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View of toes in front of a white background with a pronounced black toenail on the big toe

Black Toenail: Causes, Treatment, and Prevention Tips

Discoloured toenails can be unsightly. The condition can stem from an injury, an underlying health issue, or ill-fitting shoes. A black toenail is likely a bruise under the nail, called a subungual hematoma. Seeing a black toenail at first glance can be alarming and uncomfortable, especially for first-timers, but the discolouration and potential pain associated with blackened toenails are generally not a cause for concern! While the condition may not always be serious, understanding its possible causes and prevention and treatment options is crucial for maintaining overall foot health and finding relief.

Causes of Black Toenails

View of toes in front of a white background with a pronounced black toenail on the big toe

Trauma or Injury

Stubbing your toe, dropping something heavy on your foot, or repetitive pressure from sports like running or soccer can lead to a black toenail. This is because blunt force and friction to the nail bed can damage the blood vessels under the nail, creating a bruise. Marathon runners often get black toenails after running long distances!

Ill-Fitting Footwear

Five feet with different running shoes grouped together aerial view

Shoes that are too tight or do not provide adequate toe room can put strain on the toenail. Whether on the job or wearing the wrong shoes for your activities, ill-fitting footwear are always a no-no, with the risk of black toenails being just one reason.

Fungal Infections

Once trauma has damaged a toenail, it is very prone to developing a fungal infection. If the infection progresses and affects the nail bed, sometimes the toenail can become discoloured. This can be due to debris build up, or the brittle nature of a nail with fungus being more vulnerable to trauma.

Rare Causes

If none of the above apply to you, consult a medical professional for a proper diagnosis.

Rare causes of black toenails include:

  • Malignant melanoma
  • Chronic ingrown nail
  • Other health problems, like lupus.
  • Nutritional deficiencies
  • Medications

Black Toenails: Treatment

nail polish cover up

Generally, black toenails aren’t severe and are more of a sight for sore eyes. But you can do the following to be proactive:

  • Observation and self-care: If the black toenail is painless and there are no signs of infection, you can let the nail heal independently. It will typically take several weeks for the discoloured nail to grow naturally. The discolouration could take 6-8 months to disappear.
  • Rest: Resting can help reduce swelling and promote healing.
  • Ice: Applying ice packs wrapped in a cloth to the affected area can help reduce pain, inflammation, and swelling.
  • Pain relief: Over-the-counter pain medications, such as acetaminophen or ibuprofen, can alleviate pain if necessary.
  • Protective padding: You can use cushioned bandages or moleskin padding to protect the affected toe to prevent further irritation.
  • Professional treatment: Sometimes, a foot specialist may need to drain the blood from under the nail to relieve pressure and facilitate healing.
  • Monitor for any yellowing or fungal infections: Once a toenail turns black due to trauma, the risk of fungal infection increases, so keep an eye out for any symptoms. You can also preventatively apply a topical antifungal medication, or see a chiropodist about any developing concerns.
  • Paint your nails: If aesthetics are a primary concern, you can cover the nail with nail polish to hide the visible signs of a black toenail. Just first make sure you don’t have any exposed skin, fungal infections or abrasions, as this can then lead to infection.

Prevention Tips For Black Toenails

  • Invest in your footwear: Ensure that your shoes fit well and provide enough room for your toes to move freely. Avoid tight or narrow shoes that can cause pressure on the toenails. Investing in the proper footwear also means having specific footwear for each purpose – for instance, at work, casually, or while playing a sport
  • Protect your feet: If you engage in activities that pose a higher risk of a toe injury, such as sports or heavy lifting, consider wearing protective footwear or toe guards.
  • Trim your toenails: Trim your toenails straight and avoid cutting them too short to prevent trauma or ingrown nails. For more tips on how to cut your toenails, read our nail trimming guide. Further, use toenail clippers for your toenails, not fingernail clippers.
  • Maintain good foot hygiene and habits: Keep your feet clean and dry to minimize the risk of fungal infections affecting the nails. Practice pedicure safety.
  • Regular inspections: Regularly examine your feet and nails for any signs of damage or discolouration. Promptly address any issues to prevent further complications.

Treat Your Black Toenails at Toronto's Feet First Clinic!

We’re your neighbourhood foot care experts. For nail, toe, or foot conditions, visit us at Toronto’s Feet First Clinic for diagnosis, treatment, and prevention plans! Call us at (416) 769-3338 or book an appointment here!

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Carolina Charles

Patient Relation Coordinator (She/Her)

If you’ve been to the clinic before, chances are you had the pleasure of meeting Carolina! Carolina’s daily goal is going above and beyond to make sure patients are always completely satisfied. Having worked in the podiatry industry for 22 years, Carolina brings a wealth of knowledge pertaining to client service, insurance policies, and procedures.​ She steers the ship to make sure everything runs smoothly on the daily. Carolina is known for spicing up every outfit with her signature costume jewellery.