Hitting against a wardrobe, dropping a heavy object on your toe… Everyone has already experienced this misadventure which can be accompanied by the formation of a “bruise” in the days following the shock. Most of the time, the hematoma resolves on its own. But if it is not well treated, complications can appear. The "blue nail" can also have a pathological origin and require medical supervision. How do these hematomas form and what are the possible treatments? Le Figaro takes stock with Pierre Schlienger, podiatrist and podiatrist and creator of the Youtube channel Allopodo, which provides health advice in the field of podiatry.
The formation of a hematoma in the toenails can be due to several factors. Most of the time, it is caused by a violent and localized impact on the foot, due to falling objects or after being hit hard. The hematoma can also form following repeated microtraumas, in the event of significant friction in the shoe or repeated blows, when practicing a long-term physical activity for example (hiking, running, etc.). In all these cases, we speak of a traumatic nail. "This problem generally concerns athletes, people who practice daily physical activity, have wide feet or deformed toes", underlines Pierre Schlienger.
If it is rarer, blue nails can also be associated with circulatory disorders. For example, this symptom is frequently found in people suffering from Raynaud's disease. "Visually, it's completely different from the traumatic nail", nuances the podiatrist. It will be a perfectly uniform blue while for the traumatic nail, we will rather observe spots ranging from red to purple-brown. Another circulatory disease affected by this symptom is cyanosis, in which the abnormal bluish discoloration of the skin below the nail is due to insufficient oxygenation of the blood.
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The traumatic nail is formed following the accumulation of blood under the nail. If the hematoma is painless, it will grow back gradually at the rate of one or two millimeters per month, usually without complications.
If the hematoma is painful, it means that too much blood has accumulated, which increases the risk of detachment. Several scenarios are then possible:
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For all traumatic causes, it is necessary to start by cleaning and disinfecting in order to avoid potential contamination.
To prevent possible detachment immediately after the trauma, it is recommended to apply gauze (or cotton) with a tight bandage so that the nail is held against the skin. If necessary, the already weakened nail is likely to tear off when putting on shoes or socks.
In the 48 hours following the trauma, the blood is still liquid. If it has accumulated too much, the risk of detachment is significant. A consultation with a podiatrist is therefore strongly recommended in order to avoid any complications and prevent the risk of contamination. The practitioner will pierce the nail very gently with rotating instruments (turbine) in order to drain the blood without causing pain, then will provide personalized care and advice for optimal recovery.
In the long term, there are two types of treatment:
If the blue nail is of pathological origin (Raynaud's disease and other systemic diseases), a medical consultation is essential because the podiatrist will not be able to treat the cause.
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Pedicure-podiatry care is not covered by social security except for people with diabetes who present an increased risk of complicated wounds. For these people, social security reimburses care up to 100% with a contracted practitioner. However, for people without diabetes, some health insurance companies can offer reimbursement for pedicure care.
When preparing for a sporting event, to prevent a long walk or if you practice daily physical activity, it is important to cut your nails well and above all to wear suitable shoes: "for a hike, you will use shoes with a hull at the front, while we will favor flexible materials at the front for running. “says Pierre Schlienger.
Regarding the wearing of shoes, the laces must be tight at the ankle and looser at the front of the foot, which prevents it from moving in the shoe without compressing it.