention promptly.

Usually mild spots grow out along with the nail; however, a tumor will remain in its place.


  • Dark discoloration under the nail
  • Throbbing pain
  • Swelling or tenderness of the finger/toe


1. Seek immediate medical attention from your health care provider if:

  • You suspect that the finger/toe seems unusual–deformed–it my indicate that its broken
  • A joint nearby is affected
  • Pain is persistent or intensifying
  • More than a quarter of the affected nail is dark
  • Symptoms such as pus, discharge, heat around the affected region, redness or red streaks¬† appear

2. Control symptoms–if only less than a quarter is affected

  • Apply ice and elevate the affected finger to reduce swelling and encourage blood flow
  • Pain can be reduced by taking over-the-counter pain medication. Avoid NSAIDs such as ibuprofen and aspirin

If you choose to see you doctor, he may drain the blood through a small hole made in the nail to reduce pressure. Sometimes, the nail may have to be removed as well.

 Learn More

To learn to recognize and help with minor and major emergencies enrol in St Mark James first aid training with a credible provider (more information here).

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