Toenail Blisters – What Causes Subungual and Periungual Blisters

Photos of toenail blisters

Watch the video to see several photos of subungual and periungual blisters.

Toenail anatomy

Visualise the toenail’s relationship to the distal phalanx, and its closer proximity to the bone proximally.

Theories on the cause of toenail blisters

• Rubbing
• Pressure from above
• Seesaw effect
• Pressure to end of nail (subungual shear)

Toenail blister scenarios and their prevention

• Normal function
• Shoe too short
• Shoe too loose
• Clawed toes
• Hyperextneded interphalangeal joint (cocked-up big toe)

Toenail Blister Q&A

1. Best ways to manage toenail blisters in distance runners
2. How to decide what to do with the nail when the blister is under
3. Pts always ask will the nail fall off. Is there a way to tell?
4. Best tape or padding to prevent toe blisters
5. Lance or leave intact / When not to lance
   • REPLAY: Should blisters be lanced, deroofed or left intact
6. Are there any particular socks better at preventing blister formation?
   • REPLAY: Sock fibres and moisture management