Isla Bennett
Hand, foot, and mouth disease (HFMD) is a mild and contagious viral infection that is most common in children. It is typically caused by the coxsackievirus and results in fever, rashes, and mouth sores. In some cases, it can also lead to nail changes, known as onychomadesis, which can cause partial or complete nail shedding. This typically occurs four to eight weeks after the initial illness and can be managed by keeping nails clean and trimmed. In most cases, nails will grow back within 3 to 12 months, depending on whether they are finger or toenails.
| Characteristics | Values |
|---|---|
| How long after HFMD do nails fall off? | 4–8 weeks after the disease onset |
| How long does it take for fingernails to grow back? | 3–6 months |
| How long does it take for toenails to grow back? | 9–12 months |
| What are the nail abnormalities? | Leukonychia, Beau lines, partial or complete nail shedding, yellowish-orange discolouration |
| What is the treatment? | Usually self-limited and requires no treatment; keep nails clean with soap and water, use a good quality oil, trim nails if they catch on things |
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What You'll Learn
Nail abnormalities include leukonychia, Beau lines, and discolouration
Hand-foot-and-mouth disease (HFMD) is a mild, contagious viral infection that usually affects children. It is caused by enteroviruses, with enterovirus 71 and coxsackievirus A16 being the most common causative agents. Onychomadesis, or nail shedding, is a late complication that occurs four to eight weeks after the illness begins. Nail abnormalities associated with HFMD include leukonychia, Beau lines, and discolouration.
Leukonychia refers to white nails, which can manifest as white streaks or spots on the nails. It is a common condition in children and active adults and is usually not a cause for concern. However, it can sometimes indicate severe systemic disorders or congenital conditions. The white colour can be due to nail plate or nail bed abnormalities. Dermoscopy can help distinguish between true leukonychia, apparent leukonychia, and pseudoleukonychia.
Beau lines are transverse linear depressions that run across the nail plate. They are named after Joseph Honoré Simon Beau, who first described these lesions in 1846. Beau lines can occur after an illness, injury to the nail, eczema around the nail, chemotherapy, or nutritional deficiencies.
Nail discolouration can also occur after HFMD. Nails may turn yellowish-orange or exhibit a cloudlike, grey-white colour. Discolouration can be a sign of underlying health conditions, such as hyperthyroidism, which can cause brown discolouration of the nail plate.
It is important to note that nail abnormalities after HFMD are typically self-limited and may not require treatment. However, if you notice any persistent or concerning changes to your nails, it is always best to consult with a healthcare professional for proper assessment and advice.
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Nail shedding occurs 4-8 weeks after disease onset
Hand-foot-and-mouth disease (HFMD) is a mild, contagious viral infection that typically affects children. It is caused by a group of coxsackieviruses, mainly coxsackievirus A16 and human enterovirus 71. While HFMD usually manifests as fever and vesicles on the hands, feet, and mouth, it can also lead to nail changes, a complication known as onychomadesis.
Onychomadesis is characterised by nail shedding, which typically occurs 4 to 8 weeks after the initial onset of HFMD. In some cases, it may take up to 6 weeks for the nails to start shedding. This condition is believed to be caused by the temporary inhibition of nail matrix activity due to either direct inflammation from periungual HFMD lesions or the enteroviruses affecting the nail matrix more directly.
The nail changes associated with onychomadesis can vary. Initially, grey-white patches may appear on the bottom of the nails, which then spread. Eventually, the nails begin to shed, starting from the lunulae and progressing towards the free border of the nail over the course of about two weeks. In some instances, the nails may only shed partially, while in other cases, complete nail shedding may occur.
While onychomadesis can be concerning, it is typically a self-limited complication that requires no specific treatment. It is important to maintain proper nail hygiene during this time by regularly cleaning the nails with soap and water and applying a good quality oil. Additionally, nail wraps can be used to protect the nails and prevent any discomfort.
If the loose nail plates cause any issues, they can be lightly filed with a sponge file. After a few weeks, when the nail has grown back sufficiently, it can be carefully trimmed. It typically takes 3 to 6 months for fingernails and 9 to 12 months for toenails to grow back completely and regain their normal appearance.
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Nail shedding is usually self-limited and requires no treatment
Hand-foot-and-mouth disease (HFMD) is a contagious viral infection that typically affects children. It causes fever and vesicles or blisters on the hands, feet, and mouth. The disease is usually mild and resolves within 7 to 10 days with minimal treatment. While HFMD usually clears up quickly, nail changes can occur several weeks after the initial illness.
Onychomadesis, or nail shedding, is a late complication of HFMD that typically occurs 4 to 8 weeks after the onset of the illness. It is characterized by partial or complete nail shedding, leukonychia (white or yellow streaks on the nails), and Beau lines (horizontal grooves across the nail plates). In some cases, the nails may turn a grey-white or yellowish-orange colour.
Nail shedding due to HFMD is usually self-limited and requires no specific treatment. The nails will typically grow back within a few weeks, and any nail abnormalities will resolve spontaneously within 1 to 2 months. This is because onychomadesis is caused by a temporary inhibition of nail matrix activity, which resolves on its own.
While there is no specific treatment for nail shedding after HFMD, it is important to monitor the condition and follow up with a healthcare provider if necessary. In the meantime, individuals can focus on managing any discomfort caused by HFMD symptoms, such as encouraging handwashing and keeping the affected person hydrated and comfortable. Over-the-counter pain relievers can also be used to manage fever and pain.
It is important to note that nail shedding may be a sign of other underlying conditions or exposures, so seeking medical advice if concerned is always recommended.
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Nails grow back in 3-12 months
Hand-foot-and-mouth disease (HFMD) is a mild, contagious viral infection that usually affects children. It is characterised by fever, rashes, and sores or blisters on the hands, feet, and mouth. While the fever usually lasts for 2 to 3 days, and mouth sores and rashes go away within a week, nail changes can occur 3 to 8 weeks after the onset of the illness.
Onychomadesis, or nail shedding, is a common complication of HFMD. It typically affects multiple fingernails and toenails, causing them to fall off partially or completely. This nail shedding is thought to be caused by temporary inhibition or arrest of nail-matrix proliferation due to periungual inflammatory reactions or enteroviruses affecting the nail matrix directly.
While nail shedding can be alarming, it is usually self-limited and requires no treatment. Fresh, thin pink nails will begin to grow slowly underneath the damaged nail plates. Fingernails typically grow back within 3 to 6 months, while toenails may take a little longer, ranging from 9 to 12 months. During this time, it is important to keep the nails clean and well-maintained to avoid any discomfort or accidental injuries.
To facilitate nail regrowth and protect the sensitive nail bed, individuals can use nail wraps or elastic tape, which can be cut to size and safely worn underneath socks and shoes. Light filing with a sponge file can also help smooth any rough edges. As the new nail grows, it is essential to trim the loose nail plates carefully to prevent snagging or catching on objects.
With proper care and patience, individuals can expect their nails to return to their normal appearance within the given timeframe. It is worth noting that nail shedding is a harmless and temporary side effect of HFMD, and the new nails will grow back strong and healthy with the appropriate hygiene and maintenance practices.
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Keep nails clean with soap and water, and use a nail wrap
Hand-foot-and-mouth disease (HFMD) is a mild, contagious viral infection that usually affects children. It is caused by a group of coxsackieviruses, mainly coxsackievirus A16 and human enterovirus 71. The disease typically presents with fever and vesicles on the hands, feet, and mouth.
One complication of HFMD is onychomadesis, which is the partial or complete shedding of nails. This typically occurs four to eight weeks after the initial illness. Nail changes may include leukonychia, Beau lines, and yellow-orange discoloration of the nail plate.
To maintain nail hygiene during and after HFMD, it is important to keep your nails clean. Here are some tips to keep your nails clean with soap and water and to use a nail wrap:
Keeping Nails Clean with Soap and Water
- Wash your hands with soap and water: Use mild soap and warm water to thoroughly clean your hands. Pay attention to the areas under your nails, where dirt and bacteria can accumulate.
- Dry your hands and nails thoroughly: After washing, dry your hands and nails completely. Moisture trapped under the nails can lead to bacterial growth and infections.
- Remove cuticles: Cuticles can trap dirt and bacteria, so it's a good idea to gently push them back or use a cuticle remover. This will also help create a smooth surface for the nail wrap application.
- Use rubbing alcohol: Wipe your nails with an alcohol pad or cotton swab dipped in rubbing alcohol to remove any unseen debris or oil. This step will ensure that your nails are thoroughly cleaned and sanitized.
Using a Nail Wrap
- Select a nail wrap: Choose a nail wrap that suits your style and preference. Nail wraps are self-adhesive, ultra-thin polish strips that come in various designs and prints, offering an easy way to achieve stylish nails.
- Find the right size: Ensure you select the correct size of nail wrap for each nail. This is crucial for a seamless and long-lasting application.
- Apply the nail wrap: Follow the instructions provided with your chosen nail wrap brand. Typically, you would peel off the backing and stick the wrap onto your nail, starting at the cuticle and smoothing it out towards the free edge.
- Seal and protect: For added durability and shine, you can apply a nail polish top coat over the nail wraps. This is especially beneficial if you plan to spend time in the sun or pool, as it provides extra protection.
- Removal: When it's time to remove the nail wraps, always use nail polish remover. Soak the wraps for a few seconds and then gently wipe them off. Avoid tearing off the wraps, as this can damage your natural nails.
By following these steps, you can maintain clean and healthy nails while also enjoying the aesthetic benefits of nail wraps. Remember to pay attention to any changes in your nails and seek medical advice if necessary, especially if you experience any nail abnormalities after recovering from HFMD.
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Frequently asked questions
Nails fall off four to six weeks after the initial onset of the virus.
According to the Centers for Disease Control and Prevention, nail loss occurs in only 4% of severe cases.
Unfortunately, there is nothing you can do to prevent nail loss from happening. The good news is that nails typically grow back completely normal, and you shouldn't have any long-term deformities.
HFMD is characterised by fever, rashes, and erythematous papulovesicular eruptions over the palms, soles, knees, buttocks, and oral mucosa.
Fingernails grow back in 3 to 6 months, while toenails take 9 to 12 months.
