Sophia Delgado
There are many reasons why someone might experience detached nails, a condition known as onycholysis. The most common causes are injury, fungal infection, skin conditions, and certain medications. Nails can also be affected by underlying health conditions, such as diabetes, peripheral arterial disease, or immune system problems, which can cause reduced blood flow and loss of feeling in the feet. In some cases, detached nails may be a sign of a more serious condition. Treatment for detached nails typically focuses on new nail growth and preventing further detachment.
Why are my fingernails falling off?
| Characteristics | Values |
|---|---|
| Medical Term | Onycholysis |
| Description | Nails become loose and may even detach from the nail bed. |
| Causes | Injury, fungal infection, skin conditions (e.g. psoriasis), certain medications, overactive thyroid, iron deficiency, working with fingers/toes in a wet environment, chemotherapy, aging, nail products, nail shape, nail thickness, nail length, nail abnormalities, severe illnesses, untreated nail injuries, nail biting/picking/tearing, tight shoes, and more. |
| Treatment | Treatment depends on the underlying cause. General measures include keeping nails short and clean, avoiding activities that may cause nail injury, and steering clear of irritants and nail products. |
| Recovery Time | Fingernails typically take 4-6 months to regrow fully, while toenails may take twice as long. |
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What You'll Learn
Fingernail abnormalities
Onycholysis: Onycholysis is a condition where the nail becomes loose and detaches from the nail bed. It can affect a single nail or multiple fingernails and/or toenails. The distal part of the nail is most commonly affected, lifting the free edge, but it can also detach laterally or proximally. Onycholysis can be caused by various factors, including fungal infections, skin conditions such as psoriasis, certain medications, an overactive thyroid, iron deficiency, or working with the fingers in a wet environment. Treatment for onycholysis focuses on promoting new nail growth and preventing further detachment.
Beau lines: Beau lines are depressions or horizontal ridges that appear across the fingernails. They can occur after an illness, injury to the nail, eczema around the nail, chemotherapy treatment, or inadequate nutrition.
Spoon nails: Also known as koilonychia, this condition is characterised by flattened nails with concavities. Koilonychia may be associated with iron deficiency.
Brittle nails: Brittle nails are a common result of aging, but they can also be caused by low levels of zinc and iron, as well as thyroid problems.
Yellow nail syndrome: This syndrome is characterised by thickening and yellow to yellow-green discolouration of all nails. It may be associated with lymphoedema, especially of the ankles, and compromised respiration.
Leukonychia: Also known as White Nail Syndrome, leukonychia is a condition where the nail remains attached but appears white and opaque.
Paronychia: Paronychia is an infection around the nail, often caused by the yeast-like organism Candida albicans. It is characterised by inflammation (red, swollen area) at the base of the nail and changes in the appearance of the nail itself.
It is important to consult a healthcare professional if you notice any persistent or concerning fingernail abnormalities, as they can sometimes indicate underlying health issues.
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Toenail abnormalities
Toenail fungal infections are common in people whose feet remain wet for extended periods, such as those wearing the same sweaty shoes daily or working in wet conditions. People with diabetes are also at high risk for this type of infection. Fungi thrive in dark and damp environments, and symptoms include cracked, yellow, discolored, streaked, thickened, or spotted nails.
Ingrown toenails are another prevalent and painful toenail problem. It occurs when the corner or side of the toenail, usually the big toe, grows into the flesh. This can cause pain, swelling, and redness or dark discoloration at the side of the toe. Wearing tight shoes that press on the toes can increase the chances of developing an ingrown toenail.
Other toenail abnormalities include onycholysis or detached nails, which can be caused by iron deficiency, skin conditions such as psoriasis, certain medications, an overactive thyroid, or working in a wet environment. Nail clubbing is another issue, referring to changes that cause the toes to take on a widened, club-like appearance. Discoloration of the nail plates is usually the least worrisome issue and can be due to nail polish, dye from shoes, drugs, or underlying medical conditions.
It is important to maintain proper nail care and personal hygiene to prevent toenail problems. See a doctor or a dermatologist if you notice any abnormal changes to your toenails or signs of infection, such as redness, severe pain, or pus drainage.
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Nail injuries
A nail injury occurs when any part of the nail becomes injured. This includes the nail, nail bed (skin underneath the nail), cuticle (base of the nail), and the skin around the sides of the nail. An injury occurs when the nail is cut, torn, smashed, or bruised, or the nail is torn away from the skin. Smashing a finger in a door, hitting it with a hammer or another heavy object, or cutting it with a knife or another sharp object can cause a nail injury.
If the nail is torn or jagged, it should be trimmed to avoid snagging it on things and causing further injury. If the nail lifts completely off the nail bed, it may be most comfortable initially to replace the nail and hold it in place with a bandage. Nails will not reattach themselves to the nail bed after they have separated from it, but in most cases, a new nail will slowly regrow.
For more serious nail injuries, it is recommended to go to an urgent care center or the emergency room. There, the medical staff will stop the bleeding and clean the wound. Usually, the nail and finger or toe will be numbed with medicine before treatment. For a larger bruise, a small hole will be created in the nail to allow blood and fluid to drain out and relieve the pressure and pain. If the bone is broken or the bruise is very large, the nail may need to be removed, and the nail bed repaired. Part or all of the nail may be removed. Cuts in the nail bed will be closed with stitches, and the nail will be reattached with a special glue or stitches. If the nail cannot be reattached, it may be replaced with a special type of material. Antibiotics may be prescribed to prevent infection.
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Nail infections
Fingernails falling off, or onycholysis, can be caused by several factors, including injury, fungal infections, and underlying conditions. Fungal nail infections occur when fungi invade a fingernail or toenail and the skin underneath. Toenails are more commonly affected than fingernails, and symptoms include cracked, yellow, discolored, streaked, thickened, or spotted nails.
Paronychia, a bacterial nail infection, usually results from bacteria entering broken skin near the cuticle and nail fold. Symptoms include pain, swelling, and tenderness around the nail, with the skin turning red and warm to the touch. Pus may build up under the skin, and a white to yellow, pus-filled abscess may form. In some cases, the nail can start to grow abnormally and may appear yellow or green, dry, and brittle.
Most bacterial nail infections are treated with antibiotics, and drainage of pus may be required. To prevent infection, keep your hands and feet clean and dry, especially if you have a condition that affects your immune system or blood flow. Avoid biting your nails, and be cautious when engaging in activities that may cause nail trauma, such as manicures or pedicures.
If you are experiencing fingernail detachment or suspect a nail infection, consult a healthcare professional for proper diagnosis and treatment. They may recommend keeping the nail bed dry, clean, and covered with petroleum jelly and a bandage to promote healing and protect the affected area.
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Nail growth and development
The anatomy of nails serves to protect against infections or injuries, while improving sensation, dexterity, and functional ability. The structure is divided into three main parts: the nail itself, the underlying structure that supports nail growth, and the skin tissue that surrounds it. The nail plate is the visible part of the nail that we can see and paint, consisting of layers of dead keratin cells. The nail bed, located under the nail plate, is where our body constantly produces new cells to form the hard structure of our nails. The cuticle, also known as the eponychium, is a thin layer of skin that covers the base of our nails, protecting them from bacteria and fungi.
Nail growth occurs in three main phases: the anagen phase, the catagen phase, and the telogen phase. In the anagen phase, the cells at the base of our nails, called the nail matrix, divide rapidly and push older cells forward. This is the active growth phase and generally lasts around two to three months. The catagen phase is a transitional phase during which cell division decreases, causing the nail to slow down. This phase lasts about two weeks. Finally, the telogen phase is when our nails are in their resting state.
About 80% of a fingernail arises from the nail root, which determines its length, and the other 20% comes from the nail bed, which determines its thickness. On average, a healthy person's fingernails grow about 3 to 3.5 millimetres per month. Nails are constantly growing, but their growth rate slows down due to poor circulation and aging. The rate of growth also varies between fingers and toes, and even between different fingers.
Nutrition and nail care are major components in the science behind nail growth and health. A lack of proper nutrients and inadequate care can result in brittle, weak nails. Our body needs vitamins and minerals like biotin, iron, zinc, and calcium to maintain healthy nails. Incorporating a balanced diet and taking supplements can help improve nail health. Additionally, maintaining proper hygiene and avoiding harsh chemicals and excessive water exposure can also contribute to strong, healthy nails.
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Frequently asked questions
There are many reasons why your fingernails may be falling off. The medical term for this condition is onycholysis, which is when the nail becomes loose and detaches from the nail bed. This can be caused by an injury, fungal infection, skin conditions such as psoriasis, certain medications, an overactive thyroid, iron deficiency, or working with your hands in a wet environment.
If you have onycholysis, it is important to determine the underlying cause to prevent it from occurring again. Treatment options include trimming the nail, wearing gloves, avoiding nail products and irritants, changing medications, using supplements, or taking medication to treat a nail infection. You should also keep the nail bed dry, clean, and covered with petroleum jelly and an adhesive bandage.
Onycholysis is usually not an urgent problem, but it can be a sign of a more serious condition. If you notice any other symptoms or have a related condition, it is advisable to contact your doctor.
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