A black toenail is a prevalent injury due to various causes such as direct trauma, impact to the toe or overuse. This injury can be caused by continuous rubbing against the interior of a shoe especially among long distance runners.
What are the indications?
In most cases, the affected toenail turns black in appearance due to the buildup of blood between the nail and the nail bed. There is also throbbing pain as the pressure rises beneath the nail with every pulse. Over time, the nail starts to loosen from the nail bed and falls off.
Management of a black toenail
If an individual ends up with a black toenail, there are 2 main measures in managing one – trephining or removal of the nail.
When it comes to trephining, it is a process that involves the creation of a hole in the affected nail with the help of a heated instrument approximately the size of a paper clip so that it can easily pass through the nail. The main objective of this treatment option is to alleviate the pain and pressure beneath the toenail. The nail is covered with dressing to reduce the risk for infection.
As for nail removal, it is performed in severe cases in which the affected toenail becomes disfigured or interrupted by a hematoma or if a serious underlying injury such as a toe fracture is present. An anesthetic is not usually used but sometimes, nerve blocks are utilized.
It is important to note that a black toenail typically heals on its own if due to minor injuries, but there is still the risk for infection.