Skip to content
    Font Size
    A
    A
    A

    Subungual Hematoma (Bleeding Under the Nail)

    Treatment of an Uncomplicated Subungual Hematoma

    A painless and small subungual hematoma usually requires no treatment. However, the pressure generated by pooled blood under the nail can be extremely painful. To relieve the pain, your health care provider may perform decompression, also called trephination, which allows the underlying blood to drain, relieving pressure and pain to the area.

    After numbing the affected finger or toe with a nerve block, your health care provider may use one of the following decompression methods to drain the subungual hematoma:

    • Cautery. A heated wire (electrocautery device) or carbon laser is used to burn the hole or holes. This is a quick and painless procedure.
    • Needle. A large-diameter needle is used to perforate the nail.

    During the cautery procedure, the heated tip is cooled by contact with the hematoma, which prevents injury to the nail bed.

    After a decompression procedure,your nail will be bandaged. You will need to keep the finger or toe bandaged and elevated -- and use cold compresses, if necessary -- during the first 12 hours following decompression. In some cases, your health care provider may recommend you use a splint for as long as three days until the tenderness subsides.

    The main complication associated with decompression is a small risk of infection in the residual hematoma.

    Treatment of a Complicated Subungual Hematoma

    If a subungual hematoma affects a large portion of the nail surface, the nail bed is likely to have significant injury. In these cases, nail removal may be necessary, along with stitches to the nail bed.

    Resolution of a Subungual Hematoma

    Unless a subungual hematoma is very small, an affected nail will usually fall off on its own after several weeks because the pooled blood has separated it from its bed. A new fingernail can regrow in as little as eight weeks while a new toenail may not fully regrow until about six months. If there has been injury to the nail bed and/or surrounding tissues, regrowth may be delayed.

    Even with the best repair, there is still a possibility that the new nail may grow back with an abnormal appearance. See your health care provider if you notice any problems with the nail as it heals and regrows.

    WebMD Medical Reference

    Reviewed by Melinda Ratini, DO, MS on April 28, 2015
    1 | 2

    Today on WebMD

    chafing
    Pictures and symptoms of the red, scaly rash.
    woman with dyed dark hair
    What it says about your health.
     
    woman with cleaning products
    Top causes of the itch that rashes.
    atopic dermatitus
    Identify and treat common skin problems.
     
    itchy skin
    Article
    shingles rash on skin
    Article
     
    woman with skin tag
    Quiz
    Woman washing face
    Video
     
    woman washing her hair in sink
    Video
    close up of womans bare neck
    Tools
     
    Feet
    Slideshow
    woman with face cream
    Quiz