Caleb Foster
Fingernails and toenails are produced by the nail matrix cells that reside in the moon-shaped whitish area (lunula) at the base of the nail. If the nail matrix is not damaged, the nail is typically capable of regrowth. Nails grow at a rate of 0.13 inches per month and require 3-6 months to completely regrow. Toenails grow more slowly than fingernails. In cases of severe nail matrix damage, some or all of the nail may not grow back.
| Characteristics | Values |
|---|---|
| Nail regrowth after being ripped off | Nails typically grow back after being ripped off, but this depends on the extent of damage to the nail matrix and nail bed. |
| Nail matrix | The nail matrix is the part of the nail that produces new nail cells. Damage to the nail matrix can affect nail growth and appearance. |
| Nail bed | The nail bed is the skin under the nail. Damage to the nail bed can cause whitish changes in the nail or onycholysis, where the nail plate lifts from the nail bed. |
| Regrowth time | Fingernails typically regrow in 3-6 months, while toenails can take up to 12 months. |
| Factors affecting nail growth | Health conditions, medications, injuries, and footwear can all impact nail growth and health. |
| Treatment | Minor nail injuries can be treated at home, but more serious injuries may require a visit to a physician or emergency room. |
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What You'll Learn
Nail matrix damage
The nail matrix is the "factory" where your body makes new fingernails and toenails. It is made of special cells that create new cells that become your fingernails or toenails. Each nail matrix produces 196 layers of cells that combine to make each of your fingernails and toenails. The nail matrix has two parts: the germinal matrix and the sterile matrix. The germinal matrix is located under the base of your nail and produces about 90% of nail cells, giving a natural curvature to the nail. The sterile matrix lies underneath your nail and is responsible for the remaining 10% of cells, but it is more important in keeping your nail attached to the underlying skin.
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. You might notice a change in how your nail feels, dents, horizontal ridges or lines, pain or soreness, splits or cracks, spots or streaks of colour, or texture changes such as thickening or crumbling. Severe trauma, such as crushing injuries or deep cuts, may result in long-term or permanent effects if the nail matrix is significantly damaged. In rare cases, complete and permanent nail loss may occur.
Certain types of fungus (mold) can infect your nails, usually your toenails. Toenail fungus may appear as thick, yellow, cracked, or cloudy nails. Illnesses: A serious health event like a heart attack or an illness like COVID-19 or pneumonia can interrupt new nail growth and cause Beau's lines (horizontal ridges in your nails). Chemotherapy and other medications can also cause Beau's lines or slow nail growth. Peripheral artery disease (PAD) causes less blood flow to your legs and feet, which affects your nail matrix and can slow nail growth. Severe eczema can affect your nail matrix and temporarily interfere with nail growth. Up to 80% of people with psoriasis develop nail psoriasis, which can cause white lines, pitting, and crumbling.
In cases of severe nail matrix damage, some or all of your nail may not grow back. However, it is rare for the nail matrix to be permanently damaged, and with the right treatment, you can often see healthy nails grow back.
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Nail bed damage
A damaged nail bed can occur when a heavy object crushes or hits the fingers or toes, or when a person sustains a cut from a sharp object. Nail bed injuries can also occur when the nail is caught between two objects. These injuries can be minor or very painful and uncomfortable, sometimes limiting finger movement.
There are several types of nail bed injuries, including subungual hematoma, which looks like a bruise and occurs when blood vessels under the nail bed leak, and nail bed laceration, which happens when the nail and the underlying nail bed are cut. Another type of injury is a nail bed avulsion, where the nail and part of the nail bed are pulled away from the rest of the finger. This can be extremely painful and cause the finger to swell.
In most cases, nail bed injuries can be fully repaired, and the nail should return to normal. Doctors may treat these injuries by draining the pooling blood through a small hole in the nail, a procedure known as trephination. They may also remove the nail and repair the nail bed, using stitches to reattach the nail and provide protection and support while the new nail grows. Antibiotics may be prescribed to prevent infection, and X-rays may be ordered to check for any bone fractures.
With proper medical care, even if the nail falls off, it usually grows back. However, in rare cases, severe injuries can lead to nail deformities, such as hook nail or split nail. It may take several weeks or even months for the nail to grow back completely, and the new nail may still have small ridges or bumps.
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Toenail vs. fingernail regrowth rates
Fingernails and toenails are formed in the nail matrix, which has two parts: the germinal matrix and the sterile matrix. The germinal matrix contributes to about 90% of nail growth, while the remaining 10% comes from the sterile matrix, which is also responsible for keeping the nail attached to the skin underneath.
Several factors can affect the rate of nail growth, including age, hormones, overall health, and season. For instance, nail growth peaks during puberty and declines as hormone levels balance out with age. Similarly, fingernails grow faster during the summer than in other seasons.
A severe injury can cause a fingernail or toenail to fall off. However, unless the injury has caused severe nail matrix damage, the nail will usually grow back with proper medical care. It may take several weeks or even months for the new nail to appear, and it is unlikely to look normal right away. Toenails, in particular, can take up to a year and a half to completely grow back, which is three times longer than it would take a fingernail. This is because toenails are generally subjected to less trauma than fingernails, and the temporary boost in circulation from stubbing a toe, for example, does not have a lasting impact on toenail growth.
On average, fingernails grow at a rate of about 3.47 mm per month, or about 0.123 mm per day, while toenails grow at a rate of about 1.62 mm per month. The little fingernail grows slower than other fingernails, and the great toenail grows faster than other toenails.
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Preventing infection
If a nail has been ripped off, the first concern is to prevent infection. If there is any sign of infection, swelling, increasing pain, or pus, a doctor should be consulted. To prevent infection, the damaged skin should be covered with a dressing. The wound should be cleaned with soap and water to remove any foreign material. If there is any jewellery on the injured finger, it should be removed. Antibiotics may be prescribed to prevent infection.
If the nail is only partially detached, the non-adhering portion should be removed. If the nail bed and nail matrix are not damaged, the nail should regrow normally. The nail matrix is the part of the nail that produces new cells, and it is usually not permanently damaged. However, if there is damage to the nail matrix, the growing nail may be deformed.
If the entire nail has been detached, there is nothing that can be done to repair or replace it. The concern then becomes preventing infection and assessing any damage to the surrounding tissues, nail bed, nail matrix, or proximal nail fold. If there is scarring, this should be repaired by a physician.
To prevent nail injuries, it is important to wear proper footwear, especially when playing sports. Shoes should be replaced when they become worn, and they should always be the correct size. When working with heavy objects or in construction, steel-toe boots should be worn to protect the toes.
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Home treatment vs. seeking medical care
A nail that has been ripped off will grow back, but it may take several weeks or months. In the meantime, you can try home treatment to relieve pain, promote healing, and prevent infection. If you are able to stop the bleeding quickly, you can treat a nail injury at home.
Home treatment
- Apply direct pressure with a clean cloth.
- If the nail is torn, use sterile scissors to cut off rough edges to prevent further injury.
- Clean the wound and nail area with soap and warm water.
- Apply an antibiotic ointment and cover the area with a bandage.
- Change the bandage daily.
- For swelling, ice the area and elevate the injured area above the heart.
- Take over-the-counter pain medication as needed.
- If you have an artificial nail, remove it.
- File any sharp edges smooth, or trim the nail.
- Cover the nail with tape or an adhesive bandage until the nail has grown out enough to protect the finger or toe.
- Soak your finger or toe in cold water for 20 minutes after trimming the nail.
- Apply a thin layer of petroleum jelly and cover the area with a nonstick bandage.
- Soak your hand or foot in a solution of 1 teaspoon of salt dissolved in 4 cups of warm water for 20 minutes, 2 to 3 times a day, for the next 3 days.
Seeking medical care
If you are unable to stop the bleeding, or if there is a large bruise, you should seek medical attention. A healthcare provider will be able to determine if there is a fracture or if tissue under the nail needs repair. They may remove the nail to make the repair, or they may create a small hole in the nail to drain blood and relieve pressure and pain. If there are signs of infection, such as pus, redness, or heat around the nail, you should also seek medical attention.
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Frequently asked questions
Yes, a new nail will grow back to replace the old one, pushing it off as it grows.
Fingernails typically take 3 to 6 months to grow back, while toenails can take up to 12 to 18 months.
If the nail is completely detached, there is no way to reattach it. Keep the nail bed dry, clean, and covered with petroleum jelly and an adhesive bandage until the nail has grown back. Watch for signs of infection and seek medical attention if necessary.
