Liam Carter
The nail matrix is a crucial structure in the nail unit, responsible for nail growth. It creates new skin cells, pushing out old, dead cells to make nails. Located at the base of the nail, the nail matrix is delicate and susceptible to damage from injuries, illnesses, and fungal infections. This damage can affect nail growth and appearance, causing white spots, ridges, discolouration, and weakened nails. In severe cases, the nail may fall off or stop growing. However, with proper treatment and time, nails typically grow back, depending on the extent of matrix damage.
| Characteristics | Values |
|---|---|
| Nail growth | Nails grow a bit more than one-tenth of an inch per month and require 3-6 months to completely regrow |
| Nail matrix | The "factory" where your body makes new fingernails and toenails |
| Damage to the nail matrix | Can cause a range of different nail imperfections, such as white spots or ridges, and weaken the nail plate as a whole |
| Permanent damage to the nail matrix | May result in some or all of the nail not growing back |
| Treatment for nail matrix damage | Medication, relieving nail injuries, surgery |
| Factors affecting the nail matrix | Fungal infection, illnesses, injuries, medications |
| Nail matrix protection | Protected by the proximal nail fold |
| Nail growth time | Fingernails usually regrow completely in about two months. Toenails take about four months |
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What You'll Learn
Nail matrix damage can cause nail deformities
The nail matrix is a small but vital part of our hands and feet that is responsible for the growth of strong, healthy nails. It is the "factory" where new nail plate cells are created, and as these new cells are created, older cells are pushed forward and the nail plate grows. The length, size and shape of the matrix determine the thickness and shape of nail growth.
Nail matrix damage can result from mechanical injuries, such as hitting or pinching a finger, or from health-related issues, including infections and dermatological conditions such as psoriasis or eczema. This damage can cause nail deformities, such as ridges, white spots, dents, lines, indentations, and changes in nail shape. In severe cases, some or all of the nail may not grow back.
Mechanical injuries can create micro-injuries that disrupt the process of healthy nail growth, leading to a thinner nail plate, deeper grooves, and ridges. Improperly performed nail care procedures, such as cuticle cutting with a cuticle pusher or the aggressive removal of nail designs, can also cause matrix damage and nail plate distortion.
Health-related issues that can cause matrix damage include bacterial, fungal, or viral infections, which can trigger inflammation of the matrix and weaken the nail. Dermatological conditions such as psoriasis or eczema, and nutritional deficiencies of biotin, zinc, and iron can also lead to matrix damage and nail deformities.
It is important to seek medical care for any nail changes, as early identification of matrix damage can help address the nail condition through proper care or treatment. Treatments may include protective dressings, regenerative preparations with vitamin E, biotin, and keratin, ointments, oral medications, and podiatric procedures such as laser therapy.
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Nails can regrow after falling off
The nail matrix is a crucial structure within the nail unit, responsible for nail growth. It is located at the base of the nail, and any damage to it can impact nail growth and appearance. However, nails are resilient and can usually regrow after falling off, depending on the extent of the damage to the nail matrix and nail bed.
Nail injuries are common, and nails can fall off due to various reasons, including trauma, fungal infections, and certain illnesses. In most cases, nails will slowly regrow, but it is important to ensure proper medical care to promote healthy nail growth. The time it takes for a nail to regrow depends on the severity of the injury and whether it was a fingernail or toenail, with toenails generally growing more slowly.
If the nail matrix is not permanently damaged, the nail will typically regrow, although there may be some minor defects in the nail plate. The matrix creates new skin cells, pushing out old, dead cells, so injuries to the nail bed or disorders affecting the matrix can disrupt this process. Proper treatment is essential to support nail regrowth and prevent infections.
To promote nail health and regrowth, it is recommended to maintain a well-rounded diet and good general health. Additionally, keeping fingernails trimmed and avoiding nail biting or cuticle biting can help prevent nail trauma. In the case of toenails, wearing properly sized shoes is crucial, as ill-fitting shoes can cause repeated trauma and lead to deformities in the nails.
While nails can usually regrow after falling off, severe or deep injuries to the nail matrix may result in permanent nail deformities or even prevent the nail from growing back. Therefore, it is important to seek medical advice for significant nail injuries and follow the recommended treatment plan to optimize nail health and regrowth.
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Nail injuries and their treatment
A nail injury can occur when any part of the nail becomes injured, including the nail, nail bed, cuticle, and the skin around the sides of the nail. This can be caused by cutting, tearing, smashing, or bruising the nail, or the nail being torn away from the skin.
For mild nail injuries, board-certified dermatologists recommend the following treatment:
- Treat the wound: If any part of the nail is hanging off, gently trim away the part not connected to the skin.
- Clean the wound: Use soap and water to gently clean the wound. If the wound is bleeding, do not put a dry bandage or gauze on top. Once the bleeding stops, this will stick.
- Apply petroleum jelly: Keep the wound moist by applying petroleum jelly, then cover with gauze or a bandage. Repeat these steps daily while the wound heals.
- Do not use sticky products: Avoid sticky products, such as an adhesive bandage or medical tape, on the nail itself. Only apply these products to the skin around the nail to avoid further irritation.
- Wrap the wound: Wrapping the wound with an elastic bandage is another option, but do not wrap it too tightly.
- Reduce swelling: Apply a cool, damp washcloth to the wound to reduce swelling. Prop the injured arm or leg on pillows so that the nail is higher than the heart to further reduce swelling.
- Relieve pain: Take ibuprofen or acetaminophen to relieve pain and reduce swelling when the injury is new.
For more serious nail injuries, it is recommended to go to an urgent care center or the emergency room. Treatment may include:
- Stopping the bleeding and cleaning the wound.
- Numbing the affected area with medicine before treatment.
- Draining blood and fluid: For larger bruises, a small hole may be created in the nail to drain blood and fluid, relieve pressure, and reduce pain.
- Removing the nail: If the bone is broken or the bruise is very large, the nail may need to be removed, and the nail bed repaired.
- Stitches: Cuts in the nail bed will be closed with stitches, and the nail may be reattached with special glue or stitches.
- Antibiotics: Your provider may prescribe antibiotics to prevent infection.
In the case of nail matrix injuries, the nail may fall off, and there may be bruising, ridges, or discolouration. With proper treatment, healthy nails can often grow back. However, severe damage to the nail matrix can result in permanent nail deformities or prevent the nail from growing back at all.
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Conditions affecting the nail matrix
Injuries and Trauma
Injuries to the nail matrix can result from pinching or crushing your finger or dropping something heavy on your toe. Trauma to the nail matrix can also occur from wearing tight shoes, cutting nails too short, or repeated trauma, such as from working or playing. These injuries can cause bruising, ridges, discoloration, nail infections, and ingrown nails. In some cases, the nail may fall off or never grow back.
Illinesses
Serious illnesses, such as a heart attack, COVID-19, or pneumonia, can interrupt nail growth and cause horizontal ridges (Beau's lines) in the nails.
Medications
Chemotherapy and other medications can temporarily affect the nail matrix, causing Beau's lines, slow nail growth, Mees' lines (white bands across the nails), and nail color changes.
Peripheral Artery Disease (PAD)
PAD causes reduced blood flow to the legs and feet, which affects the nail matrix and slows nail growth.
Skin Conditions
Skin conditions such as severe eczema and psoriasis can affect the nail matrix, interfering with nail growth and causing various changes in the nails, including white lines, pitting, crumbling, and texture or color changes.
Subungual Melanoma
Subungual melanoma, or nail matrix melanoma, is a type of skin cancer that affects the nail matrix. It can cause brown or black discoloration, stripes, or other changes in pigmentation.
Pterygium Unguis
Pterygium unguis is a condition that causes scarring that extends to the nail matrix. It affects the shape of the nail, causing ridges on the nail plate.
Lichen Planus, Burns, and Lupus Erythematosus
These conditions can cause pterygium unguis, leading to scarring and ridges in the nail plate.
Nevomelanocytic Nevus
Nevomelanocytic nevi are moles or collections of melanocytes under the nail matrix. They can be present from birth or acquired later due to nail trauma or aging.
Fungal Infections
Certain types of fungi can infect the nails, usually the toenails. Symptoms include thick, yellow, cracked, or cloudy nails.
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The nail matrix's role in nail growth
The nail matrix plays a crucial role in nail growth and is often referred to as the "factory" where new nails are produced. Located at the base of the nail, it is responsible for creating new skin cells, which push out the old, dead skin cells, facilitating nail growth. The matrix is a delicate structure, and any damage to it can impact the overall health and appearance of the nail.
The nail matrix consists of two main parts: the germinal matrix and the sterile matrix. The germinal matrix, situated below the lunula (the white, crescent-shaped area at the base of the nail), is responsible for approximately 90% of nail production and gives the nail its natural curvature. The sterile matrix is the area of the nail located above the lunula.
The length and shape of the nail matrix determine the thickness and shape of nail growth. A longer matrix will result in a thicker nail, while the shape of the matrix influences whether the nail will have a deep C curve or be flatter. The matrix is protected by the proximal nail fold, a fold of skin that covers the area from the last joint of the finger or toe to the base of the visible nail.
Injuries or trauma to the nail matrix can lead to visible imperfections in the growing nail, such as white spots, ridges, or grooves. These imperfections occur due to the damage inflicted on the soft cells beneath the proximal nail fold. In some cases, severe trauma to the matrix can cause the nail to stop growing entirely, resulting in permanent nail deformities. However, with proper medical care, healthy nails can usually grow back even after falling off.
Certain health conditions, such as fungal infections, illnesses, and medications, can also affect the nail matrix and nail growth. For example, toenail fungus may cause thick, yellow, cracked, or cloudy nails. Illnesses like COVID-19 or pneumonia can interrupt nail growth and cause horizontal ridges known as Beau's lines. It is important to seek appropriate treatment for any nail matrix conditions to promote healthy nail growth.
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Frequently asked questions
Yes, a nail needs a nail matrix to grow back. The nail matrix is the "factory" where new nail plate cells are created. The nail matrix is located at the base of the nail and creates new cells that push out old, dead skin cells to make your nails.
The nail matrix is the area where your fingernails and toenails start to grow. It is located at the base of the nail and is protected by the proximal nail fold. The nail matrix is made up of the germinal matrix and the sterile matrix.
If your nail matrix is damaged, your nail may stop growing or grow back with defects. The severity of the defect will depend on the severity of the damage to the nail matrix. Minor damage will produce minor defects, while more significant damage can result in a permanently deformed nail.
Nail matrix damage can be caused by injuries, illnesses, and fungal infections. Examples of injuries that can cause nail matrix damage include pinching or crushing your finger or dropping something heavy on your toe. Serious illnesses, such as a heart attack or COVID-19, can also interrupt nail growth and cause horizontal ridges in your nails.
The treatment for nail matrix damage depends on the cause. Medication may be prescribed for nail fungus or nail psoriasis. For a bruise under the nail, a procedure called nail trephination can be performed to drain the trapped blood and relieve pain. In some cases, surgery may be necessary to remove cancerous cells or repair a deep tear.
