Ava Monroe
Nails 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. However, severe nail matrix damage may result in a permanent loss of the nail. Certain injuries and illnesses can damage the nail matrix and affect how the nails look or grow. Fingernails may take up to 6 months to grow back, while toenails may take up to 18 months.
| Characteristics | Values |
|---|---|
| Possibility of nail regrowth | Nails usually grow back, but it may take a while. |
| Nail growth rate | Fingernails may grow one-tenth of a millimeter each day, so completely removed fingernails usually grow within 4 to 6 months. Toenails may grow at about half or one-third the rate of fingernails, so they may take up to 18 months to regrow. |
| Factors influencing nail growth | Aging, diseases, and injuries can decrease blood flow to the hands and feet, slowing nail growth. Illnesses like COVID-19, pneumonia, or a heart attack can cause Beau's lines (horizontal nail ridges). Chemotherapy and other medications can cause Beau's lines or slow nail growth. Peripheral artery disease (PAD) reduces blood flow to the legs and feet, impacting toenail growth. Skin conditions like severe eczema and psoriasis can also affect nail growth. |
| Nail matrix damage | If the nail matrix is severely damaged, some or all of the nail may not grow back, resulting in permanent nail deformities. |
| Nail bed separation | Nails may separate from the nail bed due to injury, fungal infection, skin conditions, or chemical exposure. Once separated, the nail will not reattach. |
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What You'll Learn
Nail matrix damage
Nails have a good regeneration capacity, but they grow slowly. Fingernails may grow one-tenth of a millimeter each day, so completely removed fingernails usually grow within 6 months. Toenails may grow at about half or one-third the rate of fingernails, so completely removed toenails may grow within 18 months. Aging and diseases may decrease the blood flow to the hands and feet and sometimes slow the rate of nail growth.
The nail matrix is the "factory" where your body makes new fingernails and toenails. It is where your fingernails and toenails form and is essential for healthy nails. A deep cut or trauma to the germinal matrix at the base of the nail can cause the nail to stop growing and never grow back. The nail matrix creates new skin cells, which push out the old, dead skin cells to make your nails. As a result, injuries to the nail bed or disorders that affect the matrix can affect nail growth.
Injuries and certain health conditions can damage the nail matrix and interfere with nail growth. Minor damage to the nail matrix can temporarily change the nail's appearance. You might notice a change in how the nail feels to the touch. A severe injury could cause the nail to fall off. Once the nail matrix heals, the nail will usually start to grow again. It may take several weeks before you see the new nail appear. In cases of severe nail matrix damage, some or all of the nail may not grow back.
Illnesses, such as a heart attack, COVID-19, or pneumonia, can interrupt new nail growth and cause Beau's lines (horizontal ridges in the nails). Chemotherapy and other medications can also cause Beau's lines or slow nail growth. Peripheral artery disease (PAD) causes less blood flow to the legs and feet, which affects the nail matrix and can make nail growth slower. Severe eczema can also affect the nail matrix and temporarily interfere with nail growth.
Nail damage can be caused by working, playing, or repeated trauma. Longer nails are more likely to become damaged because they can be levered off the nail bed or run into the end of an athletic shoe. Poorly fitting shoes are likely to injure nails through repeated trauma.
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Toenail fungus
While it is rare, a nail may not grow back in the case of severe damage to the nail matrix. The nail matrix is the part of the body responsible for producing new nails. Certain injuries and illnesses can damage the nail matrix and affect how the nails look or grow. For example, a severe injury could cause a nail to fall off, and if the nail matrix is severely damaged, the nail may not grow back. However, with proper medical care, nails usually grow back even if they fall off.
Additionally, certain skin conditions like eczema and psoriasis can affect nail growth and cause changes in the appearance of the nails, including white lines, pitting, and crumbling. In some cases, these conditions may also impact the nail matrix and potentially interfere with nail growth. It is important to seek medical care if you notice any persistent changes in the appearance or texture of your nails, as it could indicate an underlying issue affecting nail growth.
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Fingernail growth rate
Fingernails grow at an average rate of about one-tenth of a millimeter or 0.123 mm per day, which amounts to approximately 3.47 millimeters per month. This means that it takes about 6 months for fingernails to grow out completely. However, it is important to note that the growth rate can vary depending on various factors. For instance, the nails on the dominant hand tend to grow faster, possibly due to more frequent use and subsequent injuries. Similarly, the growth rate of nails on different fingers varies, with the little finger's nail growing slower than the others. Age also plays a role in nail growth, with older individuals experiencing slower growth rates. Hormone levels can influence nail growth, with pregnancy and puberty being associated with rapid nail growth. Additionally, overall health and certain health conditions can impact nail growth, with infections and malnutrition slowing the process.
Toenails, on the other hand, grow at a slower rate than fingernails, typically taking 12 to 18 months to grow out completely. This difference in growth rate is attributed to toenails generally experiencing less trauma and injury than fingernails. Toenails grow at an average rate of 1.62 millimeters per month. Similar to fingernails, the growth rate of toenails can be influenced by overall health and certain medical conditions.
While nails have a good regeneration capacity, their growth can be affected by certain factors. Injuries or illnesses can damage the nail matrix, which is responsible for nail growth, leading to defects or deformities in the nail. Severe damage to the nail matrix may result in permanent nail loss. However, such cases are rare, and with proper medical care, nails usually grow back.
To promote healthy nail growth, it is recommended to maintain a nutritious and well-balanced diet, practice good nail hygiene, and avoid habits like nail-biting. Additionally, keeping nails short and wearing well-fitting shoes can help prevent nail damage and trauma.
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Nail bed trauma
Nail bed injuries are a common type of fingertip injury, often occurring when a heavy object crushes or hits the fingers or toes, or when a person sustains a cut from a sharp object. They can be minor, or they can be very painful and uncomfortable, sometimes limiting finger movement.
Nail bed injuries can occur in many ways, often when a nail is caught between two objects, or hit by something heavy, such as a hammer, or being slammed in a door. Cuts to the nail bed can be caused by sharp objects such as knives or saws. They can also be caused by nail biting, picking objects with the nail, or prying the eponychial fold.
A subungual hematoma is a common nail bed injury, caused when blood gets trapped under the nail bed, often as a result of crushing or hitting the nail. This can be treated by a doctor drilling a tiny hole in the nail to relieve the pressure of the accumulated blood.
Nail bed avulsions are another common injury, caused by the nail and part of the nail bed pulling away from the rest of the finger, often as a result of crushing or high-impact injuries. Avulsions can be very painful and may cause the finger to swell. In these cases, the nail will have to be removed if it has not already come off.
Nail bed injuries can often be fully repaired, and the nail will grow back, although sometimes with small ridges or bumps. The rate of growth will be slower than usual, but will eventually return to normal. Recovery time depends on the severity of the injury, but can take 6-9 months.
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Nail separation
While nails have a good regeneration capacity, it is possible for a nail to not grow back. This can happen in cases of severe nail matrix damage. The nail matrix is the "factory" where your body makes new nails. Certain injuries and illnesses can damage the nail matrix and affect how your nails look or grow.
One condition that can cause nail separation is onycholysis, which is when the nail separates from the nail bed. It is a common nail disorder that can affect people of any gender, age, or race, although it is most frequently seen in adult women. Onycholysis can be caused by trauma to the nail, such as stubbing a toe or repeatedly tapping nails for a long time. It can also be caused by skin disease, nail infections, tumours, or systemic events. For example, peripheral artery disease causes reduced blood flow to the legs and feet, which can affect the nail matrix and slow nail growth.
Onycholysis is usually painless, but it can be painful if it is acute or inflammatory. The detached nail is usually white and opaque, with a sharply defined border between the pink portion of the nail and the white edge of the lifted nail. The nail surface may be normal or pitted, indented, or crumbly. While there is no cure for onycholysis, treatments are available depending on the cause. The first step in treating onycholysis is to determine what is causing the nail to lift and then address the underlying cause. General measures to support nail health include clipping the affected portion of the nail, keeping the nail short with regular trimming, and avoiding activities that can result in nail injury. Specific measures will depend on the underlying cause and may include antifungal medication or treatments for nail psoriasis.
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Frequently asked questions
It is rare but possible for a nail to be permanently damaged and not grow back. This usually happens when there is severe damage to the nail matrix, which is the "factory" where your body makes new nails.
Damage to the nail matrix can be caused by injuries, illnesses, and skin conditions. For example, a heart attack, COVID-19, peripheral artery disease, severe eczema, and psoriasis can all affect nail growth.
If your nail falls off, you should keep the area dry and clean to prevent infection. You can also cover the nail with tape or an adhesive bandage until the new nail grows in. It usually takes 6 months for fingernails to grow back and up to 18 months for toenails.
To prevent nail damage, you should keep your nails short and wear well-fitting, roomy shoes. Avoiding dangerous situations and keeping your overall health in good condition can also help prevent nail damage.
