Splinter Hemorrhages

Splinter hemorrhage occurs when blood spots appear beneath the nails, resembling thin wooden splinters beneath the nail. Trauma is often the primary cause of splinter hemorrhages, but they can also be a potential sign of other underlying health conditions. Visiting a healthcare provider is typically recommended for the treatment of splinter hemorrhages.

What is a Splinter Hemorrhage?

Splinter hemorrhages are small spots of blood appearing beneath the surface of the nail. This happens when blood vessels underneath the nail surface have burst due to trauma or damage. Blood visible from above may look reddish brown and much like wooden splinters dislodged under the nail on the finger's skin.

Splinter hemorrhages may occur on the nails of the hands or the toes and run vertically along the growth of the nails. Splinter hemorrhages are mostly a problem of trauma or injury to the nails. They may also be a sign of an underlying health condition. 

Symptoms of a Splinter Hemorrhage

Splinter hemorrhages are streaks of blood underneath the nail, appearing dark red or brownish and running in the direction of nail growth. The primary symptom manifests as dark red spots in the nail, approximately 1 mm to 3 mm long, usually near the nail tip.

Initially, splinter hemorrhages may appear purple to dark red in colour and gradually darken to a deeper shade of red or brown. Splinter hemorrhages can occur without any associated pain in the fingertips.

If a splinter hemorrhage is caused by finger or nail injury, additional symptoms such as swelling, inflammation, and pain may accompany the blood clot formation beneath the nail surface.

Causes of Splinter Hemorrhages 

Splinter hemorrhages are mostly a symptom of nail or finger injury caused by hitting the fingers against hard surfaces. Stubbing a toe or injuring a finger during any activity may cause blood vessels underneath the nails to rupture and release blood. 

Splinter hemorrhages caused by trauma or injury typically go away on their own. However, splinter hemorrhages can also be caused by underlying health issues that affect the blood vessels, leading to their rupture. The seriousness of these conditions may vary depending on the cause and can often be treated with common medications.

Some of the reasons for having splinter hemorrhages that are not a result of injury include:

• Skin conditions: Various skin conditions, such as nail psoriasis and lichen planus, may cause splinter hemorrhages.
• Bacterial or fungal infection: Fungal infections in the fingers and bacterial endocarditis, a heart issue, can cause splinter hemorrhages.
• Inflammation: Systemic diseases like rheumatoid arthritis, peptic ulcers, etc., may cause inflammation underneath the nail, leading to splinter hemorrhages.
• Vasculitis: Damage to blood vessels due to inflammation can result in the appearance of splinter hemorrhages.
• Diabetes: Diabetic patients may experience blood vessel damage that can lead to splinter hemorrhages.
• Cholesterol: Individuals with high cholesterol levels may be prone to splinter hemorrhages.
• Medicinal drugs: Certain drugs used in the treatment of cancer may have side effects that lead to splinter hemorrhages.
• Non-cancerous tumour: A benign tumour of the nails, known as onychomatricoma, may cause the appearance of splinter hemorrhages.

Splinter Hemorrhage Treatment

Treatment for splinter hemorrhages may depend on the underlying problem. If the hemorrhages are caused by trauma, they may resolve on their own as the nail grows. If the hemorrhage is not caused by injury, visiting a doctor may aid in diagnosing and identifying the problem.

If the splinter hemorrhage is caused by infection or a skin condition, using medication may help resolve the issue. In the case of other problems, such as cancer, the appropriate treatment procedure will be followed.

Splinter hemorrhages are typically small blood clots that appear as tiny lines or streaks under the nails. They are often caused by damage to the small blood vessels under the nail, and the treatment may vary depending on the underlying cause. Here are some general considerations:

• Address Underlying Causes: If splinter hemorrhages are occurring frequently or persistently, it's essential to identify and address any underlying health conditions. Consult with a healthcare professional to determine the cause and appropriate treatment.
• Avoid Trauma: Take measures to prevent further trauma to the affected nails. Avoid activities that may cause injury to the nails, and be gentle when caring for your nails.
• Nail Care: Keep your nails clean and well-trimmed. Regular nail care can help prevent additional damage and promote overall nail health.
• Moisturize: Use moisturizers on your nails and cuticles to prevent them from becoming dry and brittle.
• Protective Measures: Consider wearing gloves during activities that might expose your nails to trauma, such as gardening or household chores.
• Healthy Lifestyle: Adopt a healthy lifestyle with a balanced diet, regular exercise, and adequate hydration. This can contribute to overall nail health.
• Consult a Dermatologist: If you're concerned about the appearance of splinter hemorrhages or if they are associated with changes in the nails, it may be beneficial to consult with a dermatologist. Dermatologists specialize in skin, hair, and nail conditions and can provide expert guidance.
• Medical Evaluation: If the splinter hemorrhages are associated with pain, swelling, or other concerning symptoms, seek prompt medical attention for a thorough evaluation.

How is a Splinter Hemorrhage Diagnosed?

Splinter hemorrhages can be diagnosed during a visit to the doctor when the initial symptoms manifest. The doctor will likely inquire about the patient's medical history and conduct specific tests, which may involve:

• Blood culture
• Complete blood count
• Erythrocyte sedimentation rate

Additionally, the doctor may request imaging tests, such as an X-ray, to identify any abnormalities. If there is a suspicion of a serious condition, the doctor may order a chest X-ray and echocardiogram to investigate potential abnormalities in the heart.

In the event that the doctor suspects the splinter hemorrhages may indicate melanoma, a form of skin cancer, a biopsy of the affected finger may be recommended for further examination.

How to prevent the Risk of Splinter Hemorrhages?

Since trauma and injury are the primary causes of splinter hemorrhages, remaining vigilant while working can help prevent such injuries. Consuming a nutritious diet rich in Vitamin B and Zinc can contribute to healthy nail growth.

If splinter hemorrhages are a result of medication usage, discussing the side effects with a doctor and considering adjustments to the dosage may assist in treating them.

When should I see the doctor?

If splinter hemorrhages occur spontaneously without any recent history of trauma or injury to the feet or hands, and they fail to resolve on their own within a few days, it would be advisable to seek medical attention.

If you experience splinter hemorrhages, which are often caused by trauma or injury and typically resolve on their own, it's generally a natural process. However, it's essential to reach out to your healthcare provider under certain circumstances:

• If you cannot recall any specific injury or trauma to your nails.
• If the splinter hemorrhage persists for more than a few days or doesn't resolve as your nail grows.
• If you consistently notice recurrent instances of splinter hemorrhages.
• If the condition is impacting multiple nails.

Conclusion

Splinter hemorrhages appear on the nails and are usually a result of injury to the affected hands or toes. They go away on their own after some time, but they may also appear without any associated injury, which could indicate an underlying health problem. Seeking an expert opinion in such cases may help in successfully treating any underlying issue at the earliest opportunity.

FAQs

1. When are splinter hemorrhages serious?

Splinter hemorrhages that appear on their own, without any history of injury to the affected body part, maybe a sign of a problem. A doctor may be able to determine the severity of the issue

2. Can vitamin deficiency cause splinter hemorrhages?

Splinter hemorrhages may not be related to any vitamin deficiency but can potentially be treated by increasing the intake of Vitamin B, which promotes healthy nail growth.

3. What deficiency causes black lines on nails?

Splinter hemorrhages which may appear as black lines, may not be related to any vitamin deficiency.

References:

https://my.clevelandclinic.org/health/diseases/23341-splinter-hemorrhage

CARE Medical Team