Ava Monroe
Nails serve important functions as protective layers for fingertips and indicators of health and well-being. They are produced by the nail matrix, which is made of special cells that constantly make new nail cells. When nails stop growing or are damaged, it is often due to injury, overexposure to moisture, fungal infections, or certain health conditions. In some cases, it may be a result of nutritional deficiencies, such as a lack of zinc, biotin, or folate. Lifestyle factors, such as diet, drinks, or supplements, can also contribute to imbalances that affect nail growth. Temporary interruptions, such as those caused by major stress events or chemotherapy, usually resolve with time as the nail matrix heals and resumes normal growth.
| Characteristics | Values |
|---|---|
| Reason for nail destruction | Trauma/injury, nail biting, cuticle biting, fungi, acute paronychia, onycholysis |
| Treatment | Proper care, antifungal medication, cutting away the separated nail, stopping certain nail products |
| Regrowth | Nails grow about one-tenth of an inch per month and take 3-6 months to completely regrow; fingernails regrow in 2-6 months, toenails in 4-6 months |
| Prevention | None found |
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What You'll Learn
Nail trauma and treatment
Nail trauma can occur when any part of the nail, including the nail bed, cuticle, or skin around the nail, is injured. This can be caused by a heavy impact or sharp object, such as a hammer or knife, or by closing a finger in a door or drawer. Ill-fitting shoes can also cause repeated trauma to toenails, leading to deformities. Additionally, habits such as nail biting and cuticle picking can cause trauma and increase the risk of infection.
Treatment for nail trauma depends on the type and severity of the injury. Minor nail bed injuries, such as small subungual hematomas, often heal on their own with proper care. For more severe hematomas, a doctor may perform trephination, creating a small hole in the nail to drain the pooled blood. If the bone is broken or the injury is severe, the nail may need to be removed, and the nail bed repaired with stitches or special glue. Antibiotics may be prescribed to prevent infection, and pain relievers can be taken to manage pain and swelling.
It is important to keep the injured area clean and dressed to promote healing. If the nail has lifted off the nail bed, it can be temporarily replaced and held in place with a bandage. Nails will not reattach after separation, but new nail growth typically occurs within 3-6 months for fingernails and 12 months for toenails. During this time, the nail may grow back with ridges or bumps, which may be permanent.
To prevent nail trauma, it is important to wear properly sized shoes and keep fingernails trimmed. Avoiding habits such as nail biting and cuticle picking can also reduce the risk of trauma and infection.
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Nail matrix damage
The nail matrix is the area where your fingernails and toenails start to grow. It is located at the base of the nail and creates new cells that allow your nail to grow. A healthy nail matrix is essential for healthy nails.
Any change to the appearance or texture of one or more of your nails could be a sign of a nail matrix problem. If you have nail matrix damage, your nails may have dents (large or small), horizontal ridges or lines, pain or soreness, splits or cracks, spots or streaks of colour, texture changes, such as becoming thicker or crumbly.
Injuries and certain health conditions can damage your nail matrix and interfere with nail growth. Trauma to the nail can cause the production of new nail cells to stop for as long as three weeks. Nail growth will usually resume at a faster rate and steady after about 100 days. You may notice the nail appears thicker than usual. If there is a deep cut or trauma to the germinal matrix at the base of the nail, it is possible the nail may never grow back.
In many cases, your nail matrix will heal with proper care. However, severe trauma, such as crushing injuries or deep cuts, may result in long-term or permanent effects if the nail matrix is significantly damaged. Conditions like chronic thickening, uneven or irregular growth, or, in rare cases, complete and permanent nail loss may occur.
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Onycholysis
The word onycholysis comes from the Ancient Greek words "ónuks", meaning nail, and "lúsis", meaning disintegration. The condition may be idiopathic or secondary to trauma, skin disease, nail infections, tumours, or systemic events. For example, it can occur as a reaction to detergents, such as washing dishes with bare hands or using detergent-based shampoos or soaps. It can also be caused by ingesting a photosensitiser, such as certain medications, a phenomenon known as photo-onycholysis.
The treatment for onycholysis depends on the cause. In general, it is recommended to keep the nail dry and avoid further trauma to allow the nail to slowly reattach. Trimming loose nails can prevent the nail from being pried upwards. To minimise the risk of secondary infection, antimicrobial soaks, such as dilute vinegar, can be used. If the underlying cause of the condition is not addressed, the nail bed may begin to form a granular layer of abnormal cells on its surface.
The outlook for onycholysis is good, with most instances of unknown cause healing spontaneously within a few weeks. However, the longer onycholysis persists, the less likely new nail growth will reattach due to permanent damage to the underlying nail bed. Nails typically require 3-6 months to completely regrow, with toenails taking twice as long as fingernails.
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Preventing nail damage
Fingernails and toenails can be injured in a variety of ways, including blows to the nail, closing the finger or toe in a door or drawer, and biting or picking at the nails and cuticles. These injuries can damage the nail matrix—the tissue inside the cuticle where new nails are formed—which can interfere with nail growth and cause deformities. However, with proper care, the nail matrix can heal, and the nail will usually start to grow back within several weeks.
To prevent nail damage, it is important to practice good nail hygiene and avoid behaviours that can cause trauma to the nails. Here are some tips for preventing nail damage:
- Keep your nails trimmed short, but not too short. Toenails should be trimmed straight across to prevent ingrown toenails, while fingernails should be trimmed with a slight curve at the edges.
- Avoid biting your nails and picking at your cuticles, as this can cause trauma to the nails and increase the risk of infection.
- Be careful when cleaning underneath your nails. Use appropriate tools gently to avoid breaking the skin underneath the nails, which can lead to infection.
- Avoid chemicals and products that can irritate your nails or the skin around them, such as nail polish, nail gloss, nail hardener, nail polish remover, and fake nails.
- Wear gloves when doing activities that may damage your nails, such as washing dishes, playing sports, or working outdoors.
- Wear clean socks and comfortable, protective shoes to protect your toenails from injury.
- Be cautious when handling heavy objects to avoid dropping them on your feet and injuring your toenails.
By following these tips and paying attention to your nail health, you can help prevent nail damage and maintain healthy nails.
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Nail bed separation
Fingernails and toenails can be injured in a variety of ways, including physical trauma such as a blow to the nail, catching your finger in a door, or biting your nails. These injuries can cause nail bed separation, also known as onycholysis, which is a spontaneous separation of the nail plate from the underlying nail bed. Onycholysis can be caused by a number of factors, including physical trauma, exposure to irritants, underlying illness, medications, and genetics.
In most cases, onycholysis occurs when there is trauma or injury to a specific area, such as stubbing your toe, wearing ill-fitting footwear, or having long nails that act as a lever, prying the nail away from the skin. It usually only affects one nail and should heal on its own over time. However, if left untreated, severe cases of onycholysis can result in permanent nail bed scarring.
The treatment for onycholysis typically involves medication, trimming away the separated nail, and cleaning the nail bed. In some cases, a topical or oral antibiotic may be prescribed. It is important to keep your nails clean, dry, and trimmed to avoid fungal infections and limit the risk of onycholysis. Additionally, avoiding nail polish remover and harsh chemicals can help prevent nail bed separation.
If the nail matrix, the tissue inside the cuticle where new nails are formed, is not damaged, the nail should regrow normally. Fingernails typically take about two to six months to regrow completely, while toenails can take up to four months. In the case of injuries affecting the nail bed and matrix, nails may grow more slowly for about three months.
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Frequently asked questions
Nails are prone to damage due to their location on the fingertips and toes. They can be injured by trauma, such as a blow to the nail or by trapping the finger or toe in a door or drawer. This can cause the nail to split, crack, or lift away from the nail bed. In most cases, the nail will slowly regrow, although it may take several weeks to a few months for the new nail to appear.
Nail issues can also occur due to overexposure to moisture or chemicals, such as detergents, cleaning fluids, nail treatments, and nail polish. Additionally, certain health conditions and medications can interfere with nail growth and cause changes in nail appearance.
If the nail is only partially detached, the non-adhering portion should be removed, and the damaged skin should be covered with a dressing. Keeping the nail bed clean and free of foreign material is also important. In some cases, a minor surgical procedure may be necessary to improve the nail's appearance.
Yes, nail issues can sometimes be a sign of vitamin or mineral deficiencies, such as zinc, biotin, or folate deficiency. Ensuring adequate intake of these nutrients through a well-rounded diet or supplements can promote healthy nail growth.
If you experience a nail injury, it is important to keep the area clean and free of infection. You should also ensure that your tetanus vaccination is up to date. If there is bleeding under the nail, known as a subungual hematoma, a physician should be consulted, as it may indicate a more serious issue.
