blackened toenailWhile it's extremely rare for someone who is young to develop nail cancer, it did happen to Miss Illinois Karolina Jasko. She was only in high school when she found a vertical line under her fingernail. She didn't go to the doctor until it became infected. Then she was diagnosed with melanoma.

She was fortunate. She only lost her nail. Melanoma can spread to the entire body and can be deadly. Survival of melanoma is even more uncertain if it's found on your feet and toenails. That's because it's usually detected at an advanced stage when treatment might be too late.

While melanoma of the toenail is rare no matter what your age, it's important to be seen by a podiatrist if you have bruise under your toenail that doesn't go away.

Other Symptoms

  • A new brown or black band in the nail

  • Dark color is spilling over the skin next to the nail

  • Signs of infection such as drainage, pus, and pain

  • A bruise, splitting, or bleeding of the nail without any trauma

  • A bruise under the nail that doesn't go away with time even with trauma

Although some dark bands can be non-cancerous and caused by a bacterial or fungal infection it's important to get it checked out as soon as possible.

Sixty percent of these types of melanoma are found in the fingernails and 40% are found in the toenails. Most commonly it's found in the hallux nail or big toenail.

Risk Factors

  • Over 50

  • Personal or family history

  • Personal or family history of atypical moles

  • People of color

Unlike melanoma of the skin, melanoma of the nail is not cause by sun exposure.


Although it's not possible to prevent the condition, early identification and treatment provides the best chance for effective treatment and survival. 


Treatment options depend on how early the melanoma is detected. They include surgery, chemotherapy, and radiation.

Other Cancers Affecting the Feet

Other types of skin cancers that affect the feet more often than nail cancer are basil cell carcinoma, squamous cell carcinoma, and malignant melanoma. For information about how to prevent these skin cancers, see "Protecting Your Feet From the Sun Can Avoid Skin Cancer Disaster".

black toenailOther Causes of Black Toenails

While skin cancer of the toenail is rare, other causes of black toenails are common.

Black Toenails in Hikers and Runners

Hikers and runners often develop black toenails, usually due to wearing footwear that is too short or doesn't fit correctly. Constant pressure against the nail can cause a subungual hematoma or a bruise under the nail.

Injuries to the Toenails

Black toenails can also occur due to injury to the nail. Dropping a heavy object on your toe or badly stubbing it can damage the nail.

Toenail Fungus

Toenail fungus is another cause of dark or discolored toenails. Fungal toenails are more common in runners and hikers particularly when shoes don't fit properly. Constant pressure to the nails can cause them to lift, allowing fungus easy access to the nail bed. Learn more about toenail fungus and how it's treated here!

Chronic Ingrown Toenail

While not very common, ingrown toenails that recur can turn your toenails black. If you've had no trauma to your nail and are prone to ingrown toenails, contact your podiatrist right away if your nail turn black. This can be a sign of a bad infection.

If you have a unexplained bruise or streak in your nail that won't go away, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.
by Barbora machackova October 20, 2021 at 01:23 PM
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