Sophia Delgado
Nails have a good regeneration capacity, but they grow slowly. Fingernails may grow one-tenth of a millimeter each day, so completely removed fingernails usually grow within 4 to 6 months. Toenails may grow at about half or a third of the rate of fingernails, so they may take anywhere from 6 months to 2 years to grow back. The rate of regrowth can vary from person to person and depends on factors such as age, overall health, and climate. Nails on the dominant hand tend to grow faster than the non-dominant hand, and trauma or injury can also increase the rate of regrowth due to increased blood flow to the injured area. In the case of minor damage to the nail matrix, the nail will usually grow back once healed. However, in cases of severe nail matrix damage, some or all of the nail may not grow back.
| Characteristics | Values |
|---|---|
| Nail regeneration | Nails have good regeneration capacity |
| Nail growth | Nails grow slowly, with toenails growing at about half or a third of the rate of fingernails |
| Fingernail growth rate | Fingernails may grow by one-tenth of a millimeter each day, taking up to 6 months to grow back completely |
| Toenail growth rate | Toenails may take up to 18 months to grow back completely |
| Factors affecting nail growth rate | Age, overall health, climate, season, hand dominance, trauma/injury, blood flow, hormones, and pregnancy |
| Nail matrix | The nail matrix is where new cells form and nails are created; it consists of the germinal matrix (90%) and the sterile matrix (10%) |
| Nail damage | Minor damage to the nail matrix can change the appearance of the nail, while severe damage can cause the nail to fall off |
| Nail separation | Onycholysis is a condition where the nail separates from the nail bed due to injury, fungus, or other causes |
| Nail protection | Nails protect the soft tissue and skin underneath them |
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What You'll Learn
Nails grow back, but slowly
Losing a fingernail or toenail can be painful and worrying, but thankfully, nails do grow back. However, this process can take a while, and it may be several months to a year or two before your nail is fully regrown.
The nail matrix, which is the root of your nail, is responsible for nail growth. About 90% of your nail growth comes from your germinal matrix, and the remaining 10% is from your sterile matrix, which also keeps your nail attached to the underlying skin. When new cells form in the matrix, older cells move up and push through your skin. The cells on the surface then die and harden, turning into nails.
Injuries and certain health conditions can damage your nail matrix and interfere with nail growth. Minor damage to your nail matrix can temporarily change your nail's appearance, while more severe injuries could cause your nail to fall off. However, even if your nail falls off, it usually grows back with proper medical care. It's rare for your nail matrix to be permanently damaged, preventing your nail from growing back.
The rate of nail regrowth can vary from person to person and depends on several factors. Nails tend to grow slower in older adults and in colder climates, while nails on the dominant hand tend to grow faster. Trauma or injury can increase the rate of regrowth due to increased blood flow to the area. Overall health also plays a role, and nail growth may slow if you're sick or malnourished.
While you wait for your nail to grow back, it's important to keep the area clean, dry, and protected. You can also take steps to speed up the healing process, such as applying a cold compress to reduce swelling and inflammation.
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Nail matrix damage can prevent regrowth
The nail matrix is the "factory" where new fingernails and toenails are made. It consists of two parts: the germinal matrix, which contributes about 90% of the cells that make up the nails, and the sterile matrix, which contributes the remaining 10% and is responsible for keeping the nail attached to the underlying skin. The nail matrix is located just below the nail fold, which protects it from injuries.
However, damage to the nail matrix is a common problem, often resulting from mechanical injuries or improperly performed nail care procedures. Mechanical injuries can include a strong blow, pinching the fingertip in a door, or crushing with a heavy object. Improper nail care procedures, such as cuticle picking, improper use of a drill, or cuticle cutting with a cuticle pusher, can also cause matrix damage. These habits and procedures can exert too much pressure on the lunula area, where the nail is still soft and delicate, leading to nail plate distortion and matrix damage.
When the nail matrix is damaged, it can interfere with nail growth and cause nail growth disorders, an unfavourable appearance, and pain. In severe cases of nail matrix damage, some or all of the nail may not grow back. Proper treatment is essential to promote healing and nail regrowth. This may include medical care from a doctor, who can repair any lacerations, reattach the nail, or perform reconstructive techniques such as grafting. Antibiotics may also be prescribed to prevent infection.
While it is rare for the nail matrix to be permanently damaged, preventing nail regrowth, it is important to seek professional help for severe injuries. With proper care and treatment, healthy nail growth can often be restored.
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Nail separation (onycholysis) treatment
A nail that has fallen off due to severe injury will usually grow back with proper medical care. However, in cases of severe nail matrix damage, some or all of the nail may not grow back. The nail matrix is where your fingernails or toenails form, and it is made of special cells that create new cells that become your fingernails or toenails.
Onycholysis is a condition where the nail separates from its nail bed. It often appears after an injury to the nail, but it may have other causes, including fungi, bacterial infections, or underlying medical conditions. Treatment for onycholysis may involve cutting away the separated nail as it grows out and taking antifungal or antibacterial medications. Other general measures include:
- Regularly trimming your nails
- Protecting your nails from any additional damage
- Washing your hands regularly to prevent infection
- Using a clean washcloth to help reach beneath your nails
- Using antifungal or antimicrobial soaks to prevent infection
- Wearing gloves when doing activities that may damage your nails, such as washing dishes, playing sports, or working outside
- Keeping your nails short to prevent them from catching on objects and pulling further off the nail beds
- Avoiding biting your nails
- Being careful when cleaning underneath your nails
- Avoiding chemicals or products that can irritate your nails or the surrounding skin, such as nail polish, nail gloss, nail hardener, nail polish remover, and fake nails
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Factors affecting nail growth speed
Several factors influence the speed of nail growth, and understanding these factors can help promote healthy nail growth. Firstly, the growth rate varies depending on the finger. For example, the little finger's nail grows slower than the other fingernails, and the nails on the dominant hand tend to grow faster. Additionally, the rate of nail growth is influenced by age, with nail growth slowing down as individuals get older, possibly due to a decrease in blood circulation. Hormone levels also play a role in nail growth speed. For instance, during pregnancy, nail growth accelerates, while during lactation, it slows down. Puberty is another period of rapid nail growth due to fluctuating hormone levels.
Health conditions and overall health can significantly impact nail growth. Certain chronic illnesses, such as thyroid disease, hypopituitarism, diabetes, and osteoporosis, can lead to fragile and slow-growing nails. Onychomycosis, pulmonary tuberculosis, and syphilis also affect nail strength and growth. Additionally, nail biting and picking, known as onychophagia and onychotillomania, respectively, can damage the nail matrix, nail bed, and surrounding skin, resulting in slower nail growth. Maintaining good nail hygiene and overall health is essential for promoting nail growth. This includes keeping nails trimmed, pushing back or trimming cuticles, moisturizing, and eating a nutritious diet.
Injuries to the nail or the nail matrix can cause onycholysis, where the nail separates from the nail bed. Minor matrix injuries can temporarily change the nail's appearance, while severe injuries may cause the nail to fall off. With proper treatment, the nail matrix can heal, and nail growth can resume. However, severe cases of nail matrix damage may result in permanent nail loss.
The rate of nail growth also varies across individuals and is influenced by factors such as sex, season, exercise level, diet, and hereditary factors. For example, nails tend to grow faster during the summertime and on longer fingers. While most of these factors are beyond individual control, consulting a healthcare professional can help address any nutritional deficiencies or underlying conditions that may impact nail growth.
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Nail loss: first aid and prevention
Nail injuries are common, and in most cases, the nail will grow back over time. However, proper first aid and prevention methods are crucial to ensure the nail heals properly and to reduce the risk of further injury or infection.
First Aid for Nail Loss
If you experience nail loss due to an injury, here are some first aid steps to follow:
- Apply pressure and clean the wound: If there is bleeding, apply direct pressure with a clean cloth. Clean the wound and the affected nail area with soap and warm water to prevent infection.
- Trim rough edges: Use sterile scissors or nail clippers to carefully trim any rough or jagged edges of the nail to prevent further injury.
- Treat with ointment and bandage: Apply a thin layer of antibiotic ointment to the injured area and cover it with a sterile bandage to keep it protected and clean.
- Elevate and ice the area: Keep the injured hand or foot elevated above the level of the heart to help control pain and reduce swelling. Apply ice to the area to further reduce swelling and pain.
- Manage pain: Take over-the-counter pain medication such as acetaminophen (Tylenol) or ibuprofen (Advil, Aleve) as needed.
- Seek medical attention: If the injury is severe, or if there are signs of infection, seek medical care. A healthcare provider will assess the injury and may remove the nail to repair any tissue damage. They may also provide a tetanus shot if necessary.
Preventing Nail Loss
To help prevent nail loss and injuries, consider the following:
- Keep nails trimmed short: Short nails are less likely to catch on objects and suffer traumatic injuries.
- Choose appropriate footwear: Ensure your shoes fit well and have a wide toe box to prevent rubbing and potential nail injuries.
- Wear protective gear: When playing sports or engaging in activities where your hands are at risk, wear gloves or other protective gear to shield your nails from potential trauma.
- Be cautious with sharp objects: Always keep your supporting hand away from the path of sharp objects like box cutters or knives.
- Handle machinery with care: Be cautious when using machinery or tools that could potentially cause nail injuries, such as hammers or power tools.
- Use door guards: Install door guards to prevent fingers, especially those of children, from being accidentally caught and injured by closing doors.
- Avoid biting nails: Biting your nails can weaken them and make them more susceptible to injuries.
- Be gentle when cleaning nails: When cleaning underneath your nails, avoid using harsh tools that can break the skin and lead to infection.
- Avoid irritating chemicals: Stay away from nail products and chemicals that can irritate your nails or the surrounding skin, such as nail polish, nail hardener, and nail polish remover.
Remember, if you experience any signs of infection, such as redness, drainage, or pain, seek medical attention promptly. Most nail injuries heal with proper care, and the nail will usually grow back, although it may take several months for the nail to fully regenerate.
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Frequently asked questions
No, the nail doesn't grow back in layers. If a layer of your nail is damaged, the whole nail needs to grow out. Nails have good regeneration capacity, but they grow slowly.
Fingernails may grow one-tenth of a millimeter each day, so completely removed fingernails usually grow within 4 to 6 months.
Toenails may grow at about half or one-third the rate of fingernails, so completely removed toenails may grow within 12 to 18 months.
Keep the nail and the area clean and dry. Protect the nail bed underneath by keeping the nail in place until it is ready to fall off. Take OTC anti-inflammatory drugs to relieve mild pain. If the nail bed is injured, you may need to treat a fungal infection with antifungal medication or stop using certain nail products. If the nail matrix is damaged, treatment can help and the nail will usually grow back.
