Liam Carter
Dead toenails are a common occurrence, especially among athletes and those prone to clumsiness. The most common causes are trauma, such as stubbing your toe, or ill-fitting footwear, which can cause blood to pool underneath the toenail, resulting in a condition called subungual hematoma. In addition, fungal infections, psoriasis, and certain medications can also lead to toenail discolouration, crumbling, and ultimately, the nail becoming dead. Once a toenail falls off, it cannot reattach and continue growing. However, a new nail should grow back within 6 months to 2 years, depending on the severity of the damage.
| Characteristics | Values |
|---|---|
| Toenail falling off | Injury or infection |
| Fungal infections | |
| Psoriasis | |
| Medication side effects | |
| Serious illness | |
| Toenail not growing back | Underlying cause not treated |
| Damage to cells that grow nails | |
| Treatment | Oral antifungal medications |
| Home remedies | |
| Surgery | |
| Icing | |
| Elevation of legs | |
| Over-the-counter medication | |
| Clipping the nail |
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What You'll Learn
Toenail fungus can prevent new nail growth
Toenail fungus is a widespread fungal infection that affects the toenails. It is caused by a type of mold called a dermatophyte, which feeds on keratin, the protein that makes nails hard. Toenail fungus typically occurs when fungi get between the toenail and the toenail bed, the tissue right underneath the toenail. It can cause the nail to become thick, discoloured, crumbly, and easy to break. In some cases, the whole nail can break off, leading to pain and swelling of the surrounding skin.
Fungal infections can develop for various reasons and are more likely to occur when the skin or nail is broken. Certain risk factors, such as athlete's foot, hyperhidrosis (excessive sweating), nail injury, poor blood circulation, and a weakened immune system, can increase the likelihood of contracting toenail fungus. Additionally, walking barefoot in communal areas like public showers, locker rooms, and swimming pools can expose individuals to the fungus.
It is important to seek medical attention if a fungal infection is suspected. A pharmacist or healthcare provider can recommend appropriate treatments and provide guidance on preventing the spread of the infection. Additionally, maintaining good foot hygiene, keeping feet dry, and avoiding barefoot contact in communal areas can help reduce the risk of contracting toenail fungus.
In summary, toenail fungus is a common condition that can lead to nail detachment and impede new nail growth. Effective treatment and preventative measures are crucial to ensuring proper nail regrowth and maintaining foot health.
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Trauma to the nail can cause it to fall off
If the nail lifts completely off the nail bed, it may be most comfortable 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 a new nail will slowly regrow. If blood under the nail occupies more than half of the nail area, it could signify an underlying bone fracture or tissue tear, and a physician should evaluate the injury.
In the case of a nail injury, it is important to make sure that your tetanus vaccination is up to date. Doctors may remove part or all of the nail if the nail bed matrix is damaged. They can use stitches to repair any laceration to the nail bed and reattach the nail, if possible, to provide protection and support while the new nail grows. Antibiotics may be prescribed to prevent infection.
If only part of the toenail has fallen off, do not try to remove the rest of it. If the detached part of the toenail is still attached to the toe, use nail clippers to carefully trim it off to prevent it from catching on clothing. Toenails will typically grow back within a year and a half, though the new nail may have grooves or ridges and be somewhat misshapen.
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Blood pooling under the nail can lead to a dead toenail
A dead toenail is often the result of trauma or infection. Blood can pool underneath the toenail, causing the nail to die and fall off. This is known as a subungual hematoma. Subungual hematomas are usually caused by blunt force trauma, such as dropping a heavy object on your toe, or crush injuries, such as slamming your finger in a door. They can also be caused by repetitive pressure, such as running in tight shoes that press on the toenails.
The injury or pressure damages the blood vessels in the nail bed, causing them to leak blood that builds up underneath the nail plate. This blood has nowhere to go and puts pressure on the nail plate, causing pain and discoloration. The nail may appear black-and-blue like a bruise and the color may change over time as the injury heals. The pooled blood can separate the nail from its bed, causing the nail to fall off.
Subungual hematomas are typically minor injuries and the pain usually gets better in a few days. However, the pressure generated by the pooled blood can be extremely painful. To relieve this pressure and pain, a doctor may perform decompression, also called trephination, which allows the underlying blood to drain. This procedure can be done by using a heated wire or carbon laser to burn a hole in the nail.
In most cases, a new toenail will grow back within 6 months to a year and a half. However, if the underlying cause is not treated, the nail may not grow back properly or at all. In rare cases, surgery may be required to permanently remove the affected toenail.
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A damaged nail matrix can interfere with nail growth
The nail matrix is the most important structure within the nail unit. It is the "factory" where new nail plate cells are created, and it is responsible for nail growth. As new cells are created, they move forward, and the process of keratinization (hardening) occurs, leading to the formation of the nail. This way, the old nail plate is replaced by a new one. The matrix is also responsible for supplying nutrients and regenerating the nail bed.
The nail matrix is an exceptionally delicate structure, and any damage inflicted upon it can have various repercussions on the overall health and appearance of the nail. Injuries and some health conditions can damage your nail matrix and affect how your nails look or grow. Minor matrix damage can cause nail imperfections such as white spots or ridges, and weaken the nail plate as a whole. More serious damage can result in a permanent fault in the nail plate, and the nail may grow back with abnormalities such as discolouration and thickening.
Certain habits and improperly performed care procedures can also result in matrix damage. For example, wearing ill-fitting shoes can cause toenails to turn black due to ongoing pressure, especially on the big toes. If you work with heavy objects or in construction, it is recommended to wear steel-toe boots to protect your toes.
If you suspect damage to the nail matrix, consult a specialist who will assess the severity of the damage and decide on the method of treatment. Treatment can help, and with the right medical care, even if your nail falls off, it usually grows back. It is rare for the nail matrix to be permanently damaged, preventing your nail from growing back. However, if this happens, you may be able to take external actions to improve the aesthetics and appearance of the nail using nail styling products.
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Medication side effects can slow nail growth
Toenail issues can be caused by trauma or injury, fungal infections, or psoriasis. However, medication side effects can also slow nail growth and cause toenails to fall off. In rare cases, medication side effects can even cause permanent nail abnormalities.
Some medications that are associated with nail-related side effects include chemotherapy medications, EGFR inhibitors such as erlotinib, and retinoids such as isotretinoin. These medications can affect nail growth or structure and cause nail pigmentation. They can also damage the nail matrix, the nail bed, or the periungual tissue. In general, the higher the dose of the drug, the more likely it is to cause nail disease.
It is important to note that nail changes due to medication are most common with cancer medications. However, in rare cases, other medications may also contribute to nail changes. These changes are usually cosmetic and do not affect overall health. If you notice any concerning nail changes, it is recommended to discuss them with a healthcare professional. They can provide advice and recommend treatments to get the side effects under control.
Additionally, certain medications may increase your risk of developing fungal infections, which can lead to toenail issues. Oral antifungal medications can produce side effects, and some fungal infections may require surgery to remove the affected toenail. It is always advisable to consult a doctor if you notice any unusual symptoms while taking medications.
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Frequently asked questions
A dead toenail is often the result of trauma or injury, such as ill-fitting footwear, or an infection. In some cases, the nail may grow back within 18 months, but this is not always the case. If the underlying cause of the toenail falling off is not treated, it can prevent the nail from growing back properly, or at all.
A dead toenail can cause a lot of pain and may make you reluctant to wear sandals or show your toes. You may notice a black or purple spot under your nail, or across the entire nail. This is dried blood beneath your toenail.
If you have a dead toenail, you should visit your local podiatrist to have the nail clipped. You can also try home remedies to treat a fungal toenail infection. In rare cases, you may need surgery to permanently remove the affected toenail.
To prevent your toenail from falling off, make sure your shoes fit properly. Also, be careful when trimming your toenails to avoid injuring your toes.
