Caleb Foster
Fingernails and toenails are made in the nail matrix, which is located under the base of the nail. The nail matrix can be damaged by injuries and certain health conditions, which may interfere with nail growth. However, in most cases, the nail matrix will heal with proper care, and the nail will grow back. The time it takes for a nail to grow back depends on various factors, including the severity of the injury, the type of nail (fingernail or toenail), and individual health conditions.
| Characteristics | Values |
|---|---|
| Nail regeneration | Nails have good regeneration capacity |
| Nail growth rate | Fingernails grow one-tenth of a millimeter each day |
| Toenail growth rate | Toenails grow at about half or one-third the rate of fingernails |
| Time for a new fingernail to grow | 4 to 6 months |
| Time for a new toenail to grow | 12 to 18 months |
| Nail matrix | The "factory" where your body makes new fingernails and toenails |
| Nail bed healing time | 7 to 10 days |
| Nail injuries | Bruise under the nail, cuts in the nail bed, broken bones |
| Nail injury treatment | Nail trephination, antibiotics, bandaging, stitches, ice, elevation |
| Nail infections | Fungal, bacterial |
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What You'll Learn
Nail injuries
A nail injury can occur when any part of the nail, including the nail bed, cuticle, or the skin around the nail, is injured. This can happen when the nail is cut, torn, smashed, bruised, or torn away from the skin. For instance, smashing a finger in a door, hitting it with a hammer, or cutting it with a sharp object can cause a nail injury.
If the nail is torn or jagged, it is advisable to trim it to prevent further injury. If the nail has lifted off the nail bed, it may be more comfortable to replace the nail and secure it with a bandage. However, nails will not reattach to the nail bed after separation. In most cases, a new nail will slowly regrow and can take about two months for fingernails and four months for toenails.
If there is blood under the nail, it could indicate an underlying bone fracture or tissue tear, and a doctor should evaluate it. A common condition caused by blood trapped under the nail is called subungual hematoma, which can be treated by draining the blood through a small hole in the nail, relieving pain and pressure. This procedure is called nail trephination and must be performed within 48 hours of the injury.
For more serious nail injuries, it is important to seek medical attention at an urgent care center or emergency room. Treatment will depend on the type and severity of the injury. The medical staff will stop the bleeding, clean the wound, and numb the affected area before proceeding with treatment. In some cases, the nail may need to be removed, and the nail bed repaired. Antibiotics may be prescribed to prevent infection, and a wire may be placed in the finger to stabilize a broken bone.
It is important to keep fingernails and toenails properly trimmed and avoid biting them or the cuticles to prevent nail injuries. Wearing properly sized shoes is also crucial to avoid toenail trauma.
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Nail matrix damage
The nail matrix is the "factory" where your body makes new fingernails and toenails. It comprises two parts: the germinal matrix, which is responsible for about 90% of nail growth, and the sterile matrix, which is responsible for the remaining 10% of cells that make up your nails and is important for keeping your nail attached to the underlying skin.
Injuries and certain health conditions can damage your nail matrix and interfere with nail growth. Trauma to the nail can cause nail cell production to stop for up to three weeks, and severe trauma, such as crushing injuries or deep cuts, may result in long-term or permanent damage to the nail matrix. In rare cases, this can lead to complete and permanent nail loss. Other conditions that can affect the nail matrix include subungual melanoma (nail matrix melanoma), pterygium unguis, lichen planus, burns, lupus erythematosus, and nevomelanocytic nevi.
Minor damage to the nail matrix can cause temporary changes to the appearance of the nail, such as dents, horizontal ridges or lines, spots or streaks of colour, texture changes, and soreness. These changes will usually resolve over time as the nail grows and new, healthy cells replace the damaged ones. However, it is important to recognise changes in nail growth after an injury and consult a healthcare provider to determine the best course of treatment.
In most cases, with proper treatment, the nail matrix will heal, and healthy nails will grow again. Even if the nail falls off, it usually grows back with proper medical care. It is rare for the nail matrix to be permanently damaged, but if this does occur, it may be necessary to protect the finger or toe during physical activity.
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Nail infections
Fingernails and toenails are made up of cells produced in the nail matrix. The nail matrix comprises two parts: the germinal matrix, which accounts for about 90% of nail growth, and the sterile matrix, which is responsible for the remaining 10% of cells and is crucial for keeping the nail attached to the skin.
Injuries and certain health conditions can damage the nail matrix and interfere with nail growth. Minor damage can cause temporary changes to the nail's appearance and feel. A severe injury could cause the nail to fall off. However, with proper medical care, the nail matrix usually heals, and the nail will start to grow back. It may take several weeks for the new nail to become visible.
It is rare for the nail matrix to be permanently damaged, but it can happen, resulting in partial or complete nail loss. If the nail matrix is severely damaged, you should consult a healthcare provider about protecting your finger or toe during physical activity. Over time, you will likely adjust to the absence of the nail.
One common nail infection is paronychia, which usually results from bacteria entering broken skin near the cuticle and nail fold. The cuticle is the skin at the base of the nail, and the nail fold is where the skin and nail meet. Anyone can get a bacterial nail infection, but certain factors increase the risk. These include exposure to irritants like detergents and other chemicals, frequent wetting of the hands, and underlying skin conditions.
Symptoms of paronychia include pain, swelling, and tenderness around the nail, redness and warmth of the skin, and the buildup of pus under the skin. An abscess may form and require drainage. If left untreated, the nail can exhibit abnormal growth, ridges, discolouration, dryness, and brittleness.
Most cases of paronychia resolve with antibiotics, but some infections persist or recur after treatment. Chronic paronychia is often associated with occupational or environmental irritants and, less commonly, chronic bacterial or fungal infections. Healthcare providers may culture the pus to identify the specific bacteria causing the infection.
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Nail removal procedure
In most cases, a fingernail will grow back if it falls off or is removed, although it may take several weeks for the process to be complete. The fingernail is formed in the nail matrix, which is the "factory" where new nails are created. The nail matrix consists of two parts: the germinal matrix and the sterile matrix. The germinal matrix contributes about 90% of the cells that make up the nails, while the sterile matrix is responsible for the remaining 10% and is important for keeping the nail attached to the skin.
Certain injuries and illnesses can damage the nail matrix and affect how the nails look or grow. However, with proper medical care, healthy nails can often grow back. It is rare for the nail matrix to be permanently damaged, although it is possible in severe cases. Minor damage to the nail matrix can cause temporary changes in the appearance and feel of the nail.
Nail removal may be necessary in cases of nail deformation or injury. Deformities requiring nail removal can be caused by infection, self-mutilation, tumours, or trauma. Ingrown toenails are a common condition that may require nail removal. The procedure involves the following steps:
- A tourniquet may be applied at the base of the toe to minimize bleeding.
- A sterile rubber band can be placed around the base of the toe to create a dry operative field.
- The toe is washed with a surgical solution, and a drape is placed over the foot, with the affected toe protruding.
- A nail elevator or scissors are used to separate the nail plate from the proximal nail fold.
- The site for partial nail removal is identified, typically the lateral one-fourth or one-fifth of the nail plate.
- A nail splitter or bandage scissors are used to cut the nail straight back beneath the proximal nail fold.
- The separated nail is gently removed by applying firm and steady distal traction using a tool like a hemostat.
It is important to note that infection is common after ingrown toenail removal. Oral antibiotics may be prescribed to prevent or manage infectious complications. Additionally, incomplete matricectomy can allow a new nail to grow laterally, interfering with the lateral nail groove. Therefore, a second procedure may be required to remove any remaining nail spicules.
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Nail growth rate
Fingernails grow at an average rate of about a tenth of a millimeter per day or 3.47 millimeters per month. This means that a lost fingernail may take up to six months to completely grow back. Toenails grow slower than fingernails, at a rate of about one-third to half the speed of fingernails, and will take 12 to 18 months to grow out completely.
Several factors influence the rate of nail growth. Nails on the dominant hand tend to grow faster, possibly because the dominant hand is more prone to injuries, prompting the body to send more blood and nutrients to the area to aid in healing and repair. Similarly, nails on the longer fingers have been observed to grow faster. The growth rate also depends on age, gender, and overall health. Nail growth may slow down with age, with an estimated decrease of 0.5% per year after the age of 20. Hormone levels can also play a role, with nail growth peaking during puberty and declining as hormone levels stabilize with age. Pregnancy has been associated with rapid nail growth, while lactation may lead to slower growth.
Environmental factors, such as warm weather, have been linked to increased nail growth, while cold environments may result in slower growth. Individual factors, such as proper nail care and a nutritious diet, can also promote nail growth and prevent brittleness or breakage. Keeping nails clean and dry, trimming them regularly, and avoiding nail-biting or cutting them too short are good practices for maintaining nail health and supporting their growth.
Injuries and certain health conditions can cause damage to the nail matrix, which is responsible for nail growth. Minor damage to the nail matrix may temporarily alter the nail's appearance, while severe damage could lead to nail loss. With proper treatment and care, the nail matrix can heal, and nail growth can resume. However, in cases of extensive damage, some or all of the nail may not regrow.
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Frequently asked questions
Yes, a fingernail will grow back after falling off. It may take up to 6 months for a new nail to grow and replace the lost nail. The nail matrix, which is responsible for creating new cells that become your fingernails, usually heals with proper care.
If your fingernail falls off, you should follow your doctor's advice. In general, you should keep the area clean and covered until the nail grows back fully. You can trim any loose edges and keep the nail bed dry.
Fingernails can fall off due to various reasons, including injuries, certain health conditions, and infections. For example, a severe injury or a broken bone in the finger can cause the nail to fall off. Infections, such as fungal infections, can also affect the nail bed and cause nail loss if left untreated.
