Why is My Toenail Black?

Black Toenail Syndrome, also known as “Jogger’s toe” or “Runner’s toe” is an unfortunate consequence of repeated trauma to the toenail. This issue most commonly occurs while exercising in running shoes. You may notice that this syndrome usually affects your longest toe, which is often the second toe. The repeated force of the toe box of the sneaker knocking against your toe results in the darkened appearance of the nail. This can be a very painful condition, in which case you should seek the treatment of a podiatrist to relieve the pressure or possibly remove the nail entirely (if necessary). Read on for the underlying cause of Black Toenail Syndrome and other treatment options.

Causes:

Now that we have defined what Black Toenail Syndrome is, let’s identify the biological causes of this condition. It was explained earlier that repetitive trauma is the root cause of Black Toenail Syndrome, but what exactly is occurring on the microbiological level resulting in the darkened and discolored nail? Quite simply it is bleeding under the nail.  A subungual hematoma is an accumulation of blood cells directly underneath the nail plate. You can make the analogy that this is similar to a “black & blue” bruise on your arm after an injury.

Treatments:

1. Change your sneaker size – Poorly fitting shoes are likely to be the cause of the Subungual Hematoma. I know it is hard to part with a pair of sneakers that you purchased six months to a year ago, but truthfully you are doing more damage to your feet by keeping them. By purchasing the correct size running shoe, the repetitive trauma to your toenail and pain should be eliminated.
2. Seek the help of a podiatrist – Make an appointment with a podiatrist if the pain is unbearable or for recurrent problems with black toenails. He or she may initially attempt to save the toenail by drilling a small hole into the nail plate and allow the blood to drain while alleviating the pressure and pain. Another option is to avulse or remove the entire nail completely and allow it to heal back naturally. Your toenails grow about 1mm per month which sounds like a slow process, but if it means eliminating your pain, it is worth it. 
3. Toe crests or tube foam – Conservative treatment such as foam padding may initially help provide a soft encasing for your toe, but this is not a permanent fix. This will only somewhat decrease the force of trauma affecting your toe while exercising, this is not an end all solution. If the pain is still present, you must change the shoe size and seek professional help.

Good luck to all participants in the upcoming Riverbank Run.