Nail & Skin Disorders

What Is a Splinter Hemorrhage?

n. (splĭn ‘tər hem’ər-ĭj) small areas of bleeding or hemorrhage underneath the nail bed that take the shape of straight lines; usually caused by hard impact or physical trauma to the nail; usually grows out with the nail after a few months

How to Treat It

Treatment depends on the underlying cause of the splinter hemorrhage. But the only way to get rid of a splinter hemorrhage is to simply let it grow out. Since it is deposited on the under surface of the nail plate, the splinter hemorrhage will grow out with the nail and the nail bed over a period of time and disappear completely. This usually takes a few months.

“The nail will grow out, but it may grow back abnormal,” adds Dr. Luu.

If the splinter hemorrhage is caused by certain medications, the medication should be discontinued if possible.

If the hemorrhage is the result of a fungal infection or nail psoriasis, then obviously treating those underlying conditions will cause the bleeding to disappear and no longer recur.

If the cause is trauma from a sports-related activity, keeping the nails trimmed short can prevent these hemorrhages, says Dr. Luu.


Your client may want to check her shoes to be sure the toenails are not hitting the inside of the shoe if the splinter hemorrhages are occurring on the toenails. This can happen with abnormally shaped toes or when wearing shoes that don’t fit properly. Clients may want to have the shoes modified to accommodate an abnormally shaped toe, suggests Tammy Brown, D.P.M., of JT Enterprises Corporation.

“Local pharmacies often carry a variety of toe pads and specialty shoe providers can often loosen an area of tightness in a shoe to accommodate an abnormal digit,” says Dr. Brown.

Splinter hemorrhages that persist over a period of time should be medically evaluated to rule out the possibility of a blood disorder or other condition a person may not be aware of.

Considerations for Nail Techs

If a client comes to you with a splinter hemorrhage on her nail, fear not. While a hemorrhage may look ugly you can still work on the area of the nail that it’s on, says Dr. Satur. However, you should handle the hemorrhaged area with care. Filing, buffing, or handling a nail with a hemorrhage should be performed gently so the underlying nail bed is not traumatized.

Before you begin a service conduct a client consultation, especially if you’re dealing with a new client. Before you begin working on the injured nail ask your client what happened to it. Chances are she’ll tell you she injured it, but if she hasn’t, advise her to have her physician check it out promptly.

And while your client would probably love to camouflage that nasty hemorrhage with polish it may be a good idea to have her get it checked out before you apply anything on the nail.

“If there are systemic causes involved the client should be referred to a physician so her medical issues can be treated or addressed before that client can cover up the nail with nail polish or acrylic nails,” says Dr. Luu.

If a client has a splinter hemorrhage on more than one nail or has recurring hemorrhages you should advise her to see her physician if she hasn’t done so already. It may be a sign of a more serious disease or condition.


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