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Subungual Hematoma

What is a subungual hematoma?

A subungual hematoma is a collection of blood under your fingernail or toenail. The most common cause is an injury, such as slamming your nail in a door or dropping an object on your nail. A subungual hematoma can occur if you take blood thinning or cancer treatment medicines. You may also be at risk if you have an autoimmune condition, Kaposi sarcoma, or melanoma.

What are the signs and symptoms of a subungual hematoma?

  • Red or purplish blood collection under the nail

  • Throbbing pain and swelling in the affected finger or toe

  • Tenderness to the touch

How is a subungual hematoma diagnosed?

Your healthcare provider will know you have a subungual hematoma by looking at your nail. The following tests may also be done:

  • A dermoscopy is a procedure used to look for damage to your nail through a microscope.

  • An x-ray of your hand or foot may be done to check for broken bones.

  • A biopsy is a procedure to remove all or part of your nail. The nail is sent to a lab for tests.

How is a subungual hematoma treated?

  • Ice and elevate your affected finger or toe. Place ice wrapped in a towel over the painful area for as long as directed. Elevate your hand or foot on pillows above the level of your heart to help decrease swelling and pain.

  • NSAIDs help decrease swelling and pain. This medicine is available without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.

  • Trephination is a procedure used to make a small hole or holes in your nail to drain the blood. This will help decrease pain and swelling.

  • Nail removal may be done if your nail is damaged. Your healthcare provider may also need to repair the tissue under your nail.

  • A splint may be placed on your finger or toe to prevent movement and protect the area while it heals.

How can I help care for my subungual hematoma?

  • Keep your injured finger or toe dry for as long as directed.

  • Gently trim your nail if it begins to fall off in pieces. This may decrease your risk for catching the nail on an object or ripping it off.

  • Wear shoes that are comfortable and fit correctly to prevent more injury to your toe.

When should I contact my healthcare provider?

  • You have increased redness, swelling, or pain.

  • You notice pus or a bad smell coming from your nail.

  • You see red streaks on your finger or toe that starts from your nail.

  • Your nail falls off and there is bleeding.

  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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