Introduction to Black Toenails

Black toenails are a surprisingly common concern, particularly among runners, but they can affect anyone. This condition occurs when the toenail darkens, often appearing in shades of purple, brown, or black. It may be accompanied by tenderness, swelling, or discomfort. While black toenails are sometimes harmless, they can also indicate underlying health issues, such as fungal infections or, in rare cases, melanoma. Understanding the causes and recognizing when to seek medical attention is crucial for maintaining foot health.

What Are Black Toenails?

Black toenails occur when the nail darkens due to blood trapped under the nail, fungal infections, or other health conditions. Symptoms may include discoloration that ranges from grey to deep black, tenderness or pain when pressure is applied, and sometimes swelling or warmth around the nail. The severity and appearance can vary based on the cause, but recognizing these signs early can help in determining the appropriate treatment.

Common Causes of Black Toenails

Fungal Toenails

One common cause of black toenails is a fungal infection. Although fungal toenails typically cause yellow or white discoloration, they can sometimes develop black spots due to debris buildup under the nail. Symptoms include thickened, brittle nails that may have a foul odor and dark spots that appear underneath. If left untreated, fungal infections can worsen and spread, affecting other nails or the surrounding skin. Using antifungal creams or seeking prescription medications from our podiatrist can effectively treat the condition.

Melanoma

Although rare, melanoma can develop under the toenail and is one of the most serious causes of black toenails. It typically appears as a dark, irregular spot that may cause the nail to lift or crack. Warning signs include dark streaks or spots that change over time, misshapen or distorted nail growth, and the spread of pigment to the surrounding skin. Since melanoma can be life-threatening if untreated, it is crucial to seek medical attention immediately if you notice any unusual changes.

Trauma

Black toenails are often caused by trauma, either from a sudden injury like stubbing your toe or from repeated pressure, such as wearing tight shoes or engaging in high-impact activities like running. This type of trauma leads to a subungual hematoma, where blood collects under the nail, causing dark discoloration. It may also result in tenderness, throbbing pain, and in severe cases, nail detachment. Rest, elevation, and wearing loose footwear can help alleviate symptoms, and the discoloration usually fades as the nail grows out.

Underlying Health Conditions

In some cases, black toenails can indicate underlying health issues. Conditions such as diabetes, heart disease, anemia, and kidney disease can all impact nail color due to poor circulation or oxygen deficiency. 

For example, diabetes increases the risk of fungal infections and can slow down the healing process, while heart disease can reduce blood flow to the extremities, leading to discoloration. If you have a pre-existing condition and notice darkened toenails, it’s important to contact our office for an accurate diagnosis.

When to Seek Medical Help

While black toenails are not always serious, there are certain situations when medical attention is necessary. You should see our knowledgeable podiatrist if the nail turns black without any known injury or trauma if discoloration persists for more than a few weeks, or if you experience severe pain, swelling, or pus drainage. 

Additionally, people with diabetes or other chronic health conditions should be vigilant, as even minor foot issues can lead to complications. Seeking medical advice promptly is also crucial for timely melanoma detection and to rule out other serious health concerns.

Can Black Toenails Cause Complications?

Toenail Fungus

Toenail fungus, if left untreated, can lead to several complications, including permanent damage to the nail bed, spreading of the infection to other nails or the surrounding skin, and persistent pain or discomfort. This is particularly concerning for individuals with compromised immune systems or diabetes, as they are more susceptible to infections.

Melanoma

Melanoma under the toenail, although rare, is extremely dangerous. Delayed diagnosis can allow cancer to spread to other parts of the body, significantly reducing treatment success rates. This makes early detection and prompt medical evaluation crucial. Any persistent or irregular dark spot should be thoroughly examined by a healthcare professional to rule out melanoma.

Treatment for Black Toenails

Trauma-Induced Black Toenails

Treatment for trauma-induced black toenails focuses on relieving pain and protecting the affected area. Rest and elevation are recommended to reduce swelling, and wearing loose footwear minimizes pressure on the injured toe. Protective padding can also prevent further injury. The discoloration generally fades as the nail grows out, although this process may take several weeks depending on the severity of the trauma.

Fungal Black Toenails

If a fungal infection is the underlying cause, various treatment options are available. Over-the-counter topical antifungal creams can be effective for mild cases, while prescription oral antifungal medications may be necessary for more severe infections. In persistent cases, laser treatment is an option that targets and eradicates the fungus without damaging the surrounding tissue. If symptoms persist or worsen, scheduling an appointment is recommended for a comprehensive treatment plan.

Preventing Black Toenails

Preventing black toenails involves simple yet effective measures. Wearing properly fitting shoes with adequate toe room can significantly reduce the risk of trauma-induced black toenails. Maintaining good nail hygiene by trimming toenails straight across helps prevent pressure and trauma, particularly for athletes. Keeping feet dry is essential to prevent fungal growth, and using protective cushioning can minimize the impact for runners and other high-impact sports participants. By adopting these preventive practices, you can lower the risk of developing black toenails and maintain overall foot health.

Black toenails can be caused by a variety of factors, ranging from minor trauma to serious health conditions like melanoma. Monitoring your toenails for any changes and practicing good foot hygiene are essential for maintaining healthy nails. If you notice persistent discoloration, pain, or other concerning symptoms, it’s crucial to seek medical advice. Early diagnosis and appropriate treatment can help avoid complications and ensure optimal foot health.

Worried About Your Black Toenails? Contact Richardson Podiatry Center Today!

If you’re concerned about black toenails, our experienced podiatrist, Dr. Haddad, is here to help. We provide expert evaluations, accurate diagnoses, and effective treatment options tailored to your needs. Call us today at (972) 690-5374 or fill out our contact form online to schedule an appointment. Don’t let black toenails impact your comfort and confidence – get the care you need today!