Caleb Foster
There are many reasons why your daughter's fingernails might be falling off, including injury, fungal infection, or a temporary stop in nail growth caused by the hand, foot, and mouth virus. In the case of injury, the nail may be completely or partially torn off, and treatment may include putting part of the nail back into place or repairing the nail bed. If a fungal infection is the cause, your daughter's nails may appear thick and yellow with white spots and streaks. Keeping your daughter's nails short and clean can help prevent further issues, and new nails will grow in quickly.
| Characteristics | Values |
|---|---|
| Cause | Hand, foot, and mouth virus |
| Symptoms | Small blisters on palms, soles of feet, and inside the mouth |
| Other symptoms | Nails may be painful, swollen, discolored, or detached |
| Treatment | Keep hands clean, trim nails, and leave them alone |
| Time to heal | Nails may take 6 months to grow back |
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What You'll Learn
Hand, foot and mouth virus
Hand, foot and mouth disease (HFMD) is a contagious viral infection that causes a blister-like rash on the hands and feet and painful sores in the mouth. It is typically mild and usually clears up on its own within seven to ten days. The disease is highly contagious and spreads through airborne droplets when an infected person sneezes or coughs. It can also be spread by touching contaminated surfaces and then touching your eyes, nose or mouth. Babies and children under the age of 5 are most likely to get the disease, and it tends to spread quickly among children in daycare and schools.
Nail loss is a symptom of hand, foot and mouth disease. The virus causes a temporary stop or slowing in nail growth, creating a gap in the nail bed that causes the nail above it to fall off. This symptom usually occurs 4-8 weeks after the disease onset and tends to resolve spontaneously within 1-2 months. While it may look painful, it is unlikely to be hurting your child. It is suggested that only certain strains of hand, foot and mouth cause nail peeling, shedding, or nails falling off.
If your child is experiencing nail loss, it is important to keep their hands clean and leave the nails alone. New nails will grow back quickly and the condition is not permanent. However, if it keeps happening, speak to your pediatrician.
There are other potential causes of nail loss, including fungal infections, iron deficiency, and onychomycosis (an infection of the nail caused by a dermatophyte). However, these are less common in children, and fungal infections tend to only damage nails rather than cause them to fall off.
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Iron deficiency
There are many reasons why your daughter's fingernails might be falling off, including injury, fungal infection, or vitamin deficiency. One possible cause of nail problems is iron deficiency anaemia.
One common nail change associated with iron deficiency anaemia is spoon-shaped nails (koilonychia), where the nails become thin and concave, resembling a spoon. This deformity occurs due to decreased haemoglobin production, which affects nail shape and structure. Normal toenail beds should be pink, but in severe cases of iron deficiency anaemia, they may appear pale or even white due to reduced blood flow and oxygenation. This discolouration can be a subtle yet telling sign of underlying iron deficiency.
If you suspect that your daughter's nail problems are due to iron deficiency anaemia, it is important to seek medical advice. A series of blood tests can be performed to measure haemoglobin, iron levels, and other markers such as ferritin and transferrin saturation, which can indicate iron deficiency. Treatment for iron deficiency anaemia typically involves iron supplementation, either through oral supplements or intravenous iron therapy in more severe cases.
It is important to note that nail problems are usually not caused by anything serious and, in most cases, are not permanent. New nails will typically grow back quickly, and keeping your child's hands clean and leaving the nails alone is recommended. However, if the problem persists or you have any concerns, it is always best to consult with a healthcare professional, such as a paediatrician or a GP who may refer you to a podiatrist.
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Fungal infection
While fungal infections are a potential cause of nail disorders in children, they are less common in pediatric patients compared to bacterial and viral infections. In the context of nail infections, fungi typically cause damage to the nails rather than making them fall off entirely.
Fungal onycholysis is another condition that can affect the nails and is treated with oral antifungal drugs such as terbinafine, itraconazole, and fluconazole.
It is important to note that nail disorders in children can be associated with systemic conditions or cosmetic or psychological problems. A thorough examination is necessary to rule out any underlying diseases.
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Genetic susceptibility
While nail disorders in children are uncommon, they can be associated with a systemic condition or a cosmetic or psychological problem. Children are more susceptible to bacterial and viral diseases, and nail disorders can be indicative of an underlying disease.
One of the causes of fingernail avulsion (the complete or partial loss of a nail) is genetic susceptibility. Onychocryptosis, commonly known as ingrown toenails, is one of the most frequently observed nail conditions. It is characterized by redness and swelling around the nail folds of the toes. Genetic susceptibility, along with trauma, tight-fitted shoes, and incorrectly trimmed toenails, are some of the contributing factors to this condition.
In addition to ingrown toenails, koilonychia, or spoon nails, can also be influenced by genetic factors. This condition causes the nails to become abnormally concave, giving them a scooped-out appearance due to their pliable nature. While it usually resolves within the first decade of life as the nail plate strengthens, it can persist due to factors such as injury, inflammatory dermatosis, or iron deficiency anemia.
It is important to note that nail disorders in children may have various causes, and a thorough examination by a healthcare professional is necessary to rule out any underlying diseases or conditions.
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Trauma
Fingernail and toenail injuries are common in children and can be caused by a variety of traumatic events. A traumatic injury to the nail can cause the nail to be completely or partially torn off, or for the nail to fall off some time after the injury. This is called avulsion.
Crush injuries to the fingertip or toe can cause similar damage and often require similar treatment. They can cause cuts, scrapes, blood blisters, bruises, and fractures. If the injury looks serious, or if there is a risk of a broken bone, it is important to seek medical attention.
To treat a crush injury to the fingertip or toenail, you should first wash the injured area with soap and water. If there is any jewellery on the injured digit, it should be removed before swelling occurs. Then, the finger or toe should be soaked in cold water or wrapped in an ice pack to help stop the bleeding and prevent a blood blister from forming. Any bleeding cuts should be covered with a clean cloth, paper towel, or gauze, and the finger or toe should be raised above the level of the heart to help slow bleeding and ease pain.
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Frequently asked questions
Your daughter's fingernails may be falling off due to a condition called onycholysis, which is when nails separate from the skin on which they rest (the nail bed). This can be caused by a fungal infection, certain medications, nail psoriasis, or iron deficiency. It is important to pay attention to your daughter's nails and consult a healthcare professional if you notice any changes.
Onycholysis can cause your nails to pull up from the nail beds, resulting in nail peeling or shedding. It usually isn't painful, but it can be contagious if caused by a fungal infection. Other symptoms that may accompany onycholysis include fatigue, feeling cold, dizziness, weakness, headaches, a sore tongue, and a fast heartbeat.
If your daughter is experiencing onycholysis, it is important to consult a healthcare professional for proper diagnosis and treatment. Treatment options may include antifungal medications for fungal infections, addressing any underlying conditions, and keeping your daughter's nails clean and trimmed. In some cases, your daughter's healthcare provider may need to drain an abscess or prescribe antibiotics to treat any infections.
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