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The response to the question below was authored by Marc Mitnick DPM

Possible toe fungus???

growth under toe nail

I have a small black mark on my second toenail. I dont think its a bruise because it has been there for over a week and it doenst hurt. Could it possibly be fungus? I tried scrapping it off, but it is under the nail. The mark is no where near the edges of my nail. I do get pedicures often at nail salons. If it us fungus, I am thinking that is where it came from. Any suggestions or over the counter remedies you can recommend?

Thank you

RESPONSE

Hi,

Let me start off by saying I cannot tell what the problem is with your nail just by looking at the picture, but let me make a suggestion on how you should go about treating this.
You say it has been present for a week or so and does not hurt. The fact that it does not hurt does not really mean anything for the simple reason that the growth is so small, I would assume it would not hurt.
The two most common causes of a discoloration such as yours under the nail is fungus and bleeding. The area where your dark spot is located would lead me to believe it is probably more dry blood than fungus because as you rightfully point out, the discoloration is not near the edges of the nail.
Not only will direct trauma cause a nail to bleed underneath (usually worse than pictured on your nail) but sometimes a rough area on the nail bed itself will cause some pinpoint bleeding and thus the limited discoloration that you exhibit. This too does not necessarily have to be painful.
So, what do you do with this? I would give it one month, in that time hopefully the dark spot will grow forward and eventually will be cut away if it is actually a problem with the nail. If the dark spot does not grow forward and basically stays in the same place, then you may want to see a foot specialist.
When a spot underneath the nail does not grow forward it should be examined to see what the cause is. As I mentioned earlier, in the vast majority of cases it is just a dry spot of blood but in some cases it may be an actual growth on the nail bed and this growth would need to be biopsied, to make sure it is harmless. Certainly, if the growth were to continue to enlarge, I would make an appointment to have the nail examined sooner.

Marc Mitnick DPM
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Columbia University Department of Rehabilitation

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Illinois Bone and Joint Institute

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American Family Physician

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