If not well cared for, a bruise on the nail can cause it to detach or become infected.
Hitting against a wardrobe, dropping a heavy object on your toe… Everyone has already experienced this misadventure which can be accompanied by the formation of a “bruise” in the days following the shock. Most of the time, the hematoma resolves on its own. But if it is not well treated, complications can appear. The “blue nail” can also have a pathological origin and require medical supervision. How do these hematomas form and what are the possible treatments? Le Figaro takes stock with Pierre Schlienger, pedicurist-podiatrist and creator of the Youtube channel Allopodo which provides health advice in the field of podiatry.
Why do I have blue fingernails?
The formation of a hematoma in the toenails can be due to several factors. Most of the time, it is caused by a violent and localized impact on the foot, due to falling objects or after being hit hard. The hematoma can also form following repeated microtraumas, in the event of significant friction in the shoe or repeated blows, when practicing a long-term physical activity for example (hiking, running, etc.). In all these cases, we will talk traumatic nail. « This problem usually affects athletes, people who practice daily physical activity, have wide feet or deformed toes », points out Pierre Schlienger.
If it is rarer, blue nails can also be associated with circulatory disorders. For example, this symptom is frequently found in people suffering from Raynaud’s disease. “ Visually it is completely different from the traumatic nail “, nuances the podiatrist. It will be a perfectly uniform blue while for the traumatic nail, we will rather observe spots ranging from red to purple-brown. Another circulatory disease affected by this symptom is cyanosisin which the abnormal bluish coloring of the skin located under the nail is due to insufficient oxygenation of the blood.
How does the traumatic nail form and what are the complications?
The traumatic nail is formed following the accumulation of blood under the nail. If the hematoma is painlessit will grow back gradually at the rate of one or two millimeters per month, usually without complications.
If the hematoma is sore, this means that too much blood has accumulated which increases the risk of detachment. Several scenarios are then possible:
- If the nail does not come off, there are usually no complications. The pain subsides after a few days and the nail slowly grows back.
- In case of partial detachment, a small cavity under the nail is formed. ” Over time, if too much moisture is stored there, a mycosis can then grow under the nail warns Pierre Schlienger. Mycosis is favored by exposure to sources of heat and humidity, when you frequently walk barefoot in damp places (typically the bathroom) or when you practice a risky activity such as swimming. .
- In case of total detachment, there may be poor nail regrowth. ” The flesh that surrounded the nail will then regain the space originally occupied by it. This increases the risk ofingrown toenails during regrowth », explains Pierre Schlienger.
- When the shock was very violent on the nail and the nail matrix, i.e. the fleshy part just before the nail, reformation problems can occur. The nail grows back by being a little thicker, deformed and/or yellowed, which weakens it and increases the risk of recurrence.
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What are the treatments ?
For all traumatic causesit is necessary to start by cleaning and disinfecting in order to avoid potential contamination.
To prevent possible detachment immediately after the trauma, it is recommended to apply gauze (or cotton) with a tight bandage so that the nail is held against the skin. If necessary, the already weakened nail is likely to tear off when putting on shoes or socks.
Within 48 hours of injury, the blood is still liquid. If it has accumulated too much, the risk of detachment is significant. A consultation with a podiatrist is therefore strongly recommended in order to avoid any complications and prevent the risk of contamination. The practitioner will pierce the nail very gently with rotating instruments (turbine) in order to drain the blood without causing pain, then will provide personalized care and advice for optimal recovery.
In the long term, there are two types of treatment :
- If the nail has partially fallen off, the podiatrist can perform an onychoplasty. The procedure consists of placing a resin false nail (an artificial nail plate) which has an aesthetic but above all therapeutic interest by guiding regrowth: “ by filling the nail bed with synthetic material, the flesh will be able to remain on the sides which makes it possible to prevent ingrown nails », explains Pierre Schlienger.
- If the nail has completely fallen off, this means that the blood has drained badly because of the violence of the impact. “ In this case, there is not much to do, you just have to be patient because the nail takes on average 9 to 12 months to grow back. “says the podiatrist. Nevertheless, it is advisable to apply a greasy substance (moisturizing cream or oil) on the bare skin before it forms a small bead which risks causing poor regrowth or even an ingrown nail. “ It is necessary to massage the skin well to drive it out before it forms this bead and the surface is sufficiently flat “, advises Pierre Schlienger.
If the blue nail is of pathological origin (Raynaud’s disease and other systemic diseases), a medical consultation is essential because the podiatrist will not be able to treat the cause.
What support ?
Pedicure-podiatry care is not covered by social security except for people with diabetes who present an increased risk of complicated wounds. For these people, social security reimburses care up to 100% with a contracted practitioner. However, for people without diabetes, some health insurance companies can offer reimbursement for pedicure care.
How to prevent possible recurrences?
When preparing for a sporting event, to prevent a long walk or if you practice daily physical activity, it is important to cut your nails properly and above all to wear suitable shoes: “ for hiking, shoes with a shell at the front will be used, while flexible materials at the front will be favored for running. “says Pierre Schlienger.
Regarding the wearing of shoes, the laces must be tight at the ankle and looser at the front of the foot, which prevents it from moving in the shoe without compressing it.
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