Isla Bennett
Fingernails are made of keratin, a protein that forms the cells that make up the tissue in nails. They grow from underneath the skin at the matrix, which is the root of the nail. While fingernails can grow back after an injury, does surgery impact their growth? In this discussion, we will explore the relationship between surgical procedures and fingernail growth, delving into the scientific understanding of this intriguing phenomenon.
| Characteristics | Values |
|---|---|
| Nail growth after surgery | Regrowth achieved in 33 weeks |
| Nail growth rate | 0.050 to 0.150 mm/day |
| Factors affecting nail growth | Age, nutritional status, nail thickness, blood flow, overall health, hormones, nail matrix damage, trauma |
| Average nail growth time | 5 to 10 months |
| Vitamins for nail growth | Biotin, Folic Acid/Vitamin B9, Vitamin D, Vitamin B12, Iron, Magnesium |
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What You'll Learn
Factors affecting nail growth rates
Fingernails are made of a protein called keratin, which forms the cells that make up the tissue of nails. Nails grow from underneath the skin at the matrix, the root of the nail, where new cells are formed. As these new cells grow, older cells are pushed up and out through the skin, where they die and harden, becoming nails.
There are numerous factors that affect the rate at which nails grow. Firstly, the health of the nail itself is a variable that may influence the rate of growth, with intact nails potentially growing faster than avulsed nails. Nails on the dominant hand tend to grow faster than those on the non-dominant hand, and the middle fingernail is typically the fastest-growing nail, while the thumbnail and little fingernail have the slowest growth rates. Age also plays a role in nail growth, as thickness increases with age, causing a slowdown in lengthwise growth.
Trauma or injury can also increase the rate of nail regrowth, as blood flow to the injured area increases. However, severe injuries can cause a nail to fall off, and in cases of severe nail matrix damage, the nail may not grow back at all. Overall health impacts nail growth as well, with sickness or malnutrition causing a slowdown in growth. Hormones also play a role, as toenails and fingernails may grow faster during pregnancy.
Nutrition is another factor influencing nail growth rates, with vitamins and minerals such as biotin, folic acid, vitamin D, vitamin B12, iron, and magnesium contributing to healthy nail growth.
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Nail matrix injuries
The nail matrix is the area where fingernails and toenails start to grow. It is located at the base of the nail and creates new cells that allow the nail to grow. The nail matrix has two parts: the germinal matrix and the sterile matrix. About 90% of nail growth comes from the germinal matrix, while the remaining 10% comes from the sterile matrix, which is also responsible for keeping the nail attached to the underlying skin.
A healthy nail matrix is essential for healthy nails, but it is vulnerable to damage and disease. Nail matrix injuries can be caused by trauma, irritation, fungal infection, or overproduction of sterile matrix keratin. Injuries can result in bruising, ridges, or discolouration, and the nail may even fall off. In the case of severe nail matrix damage, the nail may not grow back.
Treatment for a nail matrix injury depends on the cause. For example, fungal infections are typically treated with prescription antifungal pills. If you have a bruise under your nail, a procedure called nail trephination can provide pain relief and help the new nail grow in correctly. This procedure must be performed within 48 hours of the injury, before the blood clots. For subungual melanoma, the affected area in the nail matrix and under the nail must be surgically removed.
Nail bed injuries are common, and proper management is required to ensure good healing and prevent late deformities. In some cases, grafts or microsurgical reconstruction may be necessary to restore the aesthetic appearance of the fingers.
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Nail bed injuries
Fingernails are made of keratin, a protein that forms the cells that make up the tissue in nails. The heart of your nail, also known as the matrix or nail root, is found under your skin. While you can lose the dead cells that make up the visible part of your nail, the matrix generally remains intact. However, it can be damaged, resulting in the deformation of the fingernail as it grows back.
There are several types of nail bed injuries:
- Subungual hematoma: This occurs when blood gets trapped under the nail bed, typically due to a heavy impact such as a door crush injury or a heavy weight falling on the finger. Symptoms include throbbing pain and discolouration of the nail, resembling a bruise.
- Nail bed laceration: This involves cuts to the nail and the underlying nail bed, usually caused by sharp objects like knives or saws. Lacerations may be simple or complex, depending on the force of the impact.
- Nail bed avulsion: This occurs when the nail and part of the nail bed are pulled away from the finger, often due to high-energy injuries with traction and crushing forces. Avulsion injuries commonly affect the ring finger and are often associated with other injuries, such as fractures and dislocations.
Treatment for nail bed injuries depends on the type and severity of the injury. Simple injuries may be managed conservatively, sometimes with oral antibiotics. More severe injuries may require removal of the nail plate, repair of the nail bed, and splinting. In some cases, surgical repair or reconstruction may be necessary to restore the aesthetic appearance and function of the finger.
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Nail deformities
Fingernails are made of keratin, a protein that forms the cells that make up the tissue in nails. The nails we see are dead cells, as nails form under the skin and push old cells out as they grow. Losing a fingernail is possible, but the heart of the nail, or the matrix/nail root, generally remains intact.
Grooves or raised areas in the nail are often the result of a crush injury to the nail. These deformities can cause problems for patients as dirt and dust can become trapped under the grooved or raised areas. Ridges occur longitudinally from cicatricial build-up in or beneath the matrix, with the nail assuming the shape of the matrix. To correct this, the matrix or deeper ridge must be surgically excised. Transverse ridges can be caused by regrowth after trauma or hypoxia. A longitudinal or oblique scar may result in split nail deformity, as the scar cannot produce a nail and the surrounding pull splits the nail. Treatment involves removing the nail and repairing or grafting the nail bed after excising the scar. If the scar involves the germinal matrix, a germinal matrix graft is required. A horizontal scar in the germinal matrix region can create a double nail. The volumes of the dorsal and volar portions may vary, and treatment involves excising the scar and suturing. This is characterised by progressive transverse tubing of the nail extending over the distal edge. Approximately 60% of individuals experience pain, and the nail bed vascularity may be compromised.
In cases of severe nail deformities, the best option for obtaining a normally appearing and growing nail in a traumatized digit is to excise the nail bed and transfer a thin piece of nail bed from one of the big toes. The nail on the big toe continues to grow normally, and taking a thin piece of the nail bed from a toe does not affect the toenail's growth.
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Nutritional impact on nail growth
Fingernails are made of keratin, a protein that forms the cells that make up the tissue in nails. Adequate vitamin, mineral, and nutrient intakes help support the growth, formation, and strength of new nail cells. A well-balanced diet rich in vitamins and minerals is key to achieving healthy nails.
Biotin, also known as vitamin B7, coenzyme R, and vitamin H, is a B-complex vitamin that promotes healthy cell growth and aids in the metabolism of protein-building amino acids that are essential for nail growth. It is naturally found in foods such as liver, nuts, salmon, avocados, sweet potatoes, and cauliflower. A study in 35 people with brittle fingernails found that 2.5 mg of biotin per day for six weeks to seven months improved symptoms in 63% of participants.
Folic acid or vitamin B9 is also important for nail growth and health. It contributes to red blood cell formation and the development of new cells. A deficiency in folate can cause a pigment change in your nails and make them rigid and brittle. Foods rich in folic acid include leafy green vegetables, citrus fruits, beans, cereals, and rice.
Vitamin B12 plays a role in iron absorption and the development of red blood cells, which are necessary for keeping nails strong and healthy. It is naturally found in organ meats, beef, clams, sardines, tuna, trout, salmon, eggs, and dairy products.
Iron is another important nutrient for nail health, as it is necessary for red blood cell formation and oxygen transportation to the nails. Foods rich in iron include shellfish, spinach, legumes, red meat, pumpkin seeds, quinoa, turkey, broccoli, tofu, and dark chocolate.
In addition to these specific vitamins and minerals, overall hydration and nutritional status are important factors in nail growth. Water aids in the delivery of nutrients and oxygen to the cells, and dehydration can lead to brittle, dry nails that break easily. Fatty acid-rich foods also encourage healthy cell development, which aids in the growth of healthy nails.
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Frequently asked questions
There is no clear answer to this question. While some sources claim that trauma or injury can increase the rate of nail regrowth due to increased blood flow to the injured area, others suggest that nail regrowth after surgery can take up to 33 weeks.
Several factors can influence nail growth, including age, nutrition, overall health, and hormone levels. Nails on the dominant hand tend to grow faster, and the middle fingernail typically has the fastest growth rate.
Losing a fingernail can be concerning, but proper medical care can help promote nail regrowth. Keep the wound clean, dry, and covered. Apply a cold compress to reduce swelling and inflammation. Seek medical attention for hard-to-treat nail infections or other symptoms.
