How to Drain Your Subungual Hematoma (blood Pocket Under Finger-nail) With a Drill Bit




Introduction: How to Drain Your Subungual Hematoma (blood Pocket Under Finger-nail) With a Drill Bit

Have you ever smashed your finger in something and immediately get a black finger nail?  Well along with that sweet Hot Topic look comes a throbbing pain that, even for those with high pain thresholds, can be unbearable. It's hard to even sleep with this kind of pain! So, the best thing to do is drain the blood pocket under the nail and relieve the pressure build-up.

Some use the heated pin method. But that can lead to a little more pain than necessary. Also, there is hardly any pain associated with the drill bit method except for the slight pressure you are applying. Fingernails don't have nerve endings, and by moving very slowly with a drill bit, you can reach the blood pocket without touching your nail bed!

finally, you get a satisfying eruption of crimson that, if performed soon after the injury, has a geyser effect. it's quite nice.

Step 1: Smash Finger

I happened to accidentally crush my finger with a welding tank.

Step 2: Ice and Elevate Your Finger

Do this immediately to instantly relieve pain and swelling

Step 3: Find and Sterilize/heat Drill Bit

Find the smallest drill bit you have access to and sterilize it either by heating it or using rubbing alcohol

Step 4: Start Drilling

slowly twist drill bit (by hand) into fingernail where blood clot lives, furthest from cuticle.

continue to twist slowly until you penetrate the bottom of the nail

do not use a drill for this...

(note bourbon)

Step 5: Presto

blood will form instantly once you've penetrated.

squeeze finger to relieve the pressure

Step 6: Apply Anti-spectic

apply anti-spectic

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185 Discussions

Smashed my finger for the first time ever in the car door when distracted Tuesday morning like a kn*bhead whilst working away in Cornwall. Just got back home and found this site, drilled my nail, relieved blood and looks much better - Thanks, hope I don't lose the nail!

A radiator dropped on my big toe and caused the exact same.
After going to the doctor he did exactly that with a needle, though I think he might have done a lousy job. A tiny bit of pressure relief happened but it's still painful and meanwhile the blood that has oozed out has dried up again, keeping it black.
Should I just reopen that hole again or make a new one instead?

I can not tell you how happy I was to find this article last night. So much so I created an account just to share my experience.

I dropped a pole on my toe yesterday and all night last night I was awake. I think I got a total of 2 hours of sleep. My toe was throbbing so hard it kept me up. I found this article at 2:45 am sitting in my bathroom trying to find a way to release the pain!

My husband and daughter woke up and we ran to target at 745 am, still in pain I got the smallest drill bit 1/16th.

Once I got home I sterilized my toe, the drill bit and soaked it in rubbing alcohol, I then lit the end and started drilling down with my fingers not a drill this took about 15 mins. A little blood started coming out and I instantly started feeling better. Although I saw a post before, where the blood was completely drained. Mine still has blood under the nail, is this normal?

I'll post a picture. The first is after the drill bit and the second is the night before right after it had happened and I had iced and elevated. Any advice would be great on how to drain more of the blood or if it's even necessary! I still have a bit of throbbing but was able to at least nap now!


The drill method worked for me. Fortunately I have a good selection of tiny bits - I used one that is .018" and a pin vise to hold it.

Here are a couple pics - before, during, and after.


Slammed my index finger in my car door and really didn't want to go to the ER but after 4 hours of pain I found your video and it worked thanks man

So... A question. :-)
I injured my toe a while back. As in December shoveling snow I dropped a shovel on it. Since it stopped hurting after a day or so, I ignored it. Now there's a black/redish area under the nail that has been gradually growing. Honestly, I'm not even sure if this was caused by the shovel accident! But if it is, will drilling get rid of it at this point? And if it isn't, what is it and what do I do?
Thanks for any advice!

This works well. My advice is based on doing this to my son at 3:00am due to my wanting to avoid the ER. I used the smallest drill bit we had and I turned it by hand. It took quite a while to get through the toe nail. Maybe 10-15 min? I used rubbing alcohol on the toe nail and soaked the bit in alcohol. Then I burned the bit with a lighter. The next morning he did have some pain and throbbing for about an hour and I was afraid I was going to have to take him to the clinic. But, then it quit hurting.


2 years ago

Or you can get one of these from your doctor? Haha my doctor performed my "hole punching" and gave me mine to mess around with. Obviously not to do another cautery since it isn't technically sterile anymore.


Smashed my finger, dealt with throbbing pain for about 3.5hrs, took your advise, instant relief. Its been about 1hr and all it good! Here's what I did (an aggregate of everyone's advise - thank all): soaked finger in ice water for 10 min, cleaned nail with alcohol, dipped a clean 1mm drill bit in alcohol then lit it with a lighter until alcohol burned off, used 'good hand' to gently spin drill bit, after ~45 sec it broke through. Periodically cleaned 'hole' with alcohol until bleeding was sparse. Put triple antibotic cream on it and a band aid. Will locate some medical super glue tomorrow.

Found your article when our seven year old smashed his finger. He has a high pain threshold and was spitting bullets. He freaked when we suggested it, didn't care Grandma survived this, but your words, "You might not lose the nail" gave him the gusto to go for it (with a blindfold on because he didn't want to see the blood). Fifteen minutes later, his pal stopped by and he told the tale like a warrior and went and played outside like one. Thank you for your helpful article, our son literally said, "Thank you for drilling my nail."

Finally I can sleep. I started with the red hot paper clip but didnt have the nerve to go right through. It gave me a guiding hole to finish with the tip of a drill bit. Lots of precautionary alcolhol on the toe nail, paper clip, and drill bit, plus flame on the two latter. Thanks!


This worked like a charm. I play roller derby so my big toes are always getting banged up. If I went to the doctor every time I had a black toenail I'd be out hundreds of dollars. Thanks for the post. I'm sure I'll be doing this again soon.

This worked wonderfully. Go slow, I'd suggest.
Thank you!

Hi, I too am a "health care professional", a physician. While by the book ethics would prevent me from telling anyone it's OK to do this at home, I really can't find much wrong with the theory behind this home brew trephination procedure. The only thing I would add is that the procedure should be performed in a room with little air flow (avoid open windows or fans that might kick bacteria around); and most importantly, the nail needs to be disinfected BEFORE the procedure as well as after. That way you wont be pushing surface bacteria into the newly made wound. Also. be sure and twist the drill bit by hand as the author of this 'ible did. I have seen wounds where people thought they could use a drill but the drill ended up pulling the bit itself into the nail and making a far worse wound than what was started with. Last, the best way to sterilize the drill bit is rubbing alcohol and heat. Dip the bit in the alcohol, and light it on fire and let the alcohol burn away.

In this economy it's just not possible for everyone to have health insurance. It's a shame, but it is the way it is. If people will be trying to relieve pain themselves it's definitely better to have access to the right info than to guess at it. Any other "health professionals" are welcome to chime in, but it's better in my opinion to put knowledge out there than to criticize others for doing the same.

6 replies

I believe you are doing your duty as a physician in recommending safe practices for performing this procedure. Would you agree that draining a SH will probably prevent the nail from falling off?

I've smashed my finger before and gotten little hematomas under the nail, but nothing severe enough to warrant draining. Those hurt like hell; I can't even imagine one like the one pictured.

No, draining the nail will increase the chances that your nail will stay on. Whether or not the nail falls off is depends only on the initial trauma. If the trauma sufficiently destroys the connection between the nail and nail bed then the nail will eventually fall off, drained or not. The only benefit to draining is the relief of pain. When the injury first occurs, the blood flowing to the area has no where to go and creates pressure by being caught between the nail and nail bed. This pressure can cause a lot of pain, but will not be sufficient to further traumatize the nail plate/nail bed connection. If the subungual hematoma is not drained After 24 hours, the pain should subside naturally as the pressure will be normalized by then. If the trephination procedure has not been performed within 24 hours of the initial trauma, then performing it after that will not reduce pain, since at that point any pain is from the trauma itself and not from the pressure of blood under the nail. So essentially, if this procedure is not performed within 24 hours of the injury, there can only be negative consequences to the procedure (possible infection, further trauma, etc). In fact the hospital I work at will not perform this procedure on injuries more than a day old.

I am curious about the 24 hour cut-off. My recent thumb injury was hurting more and more as time went by, and after about a day it suddenly seemed like an _excellent_ idea to drill a hole in myself.

The result was instant relief of the throbbing pain that had kept me awake all night and showed every sign of keeping me awake the next night too.

I will suggest that anyone who thinks that drilling a hole in yourself is inconceivable has never injured themselves in this way.

Agreed. I just performed this on myself. Injured myself about 36 hours ago, thumb in a car door. It was literally throbbing all night, could not sleep at all. I went to the docs and they offered to do this for me, but I'd have to come back later in the afternoon as the doc had a waiting room full of people and was already running late by the time they had got to me. Right after I got home, I looked up this tutorial and some youtube vids and just decided to do it myself, I needed the relief! Needless to say, it was INSTANT relief! Also, natural pinkish color is now showing again through where black spots are under my nail! It's still bleeding a bit, but I'm nursing it with anti-septic and paper towels. Better than it throbbing though!

So i am screwed?? A cabinet fell on my toe sunday morning, it is now Tuesday and i just now seen this option of drilling. I can no longer do this?

Thank you for backing up exactly what I was saying earlier.
Sincerely, The Crazy Female ER nurse. ;)