Ava Monroe
A detached toenail is a common condition, often caused by injury, fungal infection, or psoriasis. While it can be tempting to remove a damaged toenail yourself, it is not recommended as it could lead to serious complications and infections. Instead, it is best to consult a doctor, especially if you have diabetes, peripheral arterial disease, or an immune system problem. In the meantime, you can trim the nail, soak your foot in warm water, and keep the nail bed moisturized to promote healing and prevent further issues.
| Characteristics | Values |
|---|---|
| Cause | Accident, injury, fungal infection, psoriasis, nail biting, chemicals or products that irritate nails, diabetes, chemotherapy, antibiotics, severe illnesses, etc. |
| Symptoms | Pain, throbbing, black or purple discolouration, blood or bruising under the nail, fatigue, dizziness, weakness, headaches, sore tongue, fast heartbeat, etc. |
| Treatment | Drain blood with trephination, nonsteroidal anti-inflammatory drugs (NSAIDs), antifungal medications, topical steroids, phototherapy, cutting away separated nail, etc. |
| Prevention | Keep nails short and trimmed, wear gloves for activities that may damage nails, wear clean socks and comfortable protective shoes, be careful when putting down heavy objects, etc. |
| Regrowth | Takes several months to a year for a new nail to grow back, may grow back with a different colour, shape, or texture |
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What You'll Learn
Bruising and blood under the nail
If you have a subungual haematoma, you should seek medical care within two days. A doctor may recommend a simple drainage procedure to relieve the pressure and pain. This is called trephination and is usually a painless procedure. The doctor will make a small hole in the nail to allow the blood to drain out. However, it is important not to attempt this at home.
If you do not drain the blood within the first 48 hours, it will clot, causing a bulk under the nail that could lead to weeks of unnecessary pain. The nail may fall off on its own after several weeks, but it is important to watch for signs of infection, such as red or discoloured skin, swelling, or fever. If you notice any of these symptoms, seek immediate medical attention.
If you hurt your nail and it is coming off, do not try to remove it yourself. Allow the injured area to breathe as much as possible and keep it clean and dry. A new nail will grow in its place, but it may take several months. You can use nail clippers to carefully trim any remaining parts of the nail and a nail file to smooth any sharp edges. Apply an antibiotic ointment to the area to prevent infection.
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Fungal infections
Fungal toenail infections can be challenging to treat, depending on the severity of the infection. Mild cases may clear up on their own without any treatment. However, if you have diabetes, it is crucial to consult a doctor as soon as possible because reduced circulation can exacerbate the problem. Typically, treating fungal toenail infections involves the use of oral or topical antifungal medications, or a combination of both.
There are various over-the-counter (OTC) antifungal treatments available, such as antifungal creams, gels, sprays, and patches. These include clotrimazole (Lotrimin) and terbinafine cream (Lamisil). While these treatments can be effective for mild toenail fungus, they may take several months to show results. It is important to note that OTC treatments may not be potent enough for moderate to severe cases of toenail fungus, and prescription drugs may be necessary.
For more severe infections, your doctor may prescribe antifungal pills like itraconazole (Sporanox) or terbinafine (Lamisil). These medications are more effective than creams and gels, but they come with potential side effects such as nausea, vomiting, and headaches. Additionally, terbinafine can affect the liver, and itraconazole may negatively interact with other medications. Therefore, it is essential to consult your doctor and be monitored while taking these medications.
In some rare cases, surgery may be required to permanently remove the affected toenail. However, this procedure is not commonly performed. After removing the nail, a new nail will typically grow back, but it may take up to a year or even longer. During this regrowth period, your doctor will likely provide you with a cream or other treatment to prevent fungal recurrence.
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Psoriasis
While it is important to seek medical advice for any nail injuries or infections, this response will focus on providing information about nail care and treatment specifically related to psoriasis.
Nail psoriasis is an autoimmune condition that affects the nails on your fingers and toes. It causes discoloration, pitting, and changes in nail structure. While there is no cure, treatments can help alleviate symptoms and prevent the condition from worsening.
- Keep your nails short to prevent lifting and reduce buildup under the nails.
- Wear gloves when doing any manual work, including housework and yard work, to protect your nails and prevent irritation. Cotton gloves underneath vinyl or nitrile gloves are recommended for wet work like washing dishes.
- Moisturize your hands and nails regularly, especially after washing your hands and within three minutes of bathing, to lock in moisture and prevent dryness.
- Avoid biting or picking at your nails and cuticles to prevent injury and infection.
- Keep your nails clean and dry to prevent infection.
- Wash your hands and nails regularly to prevent infection.
- Apply a nail hardener polish to strengthen your nails.
- Cut off hangnails to maintain nail health.
- Avoid artificial nails as they can increase the risk of your nails separating from your fingers.
- If you wish to hide dents or discolouration, gently buff your nails and apply nail polish.
In addition to nail care, there are medical treatments available for nail psoriasis:
- Topical steroids: Your doctor may prescribe topical steroids to rub into your toenail and cuticle.
- Phototherapy: Your doctor may suggest phototherapy as an alternative treatment option.
- Corticosteroids: A strong or very strong corticosteroid can be safely applied once or twice a day to treat most signs and symptoms of nail psoriasis.
- Calcipotriol: Derived from vitamin D, this medication treats the buildup that can develop beneath the nails.
- Antifungal medications: If nail psoriasis leads to a fungal infection, oral or topical antifungal medications may be prescribed.
It is important to consult a healthcare provider or dermatologist if you notice any changes to your nails, as early treatment can help prevent nail psoriasis and psoriatic arthritis from worsening.
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Removing artificial nails
First, you can file down the topcoat, designs, or glitter on your artificial nails. This is like gently sanding down a shiny surface to its core. Then, apply petroleum jelly to the skin around your nails to protect it from the acetone. Next, create an acetone bath by soaking cotton balls in acetone, placing them on your nails, and wrapping each finger with aluminium foil. Wait for about 20-30 minutes, and then gently remove the foil and cotton. The artificial nails should come off easily. If they are stubborn, use a nail stick to coax them off gently.
Alternatively, you can soak your nails in warm, soapy water for about 40 minutes. Once the artificial nails have softened, gently try to lift them off. If they resist, put them back in the water for a bit longer.
Another option is to use sharp nail clippers to cut down the extensions, leaving about two centimetres of the nail above your nail bed for safety. Then, use a nail file to file away the bulk of the artificial nail.
Remember to always be gentle during the removal process and to show your natural nails some love after the artificial nails are removed. Your natural nails may feel weak, but with proper aftercare, they will bounce back stronger.
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Aftercare and regrowth
If your nail has fallen off, it's important to know that it cannot reattach and keep growing. You will have to wait for a new nail to grow back in its place. This can take anywhere from six months to two years, depending on the cause and how much of the nail remains. In the meantime, there are several things you can do to ensure proper regrowth and avoid infection:
- Keep the area clean and dry. A nail injury can lead to infection if germs enter your body through a break in your nail or skin.
- If only a part of your nail has fallen off, use nail clippers to carefully trim off the detached part to prevent it from catching on clothing or socks. Smooth any jagged or sharp edges with a nail file.
- Soak your finger or toe in cold water for 20 minutes after trimming the nail.
- Apply a thin layer of petroleum jelly, such as Vaseline, and cover the area with a non-stick bandage. Change the bandage daily and whenever it gets wet.
- For the first couple of days, prop up your foot with pillows so that it's above the level of your heart to ease any pain and swelling.
- Apply an ice pack wrapped in a thin towel for no more than 20 minutes every 3 to 6 hours as needed.
- Take over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, to help with pain and swelling.
- Keep your nails and the affected area moisturized.
- If you have diabetes or another condition that causes slow healing, be extra vigilant for signs of infection, such as increased pain or swelling that lasts for more than a couple of days.
- If you notice signs of infection, such as a fever or feeling unwell, seek medical care promptly.
- If you have a fungal infection, your doctor may prescribe topical or oral antifungal medications, depending on the severity.
- If you have psoriasis, your doctor may prescribe topical steroids to rub into your nail and cuticle, or they may suggest phototherapy.
- If you are uncomfortable tending to the nail yourself or if the damage is serious, do not hesitate to contact your doctor or a podiatrist.
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Frequently asked questions
Some common causes of nails falling off include injuries, such as stubbing your toe or dropping something heavy on your foot, fungal infections, and skin conditions like psoriasis.
If your nail is partially detached, it is recommended to leave it alone and let it fall off naturally. Trimming the detached part with nail clippers or scissors can help prevent it from catching on clothing or socks.
To treat a detached nail at home, keep the area clean and dry. Apply a thin layer of petroleum jelly and cover it with a bandage. Soak your hand or foot in warm water with salt to promote healing.
Seek medical attention if you experience signs of infection, such as redness, swelling, pain, or pus. Additionally, if the detachment is due to an injury, seek medical care within two days to address any potential blood buildup under the nail.
