So, there's a dark mark beneath your toenail. It's gnarly.
You can't remember banging it. You googled — and now you're anguished.
Is it a toenail hematoma or melanoma?
Trust me, black stains under nails are a big patient worry. The vast majority of the time it's nothing serious.
But now and again, sometimes, occasionally, it's something else...
Toenail Hematoma vs Melanoma
Toenail hematomas are bruises under your nail caused by a trauma (whether you noticed it or not).
A subungual melanoma is a blob of cancerous cells.
(Subungual means under your nail)
Now, hematomas are far, far more common than subungual melanomas.
In other words, toenail melanomas are rare.
The trouble is that they can be problematic to tell apart, even for professionals.
And especially Dr. Google.
Paging Dr. Google (Again)
You have to doff your hat to Dr. Google. Its sheer work ethic is something to behold.
24 hrs a day, 365 days a year, billions of people consult with the digital medic.
These inquiries range from splinters to tumors.
You start with a wood shard and end up with something sinister.
My point is that a web article should never (ever) replace a real assessment by a real expert.
(If in Doubt) See an Expert
This is super important when it comes to a toenail hematoma vs melanoma.
Because even medical professionals can (and do) get confused by the two conditions.
A brown nail spot that's textbook terrifying can turn out completely harmless.
And very occasionally, it's the opposite.
Blood Pool: What is a Toenail Hematoma?
Hematomas are the edumacated way of saying "bruise".
A blood pool, if you will, under your toenail.
They're triggered by trauma. Think of a nail thwack, crack, or lots and lots of pressure.
Delicate vessels nestled below your nail rupture and seep blood under your toenail.
Often there's a clear cause for toenail hematomas.
Things like a hearty bedpost kick in the dark, or a big long run with small tight shoes.
Trauma And Memory Loss
But there's a problem.
In my experience, lots of you with toenail hematomas can't recall any form of bashing.
(If you could, you wouldn't be reading this article)
All I'll say is, it's amazing what can injure the little vessels under your toenail.
It doesn't have to be a dropped can of paint during a garage clear-out.
It can be nails that gnaw against new shoes.
You won't notice it, but this is a prime candidate for "unexplained" nail bruises.
Signs You've Got a Toenail Hematoma
Don't rely on its shape or location, these vary widely depending on the damage.
The most important thing is it grows out.
Be patient with this. Toenails take a looong time to move so look at it over weeks, not days.
They're like glaciers, only made of toenails.
So remember: growing out is good, no matter how slow.
Toenail Hematoma Treatment
Want some good news about your toenail hematoma? You still have a nail.
Yep, many a toenail has fallen off weeks after a trauma.
Ask marathon runners. Or me after I dropped a 15-kilogram weight plate on mine a few years ago.
To improve its appearance, I use Gehwol Nail Care to soothe the bloodied cage-fighter look.
Then leave Mother Nature do her thing to buff out the blood.
What is a Subungual Melanoma?
Ok, ok, so enough about toenail bruises. What about melanoma cancer?
A subungual melanoma is a blur or line of cancer cancerous that forms under your toe or fingernail.
Don't get these confused with skin melanomas.
Medical science is undecided about their exact cause.
Toenail Melanoma Red Flags
They're not linked to sun exposure; and as far as we know, they're unrelated to injury.
They're also uncommon. Most health pros will see a handful in their entire careers.
That said, they do occur and it's important to act fast if you suspect one.
So what are some toenail melanoma red flags?
A Stripe Down Your Nail?
Ah, the infamous marker-pen line down your nail. It's easily the most distinctive symptom of nail melanoma.
Or is it?
Now, quite a lot of websites label these as Hutchinson's sign. That's incorrect, though (see below).
A dark brown stripe is actually a melonychia. Before you freak out, they're not an automatic consultant meeting.
Those of you with darker skin types can develop brown nail lines naturally.
They can also occur due to chemotherapy. Also, some people just get them.
Red Flag? Yes, that said a new nail stripe is worthy of a second opinion.
This is where it gets tricky.
A Hutchinson's sign is when the dark discoloration grows from your flesh to your finger (or toe) nail.
That bit right at the back of your toenail.
In other words: the discolouration crosses tissue types.
The problem is, it can be reallllly difficult for you to tell this.
Red Flag? Yes, though be sure to get an expert take on it.
It Doesn't Move
Toenail melanomas don't always present as bar code stripes. Sometimes, they're a black blob that refuses to budge.
Remember what we said about toenail hematoma's?
They always move out, no matter how sluggish.
If you've got a dark nail smudge that's been there for years, it's worth getting it checked out.
Red Flag? Yes, and take photos at time intervals if possible.
Toenail Hematoma vs Melanoma
So toenail hematoma vs melanoma.
Remember, most brown marks under your nail are blood bruises. You may not know (or remember) what caused it.
Try not to freak out; watch its progress.
If there's other signs like a stubborn stripe or its sat there ages — get it checked out.
No online article can replace an expert opinion!