Liam Carter
There are many reasons why a 2-year-old's fingernails might be falling off, including hand, foot, and mouth disease, a fungal infection, vitamin deficiency, or even a fever that occurred in the past month. In some cases, it could be a result of trauma, such as nail-biting, thumb-sucking, or an injury. Onychoschizia, or lamellar dystrophy, is another possible cause, leading to horizontal splits in the fingernails. It is always best to consult a doctor or dermatologist to determine the exact cause and receive appropriate treatment.
| Characteristics | Values |
|---|---|
| Condition | Onychomadesis, Onychoschizia, Koilonychia, Onycholysis, Onychomycosis, Trachyonychia |
| Causes | Viral infections, trauma, vitamin deficiency, iron deficiency, fungal infection, fever, hand-foot-mouth disease, mouth ulcers, metabolic changes, nail biting, thumb sucking, improperly fitting shoes, inflammatory dermatosis, injury, dermatologic conditions |
| Treatment | Antifungal agents, oral steroids, topical treatments, oral biotin, pulse-dosage steroids, intralesional steroid injections, urea cream, clipping the nail, keeping the nail short, avoiding activities that can result in nail injury, vitamin E supplements, Bactroban cream |
| Recovery Time | Fingernails typically take 4-6 months to grow back, toenails may take twice as long |
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What You'll Learn
Hand, foot and mouth disease
Onychomadesis is a nail condition that can develop 28 to 56 days after contracting hand, foot, and mouth disease. It is characterised by the separation of the nail plate from the nail bed, which gives the nails a peeling appearance. This condition is not permanent, and normal nail growth typically occurs within one to four months. However, injured nails may look different when they grow back.
In the case of a 2-year-old child experiencing nail peeling and shedding after recovering from hand, foot, and mouth disease, it is important to consult a doctor or healthcare professional. They can provide reassurance and guidance on managing the condition. In some cases, they may recommend supplementing the child's diet with Vitamin E and applying creams like Bactroban to prevent infections.
To care for a child's nail shedding at home, it is important to keep the area clean and dry. You can cover the affected nails with a thin layer of petroleum jelly and a non-stick bandage. Be sure to follow up with healthcare professionals and keep all recommended appointments to ensure proper treatment and management of the condition.
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Vitamin deficiency
Vitamin deficiencies can cause nail issues, including changes in colour, cracks, grooves, and brittleness. Nails may also become weak, rough, and lose their smoothness.
Iron deficiency, or anaemia, is a common cause of nail issues. Spoon nails, or koilonychia, are nails that become abnormally concave and can hold a drop of water. This condition is prevalent among 33% of neonates and usually goes away within the first decade of life when the nail plate strengthens. However, if it persists, it is usually caused by injury, inflammatory dermatosis, or iron deficiency anaemia. Spoon nails can also be associated with inflammatory skin diseases like psoriasis, hypo- or hyperthyroidism, or autoimmune disorders.
Biotin deficiency can also cause brittle nails that are prone to breaking. While this is rare, as it is difficult to fall short on biotin, it is still a possibility.
Vitamin E deficiency can also cause nail issues. A dermatologist suggested supplementing a child's food with Vitamin E when their nail fell off due to a fever that shocked normal nail development.
Other vitamin deficiencies that may affect nail health include zinc, calcium, and vitamins A, B, C, and E.
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Nail trauma
In the event of a nail bed laceration or cut, it is important to seek medical attention. A healthcare provider will assess the injury and may partially or fully remove the nail to clean and repair the area. Fine dissolvable stitches may be used to repair the nail bed and any soft tissue tears. The treated area will then be covered with a sterile dressing. Follow-up care is crucial to monitor healing and prevent infection.
Additionally, nail trauma can occur as a result of hand, foot, and mouth disease, a common paediatric viral infection. Onychomadesis, or nail shedding, can occur 1-2 months after the acute infection, affecting several or all nails. This condition is reversible and usually does not require specific treatment beyond reassuring the family.
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Bacterial or viral infections
Fingernail and toenail issues in children can be distressing for both the child and the parent. While it is always best to consult a doctor for a proper diagnosis, it may be reassuring to know that nail issues in toddlers are not uncommon.
Nail infections can be bacterial, viral, or fungal. Paronychia is a common bacterial nail infection that occurs when bacteria enter broken skin near the cuticle and nail fold, causing inflammation. The cuticle is the skin at the base of the nail, and the nail fold is where the skin and nail come together. Paronychia can be acute (lasting less than six weeks) or chronic (persisting longer than six weeks). Acute paronychia is usually due to a bacterial infection, most commonly Staphylococcus aureus, but can also be caused by Streptococcus pyogenes. Chronic paronychia is usually caused by mechanical or chemical factors, irritation from occupational or environmental exposures, or, less commonly, a chronic bacterial or fungal infection. Herpetic whitlow is a viral infection of the distal finger caused by the herpes simplex virus (HSV). It causes a burning, itchy sensation, and a physical exam will show vesicles and pain. Onychomycosis is a fungal infection of the nail that causes a whitish-yellowish discolouration. It can be difficult to treat and may require oral antibiotics.
In addition to infections, there are several other possible causes of nail issues in toddlers. Koilonychia, commonly known as spoon nails, causes the nails to become abnormally concave. It is prevalent among 33% of neonates and usually goes away on its own within the first decade of life. However, if it doesn't go away, it may be caused by injury, inflammatory dermatosis, or iron deficiency anaemia. Onychoschizia, also called lamellar dystrophy, is characterised by horizontal splits in the fingernails and often coexists with onychorrhexis, which is longitudinal splits in the nail plate. Together, they are referred to as brittle nail syndrome. Trachyonychia is another nail disorder that can be diagnosed based on the patient's clinical presentation, although a histological examination of nail clippings may also be performed to detect a fungal infection.
If your child is experiencing nail issues, it is important to consult a doctor for a proper diagnosis and treatment plan. Do not try to treat your child's nail issues at home without medical advice, as this could lead to further complications.
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Fungal infections
Fingernail avulsion in toddlers can be distressing for both the child and the parent. While there can be many reasons for a child's nail to fall off, one of the causes can be fungal infections.
Fungal nail infections, or onychomycosis, are common and can affect both toenails and fingernails. Toenails are, however, more frequently affected than fingernails. The infection usually develops slowly, and the nail becomes discoloured, thickened, and distorted. It may become yellow and brittle, with pieces breaking off and even coming away completely. The primary cause of most fungal nail infections is the same fungi that cause athlete's foot.
Fungal nail infections can be spread in places like communal showers, locker rooms, and gyms, where people walk around barefoot. They can also spread from person to person. Antifungal medication is available in the form of tablets or a special paint applied directly to the nail. Oral antifungal drugs include terbinafine, itraconazole, and fluconazole. Before treatment, a small sample of the infected nail may be tested to confirm the presence of a fungal infection. If treated, a new healthy nail should begin to grow from the base of the nail over a few months, and the old nail will gradually grow out and can be clipped away.
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Frequently asked questions
There could be several reasons for this, including a recent fever, hand-foot-and-mouth disease, or a fungal infection. It is important to consult a doctor to get a proper diagnosis and treatment plan.
If your child's fingernails are falling off, it is important to consult a doctor to determine the underlying cause and receive proper treatment. In the meantime, you can gently wash the affected area with clean water twice a day and cover it with a thin layer of petroleum jelly and a non-stick bandage to protect the wound and prevent infection.
Yes, some home remedies that may help include supplementing your child's diet with vitamin E or foods rich in iron, such as beans, lentils, dark chocolate, fish, and spinach. Additionally, keeping your child's hands and nails clean and applying vitamin E oil to the nails may also be beneficial.
