Noah Sinclair
Fingernails and toenails can fall off due to various reasons, including injury, fungal infection, or skin diseases such as eczema and psoriasis. In older people, toenail problems are more common and can be caused by trauma, ill-fitting shoes, poor circulation, or poor nerve supply. If you experience nail separation, it is important to identify the underlying cause to ensure proper regrowth, which can take up to 6-18 months. To prevent further issues, keep your nails short, avoid biting them, and be cautious when cleaning under them to reduce the risk of infection.
Why do my finger and toe nails come off?
| Characteristics | Values |
|---|---|
| Causes | Injury, fungal infection, psoriasis, eczema, ill-fitting shoes, poor circulation, poor nerve supply, medication, serious illness, chemicals, nail biting, cleaning underneath nails with sharp tools, nail polish, nail gloss, nail hardener, nail polish remover, fake nails, tinea |
| Symptoms | Fatigue, feeling cold, dizziness, weakness, headaches, sore tongue, fast heartbeat |
| Recovery time | Fingernails: 6-9 months; Toenails: 12-18 months |
| Prevention/Treatment | Keep nails short, wear clean socks and comfortable protective shoes, be careful when putting down heavy objects, wear gloves when doing activities that may damage nails |
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What You'll Learn
Onycholysis, or nail lifting
Onycholysis can occur due to various reasons, including injuries to the nail or nail matrix, fungal infections, certain medications, and medical conditions such as psoriasis, eczema, thyroid disease, and iron deficiency. It is also more common in people who are pregnant and those who use harsh nail products like nail polish remover and artificial nails.
The affected nail may appear lifted from the nail bed, with a white or yellow discolouration. The nail may also thicken and develop pits or indentations. In some cases, the skin around the nail may become infected, exhibiting redness, swelling, and irritation.
To prevent onycholysis, it is important to keep your nails short and avoid biting them. When cleaning underneath your nails, be gentle and avoid using tools that can break the skin, such as cuticle sticks. Additionally, wear gloves when doing activities that may damage your nails, such as washing dishes or playing sports.
If you experience onycholysis, it is advisable to consult a healthcare professional to determine the underlying cause and receive appropriate treatment. Treatment options may include cutting away the separated nail, taking antifungal medications, or discontinuing the use of certain nail products.
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Fungal infections
Fingernail and toenail separation from the nail bed is called onycholysis. It is usually not painful, but it can be contagious if caused by a fungal infection. Fungal infections occur when fungi get between your nail and nail bed, usually through cracks or cuts in your fingers or toes. Fungi thrive in warm, dark, and moist environments, such as sweaty feet inside trainers for long periods.
Fungal nail infections can cause the nail to thicken, become brittle and crumbly, and turn white or yellow. The nail may also become distorted and difficult to trim. In some cases, pieces of the nail may break off and come away completely.
Fungal nail infections are typically treated with antifungal medication, which comes in the form of tablets or a special paint applied directly to the nail. Laser treatment is another option for stubborn infections, but it is not widely available and can be expensive. Mild cases of fungal nail infection may not require treatment, as they are unlikely to cause further problems.
To prevent fungal nail infections, it is recommended to keep your nails short and avoid biting them. Wearing clean cotton socks and well-fitting shoes made of natural materials can help keep your feet dry and allow them to breathe. Additionally, wearing gloves when doing activities that may damage your nails, such as washing dishes or playing sports, can help protect your nails from infection.
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Injury or trauma
Trauma to the nails can occur when a nail suffers a blow or impact, such as dropping a heavy object on it or closing a finger or toe in a door or drawer. This can result in a subungual hematoma, which is a collection of blood under the nail that causes discoloration and can be very painful. Subungual hematomas are typically minor injuries, and the pain usually subsides within a few days, either on its own or after a simple drainage procedure to relieve the pressure. However, if the trauma has caused additional damage, such as a broken bone or deep cut, further treatment and a longer healing time may be necessary.
Nails can also be accidentally torn or split, or they can lift away from the nail bed due to repeated trauma, such as wearing ill-fitting shoes. This can resemble a fungal infection, with the nails becoming thickened or discolored. If the nail is torn or jagged, it should be trimmed to prevent further injury and snagging on objects. Nails will not reattach to the nail bed once they have separated, but new nails will usually regrow slowly. If the injury includes the base of the nail, some cosmetic changes may be permanent.
To prevent nail trauma, it is important to wear properly sized shoes and avoid walking barefoot or wearing open-toed shoes when lifting heavy objects. It is also crucial to be mindful of your hands and feet when closing doors and to avoid distractions when using tools that could slip and injure your fingers. Wearing appropriate gloves, shoes, and protective gear during manual labor can also help reduce the risk of nail injuries.
If you experience a nail injury, ensure that your tetanus vaccination is up to date. Additionally, if the injury involves significant bleeding under the nail, it is advisable to seek medical attention to rule out any underlying bone fractures or tissue tears. Your doctor can examine the trauma and determine the best course of treatment, which may include X-rays or drainage procedures to relieve pressure and promote healing.
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Skin diseases
Fingernail and toenail problems are common and can affect people of all ages. Nails support and protect the tips of our fingers and toes, and fingernails also help us to pick up objects, scratch itches, and untie knots. Common causes of nail problems include injury, infection, and skin diseases such as eczema and psoriasis.
Eczema
Onycholysis, or nail lifting, can be caused by eczema, including hand dermatitis. Nails affected by onycholysis separate from the skin on which they rest (the nail bed). This creates a space under the nail that can gather dirt and debris, and when water gets underneath, bacteria and yeast can cause infection. The portion of the nail that has separated from the nail bed cannot reattach itself, so treatment focuses on allowing new, healthy nail growth, which can take several months. To prevent onycholysis, keep your nails short and avoid biting them. Be careful when cleaning underneath your nails, and avoid chemicals or products that can irritate your nails or the skin around them, such as nail polish, nail hardener, and fake nails.
Psoriasis
Nail psoriasis causes changes to the structure of your nails, which may include onycholysis. It can also cause pitting, thickening, and yellowing of the nails. Treatments for nail psoriasis include topical medications, light therapy, and injectable medications.
Other skin diseases that can affect the nails include lichen planus, which causes the nail plate to split or layer as it grows off the nail bed, and nail infections such as tinea, which is more common in toenails and affects older people.
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Iron deficiency
Koilonychia, or spoon nails, is a common nail problem that can be a sign of iron deficiency. Spoon nails are characterised by an indented shape, with a concave appearance that can hold a drop of water. This condition can affect both the fingernails and toenails.
People with iron deficiency often experience nail abnormalities, such as pale or spoon-shaped nails. This is because iron is necessary for the production of new red blood cells, and a deficiency can lead to anaemia, resulting in pale skin and nails.
Vegetarians, individuals with certain medical conditions like lupus, and those living at high altitudes are more prone to iron deficiency and, consequently, spoon nails. Furthermore, certain factors can increase the risk of iron deficiency, such as an inability to absorb iron, inadequate iron intake, and conditions like celiac disease, cancer, intestinal bleeding, or excessive menstruation.
Treating iron deficiency can help resolve nail issues. This can be achieved through dietary changes by incorporating iron-rich foods like beans, lentils, dark chocolate, fortified bread and cereals, iron-rich fruits (dates, figs, prunes, raisins), leafy greens (spinach, kale), meat, seafood, nuts, and seeds. In some cases, supplements may be necessary to correct and prevent iron deficiency and its associated nail problems.
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Frequently asked questions
Fingernails and toenails can come off due to onycholysis, which is the medical term for when your nail separates from the skin underneath it. This is often caused by injury or trauma, such as stubbing your toe, but can also be the result of an allergic reaction, fungal infection, or skin conditions such as eczema and psoriasis.
Treatment for onycholysis focuses on new nail growth and keeping the nail attached to the underlying nail bed. You can clip the affected portion of the nail and keep the nail short with regular trimming. Avoid activities that can result in nail injury and irritants such as nail products.
It takes about 4 to 6 months for fingernails to grow to full size, while toenails may take twice as long.
Keep your nails short and clean. Avoid biting your nails and be careful when cleaning underneath them. Wear gloves when doing activities that may damage your nails, such as washing dishes or playing sports.
