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Bruised Toenail or Fungus? How Can You Tell?

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So you’ve found yourself with a discolored toenail. Now you’re wondering if it’s a bruised toenail or fungus. It’s a good question because if it is toenail fungus, you are going to want to treat that ASAP.

Toenail fungus affects millions of people and becomes more prevalent as we age. Not only is it rather unsightly, but toenail fungus is hard to treat and spreads easily.

The sooner you start treating a nail fungal infection, the more chance of success you will have of getting rid of it and the less time it will take.

In this article, we will show you how to tell the difference between a bruised toenail and toenail fungus. Do you really need to worry about it, or do you need to start treating it before it gets worse?


How Do I Know if it’s Just a Bruised Toenail?

There are a few ways to figure out whether the discoloration on your toenail is just a bruise, and not toenail fungus.

Bruising

The first question you need to ask yourself is the obvious one: did I hurt my toe recently?

Bruising is caused by trauma when the small blood vessels near the skin’s surface are broken by the impact of a blow or injury and blood accumulates between the nail plate and the nail bed.

Now you’d probably remember if someone ran over your foot with their car, or you dropped something really heavy on it.

However, bruising under the toenail can also come as a result of a not-so-serious injury.

For lesser injuries, it can sometimes take a couple of days for the bruising to appear, so you may have forgotten having stubbed your toe on a piece of furniture in the middle of the night making a midnight trip to the loo.

Or maybe that day you were playing basketball and your opponent stepped on it while rushing for the ball. It doesn’t take a severe injury to cause bruising.

Running

The second question you need to ask yourself – do I run or jog for exercise?

“Runner’s toenail” can cause a blackening of the nail from the repeated stress of running.  Unlike one distinct trauma that causes a bruise, runner’s toenail occurs as a result of thousands of ‘microtraumas’.

Every time your foot touches the ground when you’re running, your toes get pushed into the front of your running shoe. Even though a running shoe is relatively soft and absorbs a lot of the impact, it’s still an impact.

Think of it like, if a toddler were to hit your toe with a plastic toy hammer. That of course wouldn’t hurt.

Now think of running being like taking that little toy hammer and hitting your toe a thousand times a week in the same spot.

This eventually causes damage to the blood vessels resulting in a bruise.

Runner’s toenail usually affects the big toe or the second toe. They are the ones that are the longest and usually take the brunt of the toe-to-shoe impact.

Incidentally, this can also be caused by simply wearing shoes that are too tight!

If you answered yes to either of the above questions, then it’s most likely a bruise.

But it’s not an absolute – you may have injured your toe that did not bruise and you happen to have toenail fungus! Knowing what toenail fungus and a bruised toenail look like, can help you further narrow down the culprit.

Is it tender to the touch? Does it hurt like a bruise? In most cases, toenail fungus doesn’t hurt unless it’s so far advanced that the nail is misshapen and has caused an ingrown toenail.


What does a toenail bruise look like?

The color of your toenail is a good indicator of what’s going on. Toenail bruising usually starts off as a dark red and turns purple, then dark rusty brown, and finally, it turns black.

And If the dark spot in the nail looks shiny, you can still see through the nail around the colored spot to the nail bed, and the discolored spot is uniform in color (i.e. all the same color), then it’s most likely a bruise.


What does fungus look like?

Toenail fungus usually starts off as a small white or yellowish spot near the tip of the nail.

As the fungal infection spreads and goes deeper into the nail, it causes the nail to discolor and become opaque. The nail thickens and eventually crumbles at the edges.

Nail fungus varies from white to yellow and can sometimes appear brown.

Regardless of the color of your fungi, it will be sort of splotchy looking rather than one uniform color.

The progression of the color of bruising will happen in a matter of days from dark red to black, as opposed to nail fungus which starts off white or yellowish and may eventually turn brown after weeks or months.

Nail fungus will make the nail look dull as the fungus starts to separate the keratin in the nail plate and it becomes opaque.


Bruised Toenail or Fungus?

One of the sure-fire ways to tell if it’s just a bruise or toenail fungus is if it’s spreading. The area of discoloration will not get bigger if it’s a bruise.

Another way to differentiate between nail fungus and a bruise is to watch how it moves as your nail grows.

Nail fungus starts at the tip of the nail and spreads toward the base of the nail. Because your nails grow from the base of the nail up, it sort of looks like it’s not moving because the fungus is spreading in the opposite direction than the nail is growing.

A bruise on the other hand, can start anywhere on the nail, depending on where the trauma happened. As your nail grows out, the bruise will move up with the growing nail, toward the tip of the nail.

But unless you plan to sit there with your foot under a film camera for the next few weeks and watch it back on timelapse video, it can be hard to tell because toenails grow so slowly.

The average toenail grows only 1.6mm per month, so any “moving” your bruise or fungus will be doing is not something you can watch with the naked eye.

One thing you can do is take a zoomed-in, close-up picture of your toe. Then take a picture a month later and note the distance of the discoloration from the base of the nail in the second photo compared to the first.

If there’s a bigger distance between the base of the nail and the discoloration from the first photo, then you know that you have a bruise and not toenail fungus.

The only problem with doing this is that if you do realize you have toenail fungus, then you’ve wasted weeks when you should have been treating it!

Toenail fungus is one of the hardest types of topical fungal infections to treat. Apart from prescription medication, there are no known remedies for toenail fungus that are FDA approved or have been clinically tested and proven to be effective against toenail fungus.

But if you catch toenail fungus early enough, you may just have some luck using a home remedy with antifungal properties like Vicks Vaporub, alcohol, and hydrogen peroxide.

You can also try an over-the-counter topical antifungal like Kerasal to treat it. Just understand that none of these medications are approved to treat it, and many do not succeed.


Summary

It’s probably a bruise if:

  • you hurt your toe or are a runner (or you wear shoes that are just too tight)
  • It’s tender to the touch
  • It’s run the gamut from red to purple to brown, then black
  • The nail around the discoloured area looks shiny, healthy and clear
  • It does not increase in size 

It’s probably toenailed fungus if:

  • There was no injury or trauma to your toe, you don’t jog or run and wear properly fitting shoes
  • It doesn’t hurt
  • It’s whiteish yellow or brown
  • the nail opaque, and/or thickening
  • it’s spreading to a larger area over time
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