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Subungual Hematoma (Bleeding Under Nail) (cont.)

When to Seek Medical Care for a Subungual Hematoma

If the pain is mild and the hematoma (blood collection) is less than 25% of the area under the nail, then home care can be considered.

If the hematoma is 50% or more of the underlying nail area, then medical attention is required.

If the injury that causes the subungual hematoma is severe enough to cause intense pain and tenderness, you should seek medical attention. The mechanism of injury for this condition can cause a fracture to the bone at the end of the finger or toe or a laceration to the nail bed under the nail that may require further medical attention.

Subungual Hematoma Diagnosis

  • X-ray
    • Often, an X-ray is taken to look for a fracture (break) to the underlying bone.
    • X-rays do not provide any information regarding the bleeding or hematoma formation underneath the nail.
  • Nail bed evaluation
    • Depending on the type of injury and the degree of the injury and how much blood forms under the nail, the doctor may decide to remove the nail to check the nail bed for lacerations (cuts). While it used to be customary to have the nail removed to examine the nail bed for lacerations or injuries, this is no longer routine practice if the nail edges or margins are intact.

Subungual Hematoma Home Remedies

  • Ice, elevation (keeping your arm or leg above the level of your heart), and pain medications are recommended for minor hematomas. Wrap ice in a towel and do not apply ice directly to skin. A bag of frozen vegetables (corn or peas) wrapped in a towel works well.
  • If the hematoma involves more than 50% of the area of the nail, then medical attention is needed.
  • If the nail was removed by the injury and the nail bed wasn't cut, the following home treatment is recommended until the nail bed begins to be less sensitive, usually in seven to 10 days.
    • Twice daily soaks with antibacterial soap and water for 10-15 minutes
    • After soaks, apply a dry, sterile bandage (Band-Aid)
Medically Reviewed by a Doctor on 11/20/2017
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