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Subungual Hematoma

WHAT YOU SHOULD KNOW

A subungual (sub-UN-gul) hematoma (HE-muh-TOE-muh) is a pocket of blood under a fingernail or toenail.

Causes

Subungual hematomas are usually the result of an injury, such as smashing a finger in a door, or an infection from an object stuck under the nail.

Signs/Symptoms

Symptoms typically include pain, bruising, or bleeding. The blood trapped under the nail usually causes pain. Eventually the nail may fall off.

Care

Your finger may have to be x-rayed to see whether a bone was broken when you injured the nail. If there is an object under the nail, it will have to be taken out. Your doctor may need to put a small hole in the nail to let out the trapped blood and help ease the pain. You may also have to get a tetanus shot.

WHAT YOU SHOULD DO

  • Apply ice to the injury for 15 to 20 minutes each hour for the first 1 to 2 days. Put the ice in a plastic bag and place a towel between the bag of ice and your skin.
  • After 1 or 2 days, you may use heat to ease the pain. Soak the finger or toe in warm water for about 15 to 20 minutes 3 to 4 times a day.
  • For 48 hours, keep your hand or foot above the level of your heart whenever possible to reduce pain and swelling.
  • Keep the area clean. You may also need to cover the nail with a bandage. Keep the bandage on until your doctor says you may take it off.
  • The nail may fall off. You may want to trim it gently as this occurs to keep it from catching on something and causing the nailbed to bleed or rip.
  • You may use over-the-counter medications to relieve the pain.
  • If you are given a tetanus shot, your arm may get swollen, red, and warm to the touch at the site of the shot. This is a normal reaction to the medicine.

Call Your Doctor If...

  • Pain or swelling gets worse.
  • You have any signs of infection (redness, swelling, pus, a bad smell, or red streaks leading from the wound).
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