Subungual hematoma refers to a painful condition where blood collects in the space between the fingernail or toenail and the nail bed. It usually results from injury inflicted by a hard and blunt object. The blood collection under the nail causes sharp and severe pain due to the pressure generated.

Causes of Subungual Hematoma

The most common cause of subungual hematoma is crushing the tip of the toe or finger. When you accidentally drop a heavy object on your toe or hit your finger with a blunt object such as a hammer, blood immediately accumulates under the nail. The most visible sign of this condition is the reddish brown discoloration of the nail immediately following the injury.

When to Seek Treatment

Whenever there is pain or the blood collection is more than 50 percent of the area under the nail, then medical attention is needed. A hematoma of 25 percent or less can usually be tended to via home care.


The diagnosis of subungual hematoma can be done through X-ray or nail bed evaluation. An X-ray is usually done to analyze the possibility of fracture to the underlying bone. Nail bed evaluation involves the removal of the nail to check the extent of the injury, blood collection and the possibility of any lacerations on the nail bed.


Elevating the injury above the level of the heart and applying ice is the first course of treatment no matter how severe the hematoma. Medical treatment may require draining the blood that has collected under the nail. Before the treatment process starts, the area may be numbed through medication injected in the affected finger or toe. After treatment, a follow up process is recommended where healing is monitored and antibiotics administered if necessary.