Black toe…seriously…that’s the name of a condition? Well it is, and a fairly common one too. If you walk a lot and at a vigorous pace, run, or participate in varied sports, you’re at risk. Its occurrence is mainly due to trauma of the big toe in particular. Persons with long toes, especially the second one, also experience it in more toes than just the big one.

Walking, jogging, and running for the most part on hard surfaces, can lead to this condition. Our sometimes bumpy roadways certainly provide for such happenings.

Causes

Toes sometimes tend to bang against the forefront of the footwear; more so if the footwear is too big or the track taken is going up or downhill. This can be experienced by persons who exercise on hills like Chancellor, or persons who hike.

Repetitive trauma mainly due to banging toes is the most common cause of this condition. The big toe and in some instances, where the second toe is longer than the big toe, the friction or banging causes bruising and or bleeding of the nail; this then leads to discolouration, which is generally blue or black in tone. The most logical reason the toes bang against the front of footwear, is because there isn’t enough room in the toe box area, to facilitate the shape of your feet. Additionally, shoes that are too short cause the same effect. Another reason, though rare, is a melanoma (form of skin cancer that can occur under the nail).

Prevention and Treatment

– Insulate yourself by using durable footwear which is shaped to suit your feet/arches; provides good traction; and is cushioned on the inside.

-Trim toenails to an acceptable level and make sure that they’re cut straight across, to aid in avoiding trauma.

– Use of quality padded socks, seamless for diabetics, is ideal. They help to protect the toes from the full impact of your journey. Insoles or orthotics (arch supports), can be prescribed or recommended by your orthopaedic specialist, general physician, podiatrist/chiropodist or foot health practitioner, to help cushion the soles of the feet. They protect against undue pressure to the fascia (fatty tissue under the soles of the feet).

If black toe occurs, allow it to grow out; a new nail usually takes between 4 – 6 months, sometimes more. Most times it grows out and a healthy nail comes forth. If some instances, however, due to the trauma caused, the nail drops off. In other cases, severe trauma can damage the nail bed so badly that new nail growth is stunted, and a new nail doesn’t grow back.

Medical Considerations

When the damaged nail (discoloured or black in hue) is as a result of a fungal infection, medication or an ointment is prescribed.

Where edema (swelling), or pain persist, you should visit your doctor or relevant foot health specialist to aid in relieving the pressure due to the blood underneath the damaged nail, or to remove the nail altogether.  The latter should be a last resort though, since the nail bed may: experience trauma resulting in irregular growth due to it healing badly; become stunted or have no growth at all; have localised numbness.

If there is severe redness, discomfort, inflammation or pus, and it’s spreading or getting worse, you may have an infection. Infections spread easily and should be addressed immediately.

Persons with diabetes or circulatory conditions should seek medical attention. Compromised blood flow could lead to pressure sores/ulcerations. In such cases, please see your foot care provider as quickly as possible. Extreme cases also require advice from a vascular specialist regarding blood flow.

Those with diabetes or compromised circulation in the lower extremities should never try to treat toenail injuries (or any other foot issues) on their own, especially if there is any indication of possible infection or ulceration. See your doctor promptly!

If pain, discomfort, soreness, swelling or yellowish/redness occurs; more so if this persists for a number of days without improvement … consult your doctor.

Your feet mirror your general health . . . cherish them!