2 days ago I jammed my fingernail very hard and it almost instantly went dark underneath. Yesterday it was incredibly sore so I pierced the nail with a hot paperclip to relieve the pressure. It helped with the pain, but since then, there has been a constant stream of clear fluid coming out from underneath the nail. The swelling around the nail also seems to be increasing. Is this to be expected or is it a sign of infection?
You have a subungual hematoma (bleeding under the nail). These can be very painful and throb anytime you hold it in a dependent position (hold in down).
It usually takes several holes to adequately drain the hematoma. One hole usually clots off. Just be sure to not injure the nail bed under the nail plate. If you touch the nail bed, you will know it, it will hurt like crazy.
The clear liquid is the serum. When the blood clots, the liquid portion of the blood (serum or plasma) separates from the cells. So, it sounds like you are draining a seroma.
Keep the nail clean with soap and water. Then apply some hydrogen peroxide (H2O2) to the nail plate, where the holes are. The H2O2 dissolves the blood clots and allows the hematoma to drain better. Also, the H2O2 will disinfect the area. (DO NOT use alcohol, that would really sting.) Contrary to what our mothers have told us, the foaming that H2O2 does is not killing bacteria, it is breaking down red blood cells.
You might also want to use a finger tip splint, just to protect the finger from being hit. Nothing sticks out like a sore finger.
The body will gradually resorb the blood left under the nail plate, but it can take a while. Also, as the nail grows out, don't be surprised if it has a ridge in it. It takes about 120-150 days for a completely new nail to grow out.
If you notice that the pain around the finger is getting worse, the drainage becomes purulent looking, the finger becomes red and hot, then you need to see someone about it. Those are the signs of an infection.
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