Isla Bennett
Losing a fingernail or toenail can be painful and annoying. Nails can fall off due to injury, infection, or autoimmune disorders like psoriasis. In some cases, a detached nail may become infected or indicate a more serious medical condition. So, it is important to keep the nail bed clean and protected. Depending on the cause and size of the lost nail, it can take anywhere from several weeks to two years for a nail to grow back.
| Characteristics | Values |
|---|---|
| Time for nail to fall off after injury | Several weeks |
| Time for nail bed to heal | 7 to 10 days |
| Time for a new fingernail to grow | 4 to 6 months |
| Time for a toenail to grow | 6 to 18 months |
| Time for toenail to grow back after exostosis removal | A few months to a year |
| Time for toenail to grow back after fungal infection | Up to 12 weeks |
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What You'll Learn
Toenail falling off due to injury
Toenail injuries are common and can be caused by a variety of factors, including trauma, fungal infections, and certain illnesses. Repeated trauma to toenails, caused by ill-fitting shoes, can lead to deformities in the nails. This can cause cosmetic concerns, such as thickened or discolored nails, and can even lead to nails lifting away from the nail bed. Other causes of toenail trauma include nail biting, cuticle biting, and repetitive picking at the thumb's nail and cuticle. Additionally, habits such as regularly getting manicures or tapping your nails on a hard surface over a long period can also contribute to nail trauma.
If you injure your toenail, it might turn black or purple due to a condition called subungual hematoma, which causes blood to collect under the nail. As blood builds up, the nail may separate from the nail bed and take several weeks to completely fall off. If the subungual hematoma covers more than a quarter of the toenail, it is advisable to contact your doctor. They may use a heated needle or wire to create a small hole in the toenail and relieve the pressure. To manage the pain, you can take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
After a toenail injury, it typically takes a considerable amount of time for the nail to grow back. Depending on the cause and size of the lost toenail, it can take anywhere from six months to two years for the nail to completely regrow. During this period, it is important to keep your feet clean and maintain your toenails by keeping them smooth and short. Additionally, wearing properly sized shoes can help prevent further nail trauma and reduce the risk of losing a toenail.
In some cases, toenail injuries may require additional medical attention to ensure proper regrowth. If the underlying cause, such as a fungal infection or injury, is not addressed, it can hinder the nail's ability to grow back properly or at all. Therefore, it is important to seek medical advice if you suspect an infection or if the injury is causing concern.
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Fungal infections
Fungal nail infections are characterised by nails that are thick, discoloured, brittle, and crumbly. They can affect both toenails and fingernails, although they are more common in toenails. The infection usually starts at the edge of the nail and spreads to the rest of it, causing the nail to become white or yellow. In some cases, the whole nail can break off, leading to swollen and painful skin around it.
Fungal nail infections are typically treated with antifungal pills, creams, gels, or nail medicine. Antifungal pills like itraconazole and terbinafine are more effective than creams and gels, but they need to be taken for 12 weeks and may not completely get rid of the fungus for 10 months or longer. These pills can also cause side effects like nausea, vomiting, and headaches, and negatively interact with other medications. For this reason, it is important to consult a doctor before taking any antifungal medication.
Nail medicine, on the other hand, needs to be applied regularly for a few months before any improvement is seen. It is important to continue using the treatment until advised to stop by a healthcare professional. If pharmacy treatments are ineffective, a GP may prescribe antifungal tablets. Before starting treatment, a GP will take a sample of the nail to test the type of infection and may also perform a blood test to check that the liver is functioning properly. Antifungal tablets may need to be taken for up to 6 months.
Home remedies like vinegar, baking soda, tea tree oil, Listerine mouthwash, and snakeroot extract have also been suggested as treatments for fungal nail infections. However, medical treatments are the only known methods to effectively treat nail fungus.
It can take 12 to 18 months for a fungal nail infection to completely clear up and for the damaged nail to be fully replaced by fresh growth. During this time, it is important to finish any prescribed medication, even if the nail starts to look better, to prevent the hidden fungus from growing back.
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Onycholysis (nail separation)
Onycholysis is a common condition in which the nail separates from the nail bed. It is easy to recognise and does not usually cause any pain. However, it may be contagious if caused by a fungal infection. Onycholysis can affect both finger and toenails and typically only impacts one nail.
Causes of onycholysis include:
- Injury or trauma to the nail or nail matrix, which is the area where nails start to grow.
- Fungal infections, which can occur when fungus gets between the nail and nail bed, usually through cracks or cuts in the finger or toe.
- Reaction to chemicals in nail products like nail polish, nail gloss, nail hardener, nail polish remover, and fake nails.
- Nail psoriasis, which causes changes to the structure of the nail.
- Iron deficiency, which can also cause anaemia.
- Hyperthyroidism, which causes the thyroid gland to release more hormones than the body needs.
- Chemotherapy and medications that cause light sensitivity, such as tetracycline, nonsteroidal anti-inflammatory drugs (NSAIDs), psoralens, and oral retinoids (vitamin A derivatives).
Treatment for onycholysis may involve cutting away the separated nail as it grows out, taking antifungal medications, or discontinuing the use of certain nail products. It is important to determine the cause of onycholysis to effectively treat the underlying issue. In the case of fungal infections, for example, a mixture of tea tree oil diluted with a carrier oil like jojoba or coconut oil can be applied to treat the fungus.
The time it takes for nails to grow back after onycholysis varies. Fingernails typically take 4 to 6 months to fully regrow, while toenails can take anywhere from 8 to 18 months.
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Toenail falling off due to psoriasis
A toenail falling off can be caused by a variety of factors, including injury, fungal infection, and psoriasis. Once a toenail falls off, it cannot reattach and continue growing. Instead, you'll need to wait for a new nail to grow back in its place.
Psoriasis is an autoimmune condition that causes skin cells to reproduce quickly, leading to a buildup of skin cells in the nail bed, which can cause the toenail to detach and fall off. Nail psoriasis is common, affecting over 50% of people with psoriasis and around 86% of people with psoriatic arthritis. It can cause the toenails to thicken, develop pinprick holes, change colour or shape, and feel tender or painful.
If you have nail psoriasis, it is important to practice good nail care to treat the condition and prevent further problems. This includes keeping your nails and feet moisturized, regularly washing your hands and nails to prevent infection, and keeping your nails trimmed short to prevent them from catching on objects and pulling further off the nail bed. You should also avoid removing extra skin under your nail with a sharp object, as this can make your toenail more likely to detach. Instead, soak your feet in warm water and smooth the edges of your remaining toenail with a file. Additionally, you can apply a nail hardener polish and cut off hangnails.
To treat nail psoriasis, your doctor may prescribe topical steroids, vitamin D or retinoid creams, or suggest phototherapy, which involves exposing your affected toes to UV rays. In some cases, oral or topical antifungal medications may be prescribed to treat any underlying fungal infections.
The time it takes for a toenail to grow back after falling off can vary depending on the cause and the size of the lost toenail. On average, it can take anywhere from 6 months to 2 years for a toenail to completely grow back. During this time, it is important to take safety precautions to prevent additional injury or infection.
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Home treatment and medical attention
Fingernails and toenails can fall off due to various reasons, including injuries, fungal infections, psoriasis, and reactions to certain medications or chemicals. While losing a nail is usually not a major concern, it can be painful and annoying. If you experience nail detachment, there are several home treatments and medical interventions you can consider to facilitate healing and prevent further complications.
Home Treatment
- Stop the bleeding: If your nail is bleeding, apply pressure with a clean cloth for several minutes to stop the bleeding.
- Apply first aid ointment: Once the bleeding has stopped, apply an antibiotic ointment to the affected area to prevent infection.
- Bandage the area: Cover the nail and the surrounding area with a bandage to keep it protected and secure.
- Keep the nail bed clean and protected: Ensure that the exposed nail bed remains clean and protected to prevent infection and promote healing.
- Trim your nails regularly: Maintain short nails to prevent them from catching on objects and causing further injury or nail bed damage.
- Avoid additional damage: Take precautions to protect your nails from further injury or trauma. Wear properly sized shoes and avoid activities that may damage the nail bed.
- Practice good hand hygiene: Wash your hands regularly to prevent infections, especially if your fingernails are affected.
- Use antifungal or antimicrobial soaks: Help prevent and treat fungal infections by soaking your nails in solutions containing lemon juice, vinegar, hydrogen peroxide, or essential oils like tea tree oil.
Medical Attention
- Seek immediate medical care for severe cases: If your nail falls off due to a severe injury or there is uncontrolled bleeding, seek immediate medical attention.
- Consult a doctor for persistent bleeding or pain: Contact your doctor if your nail won't stop bleeding or if you experience severe pain, throbbing, or discomfort.
- Evaluate for underlying conditions: If your nail falls off without any apparent injury, consult a healthcare provider. It could be a sign of an underlying condition such as nail fungus or a more serious health issue.
- Treat infections: If you suspect an infection, seek medical attention. Your doctor may prescribe oral antifungal medications or antibiotics to treat the infection and ensure the proper growth of your new nail.
- Consider surgical options: In rare cases, surgery may be necessary to permanently remove an affected toenail or to correct underlying issues causing nail detachment, such as exostosis.
It is important to remember that the information provided is for educational purposes only. Always consult a healthcare professional for personalized advice and treatment options.
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Frequently asked questions
It takes between 4 to 9 months for fingernails to grow back.
It can take anywhere from 6 months to 2 years for toenails to grow back.
Keeping your nails clean and short can help speed up the process.
It is important to keep the nail bed clean and protected. It usually takes 7 to 10 days for the nail bed to heal.
