Black stuff under your toenail usually means blood from an injury (subungual hematoma), often from stubbing your toe or tight shoes, but it could also be a fungal infection, bacterial infection, pigmentation changes, nail polish staining, or, rarely, skin cancer like melanoma. The most common culprit is trapped blood, appearing as a dark bruise that grows out with the nail, but if it's a streak, changes, or you have no injury, see a doctor to rule out serious issues.
Use Antifungal Treatments: Over-the-counter options may help with mild fungal infections. Avoid Tight Footwear: Choose well-fitting shoes to prevent trauma and discomfort. Maintaining nail health is crucial for prevention.
You can take a prescribed oral antifungal medication to treat the fungus. Options include terbinafine (Lamisil®), itraconazole (Sporanox®) or fluconazole (Diflucan®). You'll need to take the medication every day for several months (or longer).
Like other types of melanoma, subungual melanoma develops in melanocytes, the pigment cells that give skin its color. Unlike most types of skin cancer, subungual melanoma isn't related to sun exposure. Nail melanoma often shows up as a narrow brown or black streak or band on the nail.
Stubbed Toes and Repetitive Stress:
One of the primary causes of black toenails is trauma. Stubbing toes, dropping heavy objects on the feet, or engaging in activities that put repetitive stress on the toes can lead to blood pooling under the nail, resulting in discoloration.
Can You Scrape Out Toenail Fungus? No. You may be able to scrape a bit off the top of or from under your nails, but that won't cure the infection.
Patients are often relieved to learn that most black spots under toenails are simply the result of everyday activities and typically grow out with the nail over time.
Equipment used for Nail Biopsy
For numbing your skin during the biopsy, a local anesthetic called 1% lidocaine solution is often used. This prevents you from feeling pain during the procedure.
Treating Subungual Melanoma
If the melanoma spreads to other parts of the body, immunotherapy might be an option. If a doctor diagnoses subungual cancer early enough in its first stage, the survival rate is 97 percent at five years and 95 percent at ten years. The survival rate decreases for each stage.
Nail fungus, also called onychomycosis, is a fungal infection that can affect both your toenails and fingernails. Nail fungus almost never goes away on its own, and it can spread. Your dermatologist knows how to treat nail fungus, even stubborn cases.
Nail fungus is a common infection of the nail. It begins as a white or yellow-brown spot under the tip of your fingernail or toenail. As the fungal infection goes deeper, the nail may discolor, thicken and crumble at the edge. Nail fungus can affect several nails.
While no treatment truly kills toenail fungus instantly, the following options provide the most rapid and effective results:
While most black toenails are due to minor issues like bruising or pressure, you should seek medical advice if: The toenail turns black without any known injury. There's increasing pain or signs of infection (pus, warmth, redness) The nail is lifting or separating.
Go for the bar: Dig your nails into a bar of fresh, white soap. It may sound strange, but doing this will pull the dirt out from underneath your nails and help whiten the underneath of them as well.
If toenail fungus goes untreated, it worsens, causing the nail to thicken, discolor (yellow/brown), become brittle, crumble, and potentially separate from the nail bed, leading to pain, odor, and difficulty walking; it can spread to other nails/skin (athlete's foot) and, in rare cases, lead to serious bacterial infections like cellulitis, especially for those with diabetes or weakened immunity, potentially causing permanent nail damage or systemic issues.
The 5 key signs of melanoma, often remembered by the ABCDEs, are Asymmetry (uneven halves), Border irregularity (jagged edges), uneven Color (multiple shades), Diameter larger than a pencil eraser (about 6mm), and Evolving (changing in size, shape, color, or symptoms like itching/bleeding). Also watch for a sore that doesn't heal, new dark streaks under nails, or unusual sensations like itching or pain in a mole.
Stage 1 means the melanoma is at an early stage. It is only in the skin and there is no sign that it has spread to nearby lymph nodes or other parts of the body. Stage 1 can be divided into 1A and 1B.
THE '2-week rule' represents a significant organisational change in the referral of patients with suspected cancer. Targets set by the rule include that secondary care specialists should be notified within 24 hours and see patients within 2 weeks from when the general practitioner (GP) decides to refer a patient.
Do not participate in strenuous exercise or lift more than 5 pounds for 2 weeks after your procedure. After a toenail biopsy, wear loose-fitting shoes for 1-2 weeks to allow room for a bandage and minimize pressure and trauma to the healing wound. Keep the bandage dry.
Toenail surgery is a minor procedure to remove all or part of a problematic toenail. Local anaesthetic is used to numb the affected toe(s). In most cases, once the troublesome toenail (or section of nail) has been removed, a chemical called phenol is applied to the exposed nail bed.
While it could be an indication of skin cancer, there are many other conditions that present this symptom. If you're concerned about a black spot under your toenail, keep these details in mind and schedule an appointment with your provider right away.
To remove blood from under a nail: Straighten a paper clip, and heat the tip in a flame until it is red-hot. Place the tip of the paper clip on the nail and let it melt through. There are no nerves in a nail, so putting a hot paper clip on a nail should not hurt.
Black toenail syndrome is a condition where one or more of the toenails turn black. The condition is very common in athletes, especially runners, and because of this, it is also called Runner's Toes.