Isla Bennett
A falling nail can be a result of several factors, including fungal infections, injuries, and psoriasis. Treatment options vary depending on the cause and may include cutting away the separated nail, taking antifungal medications, or stopping the use of certain nail products. It is important to keep the exposed nail bed protected and clean to avoid infection. In some cases, medical attention may be required to ensure proper nail growth and rule out any underlying issues.
| Characteristics | Values |
|---|---|
| Reasons for nail falling off | Injury, fungal infection, psoriasis, medication side effects, other illnesses, chemotherapy, nail products, or allergies |
| Symptoms | Pain, swelling, bleeding, discolouration (black, purple, yellow), thickening, white spots and streaks |
| Treatment | Soak toe in cold water, trim loose parts, use antibiotic ointment, bandage, prop up foot, antifungal medication, nail removal, nail reattachment, nail biopsy, fungal test, blood test |
| Prevention | Keep nails short and trimmed, avoid biting nails, wear gloves, wear comfortable and protective shoes, avoid nail products, avoid nail salons |
| Healing time | 7-10 days for nail bed to heal, 4-6 months for fingernails to grow back, 12-18 months for toenails |
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What You'll Learn
Trimming the nail
If you have onycholysis, it is generally recommended to trim the affected portion of the nail and keep the nail bed protected. Trimming helps prevent further injury and stops the nail from catching on objects, which could lead to more pain and potential infection. It is important to use clean tools, such as scissors or nail clippers, to avoid introducing bacteria or fungus to the sensitive area. Aim to cut along the line of the tear to create an even edge.
In some cases, trimming may not be necessary. If the nail has cracked or detached but does not have any rough edges, you can simply focus on protecting the nail bed and keeping it clean and dry. This can be done with a non-stick bandage, which should be changed daily and whenever it gets wet. Antibiotic ointment can also be applied to prevent infection and promote healing.
If your nail is only partially detached, it is essential to leave the remaining part of the nail in place. Trimming or filing any jagged edges can help smooth it out and prevent further issues. However, if there is a lot of blood pooling under the nail or if you are experiencing intense pain, it is recommended to seek medical attention. A doctor may relieve the pressure by creating a small hole to drain the blood, and they can also prescribe antibiotics and pain relievers as needed.
Overall, trimming the nail can be an important part of managing onycholysis and preventing further complications. However, it is just one aspect of treatment, and protecting the nail bed and addressing the underlying cause of nail separation are also crucial steps in the healing process.
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Protecting the nail bed
Keep the Nail Bed Clean and Dry
It is essential to maintain proper hygiene around the affected area. Keeping the nail bed clean and dry reduces the risk of bacterial or fungal infections. Wash any minor cuts or scrapes gently with soap and water, and apply a bandage if needed.
Cover the Nail Bed
Use tape or an adhesive bandage to cover the nail bed until the nail has grown out enough to protect the finger or toe. This helps protect the exposed nail bed from external trauma and potential infections.
Trim the Detached Nail
Trimming the detached nail can reduce the risk of it catching on objects and causing further damage to the nail bed. Use clean scissors to carefully remove the detached portion of the nail, and then soak the affected finger or toe in cold water for 20 minutes to soothe the area and reduce any throbbing sensation.
Apply Petroleum Jelly
After trimming and soaking the nail, apply a thin layer of petroleum jelly, such as Vaseline, to the exposed nail bed. This helps keep the area moisturized and protected.
Soak in a Warm Salt Solution
Prepare a solution by dissolving 1 teaspoon of salt in 4 cups of warm water. Soak your hand or foot in this solution for 20 minutes, two to three times a day, for the next three days. This helps promote healing and prevents infection.
Wear Protective Gear
To prevent further injuries to the nail bed, wear protective gear such as gloves when doing chores or playing sports. Additionally, wear clean, comfortable, and protective shoes to avoid nail damage due to poorly fitting footwear.
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Identifying the cause
Injury
Minor or acute trauma to the nail can cause it to fall off. This could include blunt force that crushes the small blood vessels under the nail, resulting in a subungual hematoma—a blood blister under the nail. The blood puts pressure on the nail, and the nail may appear black or purple before eventually falling off.
Fungal Infections
Fungal infections occur when fungi get between the nail and the nail bed, usually through cracks or cuts. These infections cause nails to thicken and turn yellow, with possible white spots and streaks.
Psoriasis
Nail psoriasis causes changes to the nail's structure, including onycholysis (nail separation). The buildup of skin cells can increase pressure beneath the nail, leading to nail detachment.
Medication Side Effects
Certain medications, such as chemotherapy, tetracycline, nonsteroidal anti-inflammatory drugs (NSAIDs), psoralens, and oral retinoids, can contribute to nail separation and potential nail loss.
Allergy to Nail Product Ingredients
Allergies to nail product ingredients can compromise the nail's integrity and lead to nail separation and loss.
Other Illnesses
Less commonly, underlying illnesses can contribute to nail loss. These include iron deficiency, hyperthyroidism, and conditions affecting circulation, such as Raynaud's.
It is important to identify the underlying cause of nail detachment to guide appropriate treatment and promote proper nail regrowth.
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Managing pain and swelling
If you have a nail injury, it is important to manage any pain and swelling you may be experiencing. Firstly, you should elevate the injured area above the level of your heart. This will help to reduce throbbing. You can also apply ice to the injury, wrapping the ice in a cloth and applying it for 20 minutes every 2 hours on the first day, then 3 to 4 times a day after that.
Over-the-counter medications can also help to manage pain and swelling. For instance, acetaminophen (Tylenol) can help with pain, while ibuprofen (Advil, Aleve) and naproxen can help with both pain and swelling. If you have been prescribed pain medication by a doctor, take it as directed. If you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding, talk to your healthcare provider before using these medicines.
If you are uncomfortable tending to the nail yourself or think the damage is serious, do not hesitate to call your doctor or a podiatrist.
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Preventing further injury
If your nail is falling off, it is important to take steps to prevent further injury and ensure proper healing. Here are some detailed instructions to achieve this:
Protect the Nail Bed
The nail bed, or the skin underneath the nail, is sensitive and vulnerable to injury when a nail falls off. It is important to protect the nail bed to prevent further damage. You can use a nonstick bandage to cover the exposed nail bed and change it daily or whenever it gets wet. Keep the bandage in place for about 7 to 10 days, until the nail bed hardens and is no longer sensitive.
Trim the Nail
If your nail is only partially detached, you can carefully trim the loose part to prevent it from catching on clothing, carpets, or other objects and causing further injury. Use clean scissors or nail clippers to snip along the line of the tear, creating an even edge. However, if the nail has cracked without leaving a rough edge, trimming may not be necessary.
Manage Pain and Swelling
To alleviate pain and reduce swelling, prop up your hand or foot so that it is elevated above the level of your heart. Apply ice wrapped in a thin towel for 20 minutes every 2-6 hours as needed. Over-the-counter pain relievers, such as ibuprofen or naproxen, can also help manage pain and swelling.
Avoid Irritants and Potential Injuries
While your nail is healing, avoid activities that may cause further injury to the nail bed. Be cautious when performing tasks that could result in impact or pressure on the affected area. Additionally, refrain from using nail products, such as nail polish, nail gloss, nail hardener, or fake nails, as these can irritate the nail and surrounding skin.
Seek Medical Attention
If you are uncomfortable treating the nail yourself or suspect a more serious injury, don't hesitate to consult a doctor or podiatrist. Deep cuts, intense pain, or signs of infection are all reasons to seek medical attention. They can provide professional care, relieve pressure from blood pooling under the nail, and prescribe antibiotics or other necessary treatments to promote healing and prevent further complications.
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Frequently asked questions
If your toenail is falling off, it is important to wear well-fitting shoes and socks and keep your toenails trimmed to prevent further injury. You should also be careful when putting down heavy objects near your feet. If your toenail has fallen off due to an injury, you should soak your toe in cold water for 20 minutes and trim off the loose part with clean scissors or nail clippers. If you are uncomfortable tending to the nail yourself or think the damage is serious, you should call your doctor or a podiatrist.
There are several common causes of a nail falling off, including fungal infections, injuries, and psoriasis. Fungal infections occur when a fungus gets between your nail and nail bed, usually through cracks or cuts in your finger or toe. Injuries can include blunt force that crushes the small blood vessels under your skin or constant pressure, like a hammertoe that rubs against the inside of your shoe.
It may take a year or more for a new nail to fully grow back, and it may be deformed. Fingernails typically take about 4 to 6 months to grow to a full size, while toenails may take twice as long.
To prevent your nail from falling off, you should keep your nails trimmed short to prevent them from catching on objects and pulling further off of your nail beds. You should also avoid biting your nails and be careful when cleaning underneath your nails. Additionally, you should avoid chemicals or products that can irritate your nails or the skin around your nails, such as nail polish, nail gloss, nail hardener, nail polish remover, and fake nails.
