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How to Treat a Blood Blister Under the Nail

Updated on April 25, 2016

What Is a Blood Blister?

Blood blisters, or hematomas, occur any time when blood leaks into the tissue surrounding a damaged blood vessel such as an artery, vein, or capillary. On the outside, they look just like bruises. They are usually harmless (though in some cases, such as brain hematomas, they are dangerous and need immediate treatment to avoid becoming fatal).

A blood blister under the nail is known as a subungual hematoma. It is normally caused by blunt trauma such as trapping your hand in the door or stubbing your toe. It is harmless, but can cause serious discomfort, sometimes requiring a painless procedure to relieve the blood that has built up. The procedure can be done at home if you have the equipment. If not, take a quick trip to the doctor's office, and a nurse can drill a small hole in the top of the nail to release the pressure and let the old blood out.

Blood Blister, or Subungual Hematoma

A blood blister, or sublingual hematoma, is caused by blood buildup under the nail, which can create painful pressure.
A blood blister, or sublingual hematoma, is caused by blood buildup under the nail, which can create painful pressure.

Symptoms of a Blood Blister

Blood blisters are fairly common and most people will be able to recognize them. The patient will first experience a throbbing sensation under the nail caused by the pressure of the blood trapped beneath. If the pressure is not relieved, soon then the nail will start to turn purple, blue, then black, at which point it is likely that the nail will fall off and the blood will all come out in one go—not a very pleasant thing to happen, in my opinion.

There is no reason to leave it that long, because the procedure is very simple and painless (though maybe a little scary at first). Please watch this video explaining how to drain a blood blister under a nail.

Draining a Blood Blister Under the Toe Nail

Treatment—How to Drain a Subungual Hematoma

The treatment for a blood blister is fairly simple to do at home with the right tools. Simply clean the area and make a small hole in the nail to allow the blood to drain.

Tools

  • Alcohol pad
  • 18-gauge needle
  • Peroxide

If you do not have the tools, then stop by your local health care provider, who can drain it for you in a quick visit.

If there is no pain, then you may leave the blood blister alone as they frequently clear up on their own. However, get it checked out at the first sign of pain or discomfort—you need to rule out the possibility of an infection.

Step 1: Clean the Needle and the Toe

Use the alcohol pad to clean the toe with the blood blister.
Use the alcohol pad to clean the toe with the blood blister.

Open the alcohol pad and use it to clean the needle, then the toe.

Step 2: Drill a Hole

Drill a hole through the nail with a needle.
Drill a hole through the nail with a needle.

Place the point of the needle on the center of the nail (or the center of the blood blister). Drill through the nail by rotating the needle left and right. Note: This is a painless procedure because the nail does not have any nerves. Do not apply a lot of pressure; the needle will drill through gradually.

Step 3: Let Out the Blood

Allow all of the blood to come out of the hole in the nail.
Allow all of the blood to come out of the hole in the nail.

When you see blood, wipe it away with the alcohol pad. Drill a little more after you first see blood to make sure that the hole is big enough to allow the rest of the blood to come out.

Step 4: Keep Blood from Clotting

Use peroxide to keep the blood from clotting in the hole so that blood can continue to drain over the next few days.
Use peroxide to keep the blood from clotting in the hole so that blood can continue to drain over the next few days.

In order to allow the continued release of blood over the next day or so, do not allow blood to clot in the hole. If it does so, dab peroxide on it to clear the hole once more.

Complications of Blood Blisters

If you don't treat your blood blister you'll most likely have the nail fall off after a very painful and awkward period of time (awkward because it hurts too much to wear shoes). Other potential complications include:

  • Infection of the nail
  • Fever
  • Nausea or vomiting
  • Headaches
  • Muscle and joint aches

If you have any of these symptoms or a general feeling of illness, you should see a doctor immediately.

REMEMBER

This article is for informational purposes and should not replace the care and attention of your doctor. If you have any problems, then you should seek medical attention from a competent doctor.

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    • RNMSN profile image

      Barbara Bethard 4 years ago from Tucson, Az

      this is good info however you might want to add complications and how often this is actually done...if its not causing severe pain this trephination would not be done at all... in all cases/first,do no harm

      and ugh the idea of someone heating a needle or gem clip to red hot intensity and burning through my nail?????whew :) but a great start to a good hub!! keep going :)_

    • a figure skater 2 years ago

      my toenails are gross from skating especially my big toenails . . . i think they're blood blisters (?) but they don't ever hurt. the only complication for me is that they look gross and i feel self-conscious to wear open-toe shoes. good thing the damaged part of the toenail is almost gone. my right big toenail has been like this for a bit more than a year and a half, and my left for about half a year

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