Do you plan to get back into hiking this Spring? What you want to avoid is coming to my office with a black and bloody toenail. 

How to Prevent A Black, Bloody Toenail After Hiking

  • Get your feet measured at a store before making a purchase. Also, a shoe fitter should be able to feel where your toes are in your boots and let you know if you've got the correct size.
  • Lacing the shoes. To prevent your feet from moving forward and having your toes hit the front of your boots, lacing can help keep your feet back. (Learn how to lace your shoes here.)
  • Buy sock with the proper thickness. Socks that are too thick can also put too much pressure on the nail and cause damage

Why It's Important to Prevent A Black Toenail

Pressure and Pain

Let's go into a little bit of what does the discolored nail mean. Why is that so important to do anything about it? If it's minimal and there's no discomfort with it, it may well resolve on its own. The blackening is caused by microtrauma to the toenail and the nail bed underneath where bleeding has occurred. This bleeding, if it's of any extent, will accumulate under the nail, build up, form what we call a hematoma and pressure and pain.

Loose Toenail That Can Fall Off

Your nail can become loose and fall off exposing the area underneath to infection.

Fungal and Thick Toenails Can Develop

When this kind of trauma goes on over time besides developing bleeding under the nail you can develop a  fungal infection of the toenail called onychomycosis. And the nail, in and of itself, besides being black, becomes thickened and discolored, often yellow, black, even green. Is a problem unto itself that needs separate attention and treatment. Learn more about fungal toenail treatment here.

Treatment for Loose or Black Toenails

If things progress to the point where the nail is actually loosened, don't attempt to remove it on your own. The safest thing is, besides applying ice if you can to relieve pain, is to bandaid or tape the nail to the nail bed until you can get home and seek medical attention.

If you've come home from your hike or finished your day's hike, and you've developed a very painful toenail that isn't just alleviated by removing the boot, that nail may need to be drained to relieve the pressure. A podiatrist will need to treat this problem.

Learn more about prevention and treatment of damaged toenails here. 

Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.