Noah Sinclair
A nail falling off is usually caused by an injury, fungal infection, psoriasis, chemicals, certain medications, or serious illness. It can be painful, and it won't reattach itself. However, with the right treatment, healthy nails will usually grow back.
| Characteristics | Values |
|---|---|
| Colour | Purple or black |
| Cause | Trauma, fungal infection, psoriasis, chemicals, certain medications, serious illness |
| Treatment | Cut down, but leave the injury to grow out on its own; protect the nail bed with a Band-Aid |
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What You'll Learn
How to treat a nail that has fallen off
A nail falling off is usually caused by an injury, fungal infection, psoriasis, chemicals, certain medications or a serious illness. Once the nail has fallen off, it is important to protect the nail bed from infection. Toenails can take several months to a year to regrow.
- Use pain medication as needed.
- Clean your toe, making sure you remove any debris, and apply an antibiotic ointment or cream to help prevent infection.
- Bandage the toe.
- If the nail has not completely fallen off, bandage the nail to your toe until it falls off.
- If there is bleeding, put pressure on the area to slow it.
- If the nail has jagged or sharp edges, use a nail file to smooth them out.
- If the nail has not completely come away from the nail bed or is still attached to another bit of nail, clip it off.
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What to do if your nail is bruised
If your nail is bruised, it's likely that the tissue under your nail is bruised, not the nail itself. This is known as a subungual hematoma, or a blood blister under the nail. The pain you feel from a bruised nail is caused by blood trapped under your nail, which puts pressure on your finger or toe nerves. This can take weeks to get better, unless your healthcare provider takes care of it right away. Trephination is a simple, painless procedure that relieves the pressure and pain quickly, but it must be done within the first 48 hours before the blood clots.
If your nail is bruised, you should seek medical care within two days. Basic wound care applies: put pressure on the area to slow the bleeding, clean the wound with soap and water, apply a bandage, and take an analgesic to help with pain if needed. You can also coat the nail with a layer of nail hardener to help protect the nail plate. Once the bleeding has stopped and the injury has healed, you can apply nail polish. However, you should avoid gel manicures.
If your nail falls off, don't pull it off. You can cut it down, but let the injury grow out on its own. The new nail will push up the old nail, and it will come off when it's ready. Once the nail falls off, protect the sensitive skin of the nail bed with a Band-Aid.
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What causes toenails to fall off
A detached toenail is a common condition, but it can be painful. Toenails usually fall off due to an injury, fungal infection, or psoriasis. However, chemicals, certain medications, and serious illnesses can also cause toenails to fall off. Once a toenail falls off, it can't reattach itself and continue to grow.
If you experience an acute trauma, your nail may turn black and seem like it's barely hanging on. You should not pull it off. You can cut it down, but let the injury grow out on its own. "Leave it alone, because there is new nail growing underneath," says Dr. Lain. "The new nail will push up the old nail, and it will come off when it's ready."
In some cases, if the nail bed is infected, a doctor may need to remove the nail by force. This procedure is called a nail evulsion.
If all or part of your toenail falls off, following certain safety procedures may help prevent additional injury or infection. Depending on the cause and severity, a doctor may recommend other treatments.
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What to do if your nail bed is infected
If your nail falls off, it's usually because of an injury, fungal infection, psoriasis, or exposure to chemicals, certain medications, or serious illness. Once your nail falls off, it can't reattach itself and keep growing, but it will usually grow back with proper medical care.
If your nail bed is infected, you should seek immediate medical attention. Your healthcare provider will ask about your symptoms and do a physical exam. They may take a sample of the tissue and send it to a lab to test for specific infectious causes such as bacteria or fungi. If the infection is severe, they may order imaging such as an X-ray to check for involvement of the underlying bone.
In the meantime, you can try some home remedies to help reduce swelling and pain. Soak the infected area in warm water for about 15 minutes a few times a day. Be sure to dry the area thoroughly afterward. If symptoms don't improve after a day or two, see your provider. You may need other treatments, such as antibiotics, to clear up the infection and help you heal. You may also need minor procedures such as drainage if an abscess has formed.
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How to treat a nail matrix injury
A nail falling off is usually the result of an injury, fungal infection, psoriasis, or a side effect of medication or illness. Once the nail has fallen off, it cannot reattach itself and continue growing.
If you have a nail matrix injury, it's important to seek medical advice. Treatment for a nail matrix condition depends on the cause. For example, if you have a fungal infection, your doctor may recommend antifungal pills. If you have nail psoriasis, certain medications, injections, or topical treatments may be prescribed.
If you have a bruise under your nail, you may benefit from a procedure called nail trephination, which drains the trapped blood and helps your new nail grow in correctly. This procedure must be performed within 48 hours of the injury, before your blood clots.
In the case of a permanent injury to the nail matrix, regeneration is impossible. However, you can take external actions to improve the aesthetics and appearance of the nail using nail styling products. If the damage to the matrix is not permanent, proper nail growth after treatment or a procedure is possible. It may take 6 to 12 months for the nail to return to its pre-injury state.
To help prevent nail matrix injuries, it's important to cut your nails properly. Trim toenails straight across to prevent ingrown toenails and trim fingernails with a slight curve at the edges, ensuring you don't cut them too short. Avoid manipulating the cuticle, either at home or at a nail salon. If you have a health condition that could affect your nails, such as psoriasis, see your healthcare provider regularly to manage the condition.
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Frequently asked questions
It usually means you've experienced some kind of trauma to the nail, such as an injury or infection.
Don't pull it off. You can cut it down, but it's best to leave it alone and let the injury grow out on its own. Protect the sensitive skin of the nail bed with a Band-Aid.
Yes, with proper medical care, your nail will usually grow back. It's rare for the nail matrix to be permanently damaged.
The nail matrix is the "factory" where your body makes new nails.
A nail bruise can look purple or black, but this might actually be blood. This is called a subungual hematoma, which is a blood blister under the nail.
