How to prevent black nails from ruining your careers


Find out the cause and what you can do to run without pain.

Both a nightmare for runners and, in some strange way, a badge of honor, the black toenail, or subungual hematoma, is actually blood pooled under the nail. It can occur from an acute or chronic injury, explains Jordan Metzl, M.D., a sports medicine physician at the Hospital for Special Surgery in New York City.

Repetitive chronic trauma can range from mild (a small painless, black and blue discoloration under the nail) to severe (large bloody blisters between the nail and the nail plate), adds podiatric surgeon Jacqueline Sutera, D.P.M.

This is what you need to know.

The most common culprit for black nails is repetitive trauma, which can result from running or wearing any type of footwear that doesn't fit. If a black nail appears shortly after a workout or a day in shoes that are too tight or too baggy, this is likely the cause.

Dropping a heavy object (such as a dumbbell) on the foot can burst the blood vessels below the nail bed and cause blood to pool underneath as well.But other problems besides trauma can also cause black nails.

Fungal infections, such as athlete's foot, can spread to the toenails and turn them into shades of yellow, blue, green, brown, purple, and black, Sutera explains. This range of colors is unique to fungi, as is the presence of subungual debris, a chalky white substance that coats the nail bed and often has a strange odor.

If you think you may have a yeast infection, see your doctor; He or she may cut and biopsy a part of the nail to confirm the diagnosis. Treatment options vary depending on the severity of the infection. Mild cases are often treated with topical medications, while more aggressive fungi require oral medication or even laser treatment.

Subungual melanoma, the most serious form of skin cancer, can also grow under the nail bed in the nail plate and cause hyperpigmentation of the skin, Sutera explains. It is often a slow, painless growth, making it especially difficult to detect.

An ominous sign is discoloration that extends past the nail and down to the cuticle, says sports podiatrist Lori Weisenfeld, D.P.M. "If you haven't had any incidence of trauma and your nail is slowly starting to change color, especially if that color goes beyond your nail, you should have it checked by your doctor," he advises.Regular pedicure patients should do a quick toe scan between polish changes to detect any novelties, Weisenfeld adds. Everyone should ask their doctors for an annual skin exam.

Occasionally dark discoloration of the nail bed is simply a matter of skin tone. Sutera. "There is skin under the toenails, and like skin on any other part of the body, the pigmentation can change over time," he explains.

Often times this type of discoloration is symmetrical and seen on multiple fingers. For example, both little fingers can develop discoloration of similar size and shape. Another telltale sign: similar coloring under the nails. These factors can help distinguish this type of benign black nail from the more malignant ones, which are usually contained in a single nail. Still, Sutera recommends that your podiatrist or dermatologist check for any new and common color changes, just to be safe.

How to prevent black toenails

Black nails are more common in runners who train longer or longer. Still, now is the time to work on tactics to prevent them as you start to improve.

A common culprit is repetitive trauma, caused by running motion and aggravated by poorly fitting footwear, such as the top of your shoe rubbing against your nail or your toe hitting the toe of your shoe.

So keep your toenails short, clip them regularly, and make sure there's a thumb-width distance from the tip of your longest toe to the end of your shoe, explains Quinton Yeldell, DPM, founder of Southern Hospitality. , a foot care company born in Brooklyn. Next, look for shoes that are wide enough that your forefoot rests comfortably inside the shoe without hitting either side.Measuring half your shoes or wearing a thinner sock can help relieve pressure and protect your toenails, Metzl says.

How to treat black toenails.

Okay, you have a black nail. Do not worry. In mild cases, no treatment is needed and the black nail will just grow back. But in some cases, the subungual hematoma can cause pain; the more blood under the nail, the more it will hurt, says Metzl.

If this is the case, see your doctor. He or she can poke a few holes in the nail to drain the blood, which relieves the pressure and will also help save the nail. However, quick action is key here - the procedure must be done within the first few days of the injury. So if you are in pain, don't play the waiting game.

And don't try to treat it yourself at home either. This is a procedure that must be done in the doctor's office. Despite what you may hear about it being a DIY hack, trying it yourself can leave you at risk of infection.

While it may be tempting to hide your discolored toenail with nail polish, think twice before painting it; nail polish does not allow the nail to breathe and you could risk losing it completely, says sports medicine physician William O. Roberts, MD. move for special occasions, not for everyday wear.

How to cure black toenails

If a black toenail breaks and causes an injury, first apply pressure until the bleeding stops. Then apply an antibiotic ointment and cover it with a bandage to prevent infection. Do this every day after you shower until the wound heals, which should take about one to two weeks.

But in cases of repeated microtrauma, that is, hitting the nails against the shoes when running, the nail can fall without bleeding or having open wounds. If that's the case, you should still use an antibiotic ointment and a bandage to protect against infection. Usually when the nail comes off, the nail bed is less sensitive and the pain should be less, Metzl says.

Sometimes there is already a new nail growing under it. "As long as it doesn't hurt too much, you should be fine to run," he says. A new nail should take six to eight weeks to grow.

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