Black Toe and Thromboangiitis Obliterans
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Black toe is a relatively common condition among runners, vigorous walkers, hikers, and participants in other sports and activities where the feet are subjected to stress and strain, such as football, basketball, baseball and soccer. The condition generally is the result of impact trauma, especially in the big toe.

People who walk and run on hard surfaces such as concrete and asphalt are more likely to get black toe than those who exercise on natural surfaces or softer man-made surfaces. Hikers can experience black toe as a result of the toes banging against the front area of their shoes or boots, especially on downhill sections of trails.

Symptoms of Black Toe
The most obvious symptom of black toe is a black or dark blue color on part or all of the toenail caused by bruising or pooling of blood under the nail. Since black toe most frequently is a result of trauma to the toe or the nail, it may be accompanied by pain or discomfort that usually diminishes within a few days. Black toe may also occur after prolonged periods of vigorous activity even without noticeable trauma or pain. In some cases, discoloration of the toenail can result from causes other than black toe, some of which are benign. Others, such as the rare disorder, subungual melanoma, are cause for concern.

Black Toenail Treatment Options For You
It is important to know that in some cases medical treatment is unnecessary, especially if minor trauma was involved.

In these cases, the black toenail will eventually fall off on its own or grow out. If you are in doubt, however, you should make an appointment with a podiatrist. Your podiatrist will determine the cause and severity of the problem, which will determine the treatment he or she recommends.

If your doctor does not see a need for medication or drainage, the nail may be left alone to heal on its own. On the other hand, if the injury is cause for concern a local anesthetic will be administered and the nail will be removed for examination of the nail bed.

If a laceration is present it will have to be washed out and possibly sutured. If the hematoma only needs to be drained to relieve the pain and pressure, there are three ways your podiatrist can do this:

Removal: The nail will be removed and the area will be cleaned, thereby removing the hematoma. In some instances the nail may be replaced on the nail bed as a protective barrier.
Needle: A sterile large-gauge needle can be used to create a small hole in the nail to allow the fluid to drain.
Cautery: A battery-operated device burns a hole in the nail until the blood begins to drain.

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