What To Do About Your Black Toenails

If you are a runner, you may have experienced “nail bed trauma” which essentially means you have pushed your nail against your shoe, causing it to become dislodged.

Once the nail has moved up and away from the nail bed, it will bleed, but you won’t see this oozing out much. Instead, the blood stays under the nail leading to the discolouration known as a “black toenail” or “blue toenail”.

There is usually no pain, apart from the soreness related to the nail being pushed or damaged.

It happens to other people too, not just runners (read my roundup of the most common foot injuries runners get). Any injury to your toe can cause this to happen, so it’s quite common.

So for such a common nail injury, there has to be a treatment, right?

Well, let’s discuss the do’s and don’ts of treating your black toenails.


This is as bad as my toes have been.  This was after running a half-marathon in very hot temperatures.

What you can do to cure your black toenail.

1. Leave it alone.

As long as your nail is not leaking blood around the edges, causing you pain or is suffering from an infection, one of the best options you have for curing the blackness is to leave it to fix itself.

The old nail will fall off eventually, and a new nail will grow underneath, so your body is curing itself.

However, there are risks that the new nail does not grow properly or gets a fungal infection, so leaving it alone may not be the best cure.

2. Have a Podiatrist drill your nail.

Treating your “subungual haematoma” involves a Podiatrist or doctor drilling a small hole into the nail to relieve any pressure and drain away the blood.

This treatment can be useful as it can reduce the amount of pain you are in and it also may help keep your nail intact.

3. See a doctor.

If you have damaged your nail by “trauma” such as when you stub your toe against a wall when your favourite team lost, there may be other injuries that need to be addressed.

If your toe is too sore to walk on, get to an emergency room as soon as possible – you could have a broken or fractured toe!

You will have X-rays to see what the issue is, but it will be helpful to rule out any significant damage.

4. Take painkillers, ice and rest.

If you are experiencing any pain or discomfort with your toenail, you can take some medication such as Paracetamol or use local creams and gels to help numb the pain.

You may also find relief from resting your foot, keeping it elevated to help blood flow and applying ice to the area around the toe.

What NOT to do with a black toenail.

1. Do not drill a hole in the nail yourself.

The Internet is full of advice about using either a drill bit or a heated paper-clip to force or burn a hole into your nail to release the pressure and drain the blood.

Let’s get this out of the way – THIS IS A VERY BAD IDEA!

Not only are you at risk of doing the procedure incorrectly, but you are also risking permanent toe damage and at high risk of introducing infection.

I am sure that going 1mm too far into your nail will cause you severe pain and will prolong your suffering.

Please do not try this yourself – Podiatrists are brilliantly qualified to treat this condition, and they do it every day. See a specialist and don’t take the risk.

2. Do not cut your skin.

Similarly to trying to drill a hole in their nails, I have read that some people try to cut away at the skin around the nail in an attempt to release the blood.

As with the first “don’t” this will be very painful and can cause infection or worse, severe toe damage.If you are not a qualified surgeon, put the knife down and seek proper medical advice.

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