Sophia Delgado
Losing a fingernail can be distressing, but it's more common than you might think. Nails can be injured by a blow, or by trapping them in a door or drawer. This kind of trauma can cause blood to pool under the nail, known as a subungual haematoma, or even result in the nail lifting away from the nail bed. This is called onycholysis, and it can be caused by injury, infection, or certain skin conditions. If you've injured your finger, it's important to take care of any immediate first aid needs, such as stopping any bleeding, cleaning the wound, and applying a bandage. Once the nail has fallen off, it's a good idea to protect the sensitive skin of the nail bed with a bandage to prevent dryness and cracking.
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What You'll Learn
Cover the nail bed with a bandage to protect the skin
If your nail comes off, it's important to keep your fingertip covered while you wait for your nail to grow back, which can take around three to six months. Covering your nail bed with a bandage will protect the sensitive skin underneath and help to keep the area clean and free of infection.
Firstly, if there is any remaining nail that is rough or uneven, use a pair of clean, sterile scissors to trim it down. Be careful to avoid causing further injury to the nail bed. Next, gently wash the wound with soap and warm water to ensure that the area is clean. You can then apply a small amount of antibiotic ointment to the nail bed to prevent infection and keep the bandage from sticking.
When applying the bandage, use a clean, sterile dressing and secure it gently but firmly to your finger. The bandage should cover the nail bed and extend slightly past the edges of the nail to ensure the whole area is protected. Change the bandage daily and continue to keep the area clean.
If you experience any signs of infection, such as pus, redness, heat, or a red streak extending from the wound, contact your healthcare provider as soon as possible.
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Treat any bleeding with basic wound care
If your fingernail falls off due to an injury, it is important to treat any bleeding with basic wound care. Basic wound care applies to bleeding under the nail, known as a subungual hematoma, or bleeding from the exposed nail bed. To treat bleeding, apply pressure to the area to slow the bleeding. Then, clean the wound with soap and water to prevent infection. You can also use an antibacterial soak, such as lemon juice, vinegar, or hydrogen peroxide, to clean the wound. After cleaning the wound, cover it with a bandage to protect the sensitive skin of the nail bed. Keep the wound covered until it has healed to prevent dryness and cracking, which can affect how the nail grows back.
If there is swelling in the area, you can ice your finger. Additionally, take an analgesic, such as Advil, to help manage pain. If there is a lot of blood under your nail bed, it is important to see a doctor within 24 hours. They may drain the accumulated blood by drilling a small hole in the nail plate. In some cases, a large subungual hematoma may indicate an underlying bone fracture or tissue tear, so it is important to seek medical attention.
After treating any bleeding, you can focus on managing the underlying cause of the nail separation. This may include trimming the nail, wearing gloves, avoiding nail irritants, or taking medication for nail infections. Keeping your nails trimmed will prevent them from catching on objects and causing further trauma. If the nail bed looks infected (red, purple, grey, or white skin with irritation and swelling), contact your healthcare provider as soon as possible. They may need to remove the nail through a procedure called nail evulsion.
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Avoid pulling off the nail, let it grow out
If your fingernail falls off or comes loose, it's important to avoid pulling off the nail. Instead, let it grow out naturally. This is because new nail growth will occur underneath, and pulling off the nail could damage this new growth. As Dr. Lain explains, "the new nail will push up the old nail, and it will come off when it's ready".
While you wait for your nail to grow out, there are several steps you can take to care for your nail and the sensitive skin of the nail bed. Firstly, keep your nails trimmed short to prevent them from catching on objects and pulling further off the nail bed. You can use nail clippers or scissors to carefully trim any affected nails. It's also important to protect the exposed skin of the nail bed. You can do this by covering it with a bandage or Band-Aid. This will prevent the skin from drying out, cracking, or being traumatized, which could affect how the nail grows.
Additionally, you should keep the area clean and apply antibacterial or antimicrobial soaks to prevent infection. You can use a clean washcloth to help reach beneath the nail during cleaning. Antimicrobial soaks may include lemon juice, vinegar, hydrogen peroxide, or essential oils such as tea tree, orange, or lemongrass. However, it's a good idea to check with your healthcare provider before using essential oils, as there is a risk of developing an allergic reaction.
If your nail has fallen off due to an injury, it's important to assess the extent of the damage and determine whether you need to seek medical attention. If there is bleeding, apply pressure to the area, clean the wound with soap and water, and cover it with a bandage. You can also take an analgesic to help with any pain and ice your finger if there is swelling. If the injury affects the nail matrix, which is the tissue at the base of the nail where nail growth occurs, you should have a professional evaluate the seriousness to prevent any long-term damage to your nail growth.
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Use antibacterial soaks and keep the area clean
If your fingernail falls off, it is important to keep the area clean to prevent infection. Wash your hands regularly with antibacterial soap and scrub the underside of your nails with soap and water or a nail brush. You can also apply antibacterial hand sanitiser to reduce bacteria on the fingertips.
To treat a detached nail, you can use antibacterial soaks. Soak the affected area in warm water for about 15 minutes a few times a day. Be sure to dry the area thoroughly afterward. Soaking the cuticle and nail bed helps pus drain from under the skin. You can also try antimicrobial soaks, which may include lemon juice, vinegar, hydrogen peroxide, and tea tree, orange, or lemongrass essential oils. However, it is a good idea to check with your healthcare provider before using essential oils, as you may be at risk of developing an allergic reaction.
In addition to keeping the area clean and using antibacterial soaks, there are other general measures you can take to support nail health. Keep your nails trimmed short to prevent them from catching on objects and pulling further off the nail bed. Apply a moisturiser to your hands, nails, and cuticles to keep your nails flexible and healthy and prevent dryness and cracking. You can also cover the sensitive skin of the nail bed with a Band-Aid to protect it.
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Take antifungal medication if the cause is fungal
If you have onycholysis—the medical term for when a nail separates from the nail bed—due to a fungal infection, your healthcare provider may prescribe oral or topical antifungal medication. Oral antifungal medication comes in the form of liquid medicines, pills, or tablets that you swallow with water. Topical medications come in the form of creams, ointments, or gels that you rub directly onto your nails.
Oral antifungal medications may include:
- Terbinafine (Lamisil)
- Itraconazole (Sporanox)
- Fluconazole (Diflucan)
Terbinafine and itraconazole are the two medicines most commonly prescribed for fungal nail infections. Antifungal medication may also come in the form of a special paint that you apply directly to the nail. This is known as antifungal nail paint.
It's important to note that antifungal treatments for nail infections often take a long time to work, and you may need to take the medication for several months to ensure the infection has completely cleared. If you stop taking the medication too early, the infection may return and be harder to treat.
In addition to antifungal medication, you can also practice good nail hygiene and care to support the treatment of onycholysis. This includes regularly trimming your nails short to prevent them from catching on objects and pulling further off the nail bed. Keeping your nails clean and washing your hands regularly can also help prevent infection.
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Frequently asked questions
If your fingernail falls off, it is important to protect the sensitive skin of the nail bed. You can do this by covering it with a bandage. It is also recommended to trim the nail and keep it short to prevent it from catching on objects and pulling further off the nail bed.
Fingernails can fall off due to various reasons, including injury, infection, or certain skin conditions. Repeated trauma to the nails, such as nail biting, cuticle biting, or closing the finger in a door or drawer, can also cause nails to fall off.
Fingernails typically take around 4 to 6 months to grow back to their full size. During this time, it is important to take care of your nails and protect them from any further damage.
