Subungual Haematoma


  • Usually associated with trauma, either a single event or over a short period due to activity or tight footwear.
  • Bruising or discolouration of the subungual and/or periungual tissue
  • Care with patients on anticoagulants


Diagnostic tips

  • Recent history
  • Exclude subungual exostosis, onycholysis, subungual melanocytic lesion
  • Acutely painful on pressure



Tests and Imaging

  • Xray to exclude fracture or exostosis


Immediate Treatment

  • Pierce nail to release pressure
  • Review anticoagulant therapy
  • Analgesia and appropriate dressing



Possible Referral

  • Podiatry for expert debridement and advice on footwear and hosiery
  • Podiatry for management of resulting onycholysis