Have you ever discovered that one of your toenails has turned black? While you don’t need to panic, please don't ignore it either! While often harmless, sometimes a black toenail can signal a more serious condition that requires immediate attention.
Today I’ll be talking about what can cause black toenails, how they’re treated, and what you can do to prevent them.
3 Causes of Black Toenails
Many black toenails are the result of trauma. This happens when:
- If you’re a runner, hiker, or rock climber and you wear shoes or boots that are too tight or don’t fit properly.
- You drop a heavy object like a tire iron on a toe
- You kick a hard object like furniture (this is a common issue for people, especially in the middle of the night)
These injuries cause bleeding under the nail, called a subungual hematoma, creating the characteristic black appearance. While they may look ugly, black toenails from trauma will eventually grow out. However, if it's painful, you'll need to have a podiatrist drain the blood that has accumulated under the nail.
While the black color will eventually disappear, you may instead be left with misshapen or dystrophic toenails. Once this occurs, there’s little you can do to correct it.
Fungal Toenails Can Cause Your Nails to Turn Black
Because our feet spend most of the year in socks and shoes, this creates the perfect warm, damp environment for fungus to thrive. When the nail lifts slightly due to pressure, fungus can enter and set-up shop underneath.
You're more likely to develop fungal nails if:
- You're an active person, especially a runner, hiker, or climber
- Your shoes cause repetitive pressure on the nail bed
- You wear cotton socks that retain moisture
- You go barefoot in pools and locker rooms, yoga studios, share nail tools, or go to a nail salon that isn’t cleaning their equipment properly.
While most people want to get their fungal nails treated, not everyone feels the need to do so for cosmetic reasons alone. There are several other reasons why it’s important to seek treatment.
- Fungal toenails can spread to more vulnerable family members.
- Toenails can become thicker, hard to cut, and painful over time.
- A fungal toenail infection can spread to other parts of the body including the hands and groin
- It can triple a diabetic’s risk for developing ulcers which can lead to amputation.
- Finally the longer you wait to get it treated, the more difficult it is to eliminate it.
Fungal nails can be challenging to treat, especially if they've been present for a while or the nail has thickened. Fortunately, our office has a comprehensive treatment plan combining the most effective methods for eliminating toenail fungus with an 80-90% success rate.
We use the Lunula laser combined with topical medications for your nails and skin, and a shoe spray to eliminate fungus in your shoes. We also have an advanced aftercare program to keep your toenails free of fungus.
To learn more about this program, check out the link in the description below.
Prevention is always better than treatment. Here's how to reduce your risk for a black toenail, a misshapen toenail, and toenail fungus.
- Always wear moisture-wicking socks instead of cotton.
- Alternate between different pairs of shoes daily to allow them to dry out.
- Make sure your shoes or hiking boots fit properly – even adult feet can grow longer—if your toenails hit the inside of the top of your shoe, this creates an entry point for fungus.
- Wear flip-flops around pools and in locker rooms
- Bring your own yoga mat to class
- Don't share towels or nail tools
- Avoid going to nail salons that don’t properly clean their equipment (check out the link in the description below).
If you’re a runner, be sure to check out my video below on “Runner’s Toe” for more specific information about preventing black toenail.
If you’re a hiker, check out my video below on “How to Prevent A Black Toenail When Hiking.”
Signs and Symptoms of Black Toenail Caused by Melanoma (skin cancer)
Now for the most important reason to never ignore a black toenail – melanoma. This dangerous form of skin cancer can appear under the nail and tends to grow slowly.
Melanoma is the most common cancer of the feet. And because we don't examine our feet as often as our face, melanoma on the feet typically has a higher death rate as it's often discovered too late.
Some signs of melanoma under the nail are:
- 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
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. Schedule an appointment with a podiatrist for proper diagnosis.
In conclusion, while most black toenails are harmless, if you have a fungal nail infection it’s important to get it treated to prevent complications later on and if it turns out to be melanoma, it's essential to get it treated immediately to save your life.
