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It usually happens if the nail gets crushed in an injury. It can cause symptoms such as intense pain and throbbing as collects under the nail. Causes These injuries can happen easily. Symptoms The most common symptom is severe, throbbing pain. It happens because of the pressure of collecting between the nail and the nail bed. Your doctor will examine your nail. But the pressure generated by pooled blood under the nail can be extremely painful. Continued To relieve the pain, your doctor may perform decompression, also called trephination, which allows the underlying blood to drain, relieving pressure and pain to the area. Your doctor may numb the affected finger or toe with a nerve block and use one of the following decompression methods: Cautery. The doctor uses a heated wire electrocautery device or carbon laser to burn a hole or holes. The heated tip of the wire is cooled by contact with the hematoma, which prevents injury to the nail bed. This is a quick and painless procedure. The doctor uses a needle to make a hole in the nail. After the procedure, your doctor will bandage your nail. You will need to keep the finger or toe bandaged and elevated -- and may also need to use cold compresses -- during the first 12 hours after decompression. In some cases, your doctor may recommend you use a splint for as long as 3 days until the tenderness subsides. The main complication associated with decompression is a small risk of infection in the residual hematoma. If you have bleeding under a large area of the nail surface, the nail bed may be injured. In this case, your doctor may need to remove the entire nail and use to repair the nail bed. Recovery Unless the area of bleeding is very small, an affected nail will usually fall off on its own after several weeks because the pooled blood has separated it from its bed. A new fingernail can regrow in as little as 8 weeks. A new toenail may not fully regrow for about 6 months. Even with the best repair, there is still a possibility that the new nail may grow back and not look normal. See your doctor if you notice any problems with the nail as it heals and regrows.