Caleb Foster
Losing a fingernail can be scary and painful, and it's important to know how to handle the situation to prevent infection and aid regrowth. Nails can fall off due to trauma or injury, and the exposed area can leave you vulnerable to infection. It's crucial to keep the area clean and protected, and to watch out for signs of infection, such as redness, red streaks, or fever. While waiting for the nail to regrow, you can trim the detached nail or leave it alone, covering the area with a bandage or tape.
| Characteristics | Values |
|---|---|
| What to do if a fingernail comes off | Protect the sensitive flesh from further injury or infection |
| First steps | Apply pressure to slow bleeding, clean the wound with soap and water, apply a bandage, and take an analgesic to help with pain if needed |
| Signs of infection | Red streaks on the hand or forearm, feverishness or nausea, skin or nail feeling warm to the touch, swelling, or significant pain |
| When to see a doctor | If there is a lot of blood under the nail bed, if there is a lack of blood flow, if there is a loss of sensation, if there are unusual colours in the fingertip, or if the nail is not reattaching |
| Treatment | Trimming the nail, wearing gloves, avoiding nail irritants, changing medications, using supplements, or taking medications to treat a nail infection |
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What You'll Learn
Protect the exposed area from further injury and infection
Protecting the exposed area from further injury and infection is critical to ensure proper healing and prevent deformities. Here are some detailed steps to achieve this:
Clean the Wound and Stop Any Bleeding
Basic wound care applies here. Start by gently cleaning the exposed area with lukewarm water and a gentle soap. If there is bleeding, apply gentle pressure to slow it down and clean the wound again. You can also apply an over-the-counter antibacterial cream, but this is not necessary unless there are signs of infection.
Cover the Area
Use a bandage or gauze to cover the exposed area and protect it from external factors. This will help keep the area clean and reduce the risk of infection. Change the bandage regularly to maintain a clean environment for healing.
Ice the Injury
Apply an ice pack to the injured finger to help reduce swelling and pain. This can also provide some comfort and relief.
Avoid Pulling or Removing the Nail
Resist the urge to pull off or remove the nail, even if it seems loose. Leave it alone, as there is a new nail growing underneath. The new nail will push up the old nail, and it will come off naturally when it is ready. Forcing it off can damage the new nail and the nail bed, causing further injury and delaying healing.
Monitor for Signs of Infection
Keep a close eye on the exposed area and the surrounding skin for any signs of infection, such as redness, swelling, or pain on the hand or forearm, or unusual discharge. If infection is left untreated, it can spread to the bloodstream and lead to serious complications like sepsis. Seek medical attention if you suspect any signs of infection.
Seek Medical Attention if Needed
If the injury is severe, or if you are unsure about how to manage it, don't hesitate to seek professional help. A doctor can assess the injury, provide guidance on wound care, and prescribe antibiotics or other treatments to prevent and treat infections. They may also recommend X-rays or other procedures to ensure proper healing and reduce the risk of long-term deformities.
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Signs to watch out for that indicate a need for medical attention
Fingernails are more than just aesthetic features; they can be windows into your health. Changes in colour, texture, or shape can signal health problems. Here are some signs that you should watch out for that indicate a need for medical attention:
Excessive Bleeding
While a small amount of bleeding from under the nail is common after an injury, excessive bleeding that fills more than half of your nail bed requires medical attention. A doctor may perform a small procedure to drill a tiny hole in the nail plate to drain the accumulated blood.
Infection
After a nail injury, it is important to keep the area clean and protected. If you notice signs of infection, such as redness, swelling, warmth, or pus, seek medical attention. Additionally, if you experience fever or nausea, it could indicate that the infection has spread to your bloodstream, which is a serious condition called sepsis that requires immediate medical care.
Loss of Sensation or Numbness
If you experience a loss of sensation or numbness in the injured finger, it could indicate nerve damage. Assess your blood flow by pressing on the tip of your damaged finger. If the colour does not return to normal within a few seconds, it may indicate a lack of blood flow and the need for medical attention.
Discolouration
Healthy nails are typically smooth, without spots or discolouration. Unusual colours, such as blue or blanched white, on the fingertip or nail bed can be a cause for concern. Blue nails, known as cyanosis, indicate low oxygen levels in the blood and may be linked to lung or heart problems. Yellow nails can be a sign of chronic bronchitis, lung diseases, or fungal infections. White nails, known as Terry's nails, may reflect issues with the liver, kidney, or heart.
Nail Shape Changes
Changes in the shape of your nails can also be indicative of underlying health issues. Nails that curve around an enlarged fingertip, known as clubbing, may suggest cardiovascular, pulmonary, or gastrointestinal problems. Soft nails with a scooped-out appearance, often called spoon nails, can indicate iron issues, such as iron-deficiency anaemia or hemochromatosis.
Dark Streaks
If you notice a dark streak that runs the length of the nail, it is crucial to contact your doctor as it could be melanoma, a dangerous form of skin cancer. Melanomas may appear on or around the fingernail, and the nail discolouration may be the only noticeable symptom.
It is important to remember that most nail injuries will heal with proper care, and a new nail will grow to replace the damaged one. However, if you experience any of the above signs or have concerns about your nail health, don't hesitate to seek medical advice.
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Treatments for onycholysis (detached nails)
Onycholysis is the medical term for when a nail separates from the nail bed underneath it. It can occur due to injury, infection, or certain skin conditions. Treatment options can vary, but may include trimming and protecting the nail, and treating the underlying cause of the detached nail.
If you have onycholysis, it is important to protect the sensitive flesh from any further injury or infection. You should gently wash your nails with lukewarm water and gentle soap. You can also apply an over-the-counter antibacterial cream to the nail, but this is not necessary unless there are signs of infection. If there is any bleeding, apply gentle pressure and clean the wound. You can also apply ice to your finger if there is swelling.
Once the nail has healed, you can start polishing your nails again, but be sure to use non-toxic nail polish. It is also a good idea to wear rubber gloves to avoid repetitive immersion in water and to keep your nails dry, which will help prevent fungal infections. You should also avoid frequent exposure to harsh chemicals, such as nail polish remover.
In addition, you should cut your nails to a comfortable length so that they are less likely to endure repeated trauma from tapping in everyday use. If the cause of onycholysis is not obvious, a doctor will note additional characteristics of your nails, such as their shape and colour, the presence of indentations in the nail surface, and the appearance of the skin under and around the nail. They may also examine you for evidence of skin rashes or thyroid problems. If a fungal infection is suspected, a sample of tissue from beneath the nail plate may be taken and tested in a laboratory.
Treatment of onycholysis will depend on the underlying cause. For example, if the cause is a fungal infection, antifungal medication may be prescribed. If the cause is nail psoriasis, creams or other medications may be used. In some cases, changing or ceasing medication may be necessary.
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First aid for immediate care
Fingernail injuries can be scary and painful. Here are some first aid steps to take if your fingernail comes off:
Protect the wound
The exposed area where the nail has come off is sensitive and prone to infection. Cover the wound with a thin layer of petroleum jelly, such as Vaseline, and then use a non-stick adhesive bandage to protect the area. If you have a large tear, trim off the detached part of the nail with scissors. This will prevent the nail from catching and tearing further.
Clean the wound
Gently wash your hands with lukewarm water and a gentle soap. If there is bleeding, apply gentle pressure to the area to slow it down and clean the wound. Apply an over-the-counter antibacterial cream if necessary.
Manage pain and swelling
Take an analgesic, such as Advil, to help with pain. If you have swelling, ice your finger.
Assess the damage
While performing first aid, assess the extent of the damage and whether a trip to the doctor is necessary. If you see red streaks on your hand or forearm, or feel feverish or nauseated, these could be signs that the infection has spread to your bloodstream, which can lead to sepsis. In this case, seek immediate medical attention.
Prevent further injury
Keep your nails short and avoid activities that may result in further nail injury. Avoid nail products and irritants, as these may also cause nail damage.
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Long-term nail care
If a nail falls off, it can be scary and painful. Nails often become bruised, blacken, and may fall off after trauma caused by an injury. It is important to protect the sensitive flesh from any further injury or infection. Here are some long-term nail care tips to keep in mind:
Keep the area clean and dry
Wash your hands with lukewarm water and gentle soap. Keep the injured area clean and dry to prevent infection. Apply an over-the-counter antibacterial cream if necessary, especially if there is any bleeding.
Avoid nail products and irritants
Avoid nail polishes, artificial nails, and other nail products that can irritate the sensitive skin underneath the nail. These products can also trap moisture, providing an ideal environment for bacteria to grow.
Trim the nail regularly
Keep your nails short by trimming them regularly. This will help prevent nail injuries and reduce the risk of the nail catching and tearing. If the nail is partially detached, you can trim off the detached part or leave it alone. If you leave it alone, the new nail will eventually push the old nail off naturally.
Protect the nail
Cover the nail with tape or an adhesive bandage to protect the sensitive skin underneath. This is especially important if the nail has fallen off completely, as there will be an opening where an infection could start. Change the bandage regularly to keep the area clean and dry.
Identify and treat the underlying cause
Nail detachment can be caused by various factors, including fungal infections, skin conditions, medications, and injuries. Identifying and treating the underlying cause is crucial for proper nail care. Consult a healthcare professional if you are unsure of the cause or if you need help determining the appropriate treatment.
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Frequently asked questions
If your fingernail comes off, it is important to protect the sensitive flesh underneath from further injury or infection. Keep the area clean and dry, and cover it with a bandage. If there is bleeding, apply gentle pressure to the wound and clean it with lukewarm water and gentle soap.
Do not pull the nail off or try to fix it with nail polish. Avoid activities that may result in further nail injury and possible irritants, such as nail products.
If you see red streaks on your hand or forearm, or feel feverish or nauseated, seek immediate medical attention as this could be a sign of sepsis. You should also seek medical attention if you notice unusual colours on your fingertip, or if you experience a lack of blood flow or loss of sensation in the finger.
Yes, a new nail will grow back underneath the old nail. The new nail will eventually push the old nail off naturally.
