Nail Trauma and Nail Bed Injury from Sports or Nailcare

Yes. In most cases, Dr. Dana Stern can diagnose trauma-induced nail disorders through a careful review of your medical history, high-quality photographs, the mechanism of injury, and the progression of your nail changes. If additional testing, imaging, or an in-person procedure is needed, she will recommend the appropriate next steps and coordinate care with your local provider.

A black or purple area after toenail injury is due to blood collecting under the nail (subungual hematoma). A dark nail can also be due to pigment and so expert evaluation is essential to rule out other potentially serious causes of nail discoloration.

Nail lifting (onycholysis) often occurs after injury if the attachment points of the nail plate to the bed are disrupted. Readhesion is possible with the right treatment protocol.

Sometimes but not always. It depends on the area of involvement.

Sometimes a slower growing nail appears to be “not growing” but is growing in a stunted capacity. When a nail ceases to grow it indicates that there has been damage to the nail matrix which may or may not be permanent.

Yes and that is an important reason to treat a damaged nail. 

Yes. During a live video consultation, Dr. Stern can prescribe medications when appropriate and coordinate any necessary testing. If you choose an asynchronous e-visit, she will provide an individualized treatment plan, including recommended prescriptions and referrals, for your local healthcare provider.

One of the most common reasons treatment is unsuccessful is that the injury was not the true cause of the nail changes. Trauma, fungal infection, psoriasis, retronychia, and other nail disorders can appear very similar. Another common reason is that the nail simply has not had enough time to grow out, or the underlying source of repetitive trauma—such as footwear or athletic activity—has not been corrected. Many forms of nail trauma are unfortunately permanent and irreversible. If this is the case, Dr. Stern will let you know if she feels your nail is not treatable so that you don’t waste time and money pursuing treatments that won’t be effective. 

Recovery depends on the severity and location of the injury. Fingernails generally require about 6 months to grow out completely, while toenails typically require 12 to 18 months. If the nail matrix was injured, recovery may take longer and, in some cases, permanent nail changes can occur.

Yes. Nail trauma can recur if the underlying cause such as repetitive sports-related injury, poorly fitting footwear, occupational activities, or repeated mechanical stress is not addressed. Identifying and modifying these contributing factors is an important part of preventing future nail damage.

Absolutely. Trauma is one of the most common causes of nail abnormalities, but it can closely resemble fungal infection, nail psoriasis, retronychia, tumors, and other nail disorders. Likewise, many patients assume their nail changes are due to an injury when another condition is actually responsible. A careful evaluation is essential to establish the correct diagnosis.

Not always. If your history and examination clearly indicate trauma, laboratory testing may not be necessary. However, if there is concern for a secondary fungal infection or another diagnosis, Dr. Stern may recommend PCR testing or other diagnostic studies including biopsy to guide treatment.

You will receive links to either your email or text that contain our demographic form, consent form, nail questionnaire and photo upload instructions. Our staff is always available to help should you have any questions or issues.