Isla Bennett
Fingernails and toenails are made from keratin, a protein that also makes up our skin and hair. They protect the soft tissue beneath them, but they can be damaged or lost due to trauma, infection, or other reasons. Nails have a good regeneration capacity and will usually grow back, but this can take anywhere from 6 months to 2 years, depending on the severity of the injury and whether it's a finger or toenail. The nail matrix, the factory where new nails are made, can be damaged by injuries and certain health conditions, which may cause permanent nail deformities or prevent the nail from growing back altogether.
| Characteristics | Values |
|---|---|
| Nail regeneration | Nails have good regeneration capacity |
| Nail growth rate | Fingernails grow at a rate of 0.13 inches or one-tenth of a millimeter per month |
| Toenail growth rate | Toenails grow more slowly, usually close to half the rate of fingernails |
| Nail matrix | The nail matrix is the "factory" where your body makes new fingernails and toenails |
| Nail damage | Minor damage to the nail matrix can temporarily change the nail's appearance. Severe damage could cause the nail to fall off |
| Nail bed injury | Bleeding between the nail and nail bed, resulting in a subungual hematoma |
| Nail infection | Symptoms include white, yellow, or green smelly discharge, thickening of the nail plate, and lifting of the nail plate off the nail bed |
| Nail fungus | Toenail fungus is contagious and can be treated with over-the-counter and prescription products |
| Nail psoriasis | Up to 80% of people with psoriasis develop nail psoriasis, causing white lines, pitting, and crumbling |
| Nail melanoma | Subungual melanoma, or nail matrix melanoma, is a type of skin cancer that affects the nail matrix |
| Nail growth factors | Overall health, diet, and hormone levels impact nail growth |
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What You'll Learn
Nail matrix damage can cause nail loss
The nail matrix is the "factory" where your body makes new fingernails and toenails. It is the living part responsible for nail growth. As new cells are produced in the matrix, they move forward, and 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.
Injuries and certain health conditions can damage the nail matrix and interfere with nail growth. Mechanical injuries are a common cause of nail matrix damage. This includes sharp injuries, such as a strong blow, pinching the fingertip in a door, or crushing the fingertip with a heavy object. Other mechanical injuries can result from the improper use of tools like drills and cuticle pushers during nail care procedures.
In addition to mechanical injuries, certain health conditions can also cause nail matrix damage and affect nail growth. These include dermatological conditions such as psoriasis, eczema, and subungual melanoma, a type of skin cancer that affects the nail matrix. Nutritional deficiencies in biotin, zinc, and iron can also contribute to nail matrix damage.
When the nail matrix is damaged, it can lead to nail loss. Minor damage to the nail matrix can cause temporary changes in the nail's appearance and texture. Severe damage can cause the nail to fall off completely. In cases of severe nail matrix damage, some or all of the nail may not grow back, resulting in permanent nail loss.
However, with proper medical care, nails usually grow back after falling off. The rate of nail regrowth can vary depending on the severity of the injury and the overall health of the individual. It typically takes several weeks to a few months for a new nail to start appearing, and it can take up to 6 months for fingernails and up to 18 months for toenails to regrow completely.
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Nails grow back, but slowly
Nails have a good regeneration capacity, but they grow back slowly. Fingernails grow at a rate of 0.13 inches or one-tenth of a millimeter per month, and toenails grow more slowly at about half or a third of that rate. This means that fingernails typically take 3-6 months to regrow completely, while toenails can take anywhere from 6 months to 2 years to fully regrow, with 18 months being a common timeframe.
The nail matrix is the "factory" where new nails are made. It is the root of the nail, located underneath the base of the nail. As new cells form in the matrix, older cells move up and push through the skin. These cells on the surface then die and harden, turning into the nail plate that protects the nail bed and the soft tissue beneath it.
Injuries, illnesses, and certain health conditions can damage the nail matrix and interfere with nail growth. Minor damage to the nail matrix can cause temporary changes in the nail's appearance, such as ridges, discoloration, or texture changes. Severe injuries can cause nail loss, and if the nail matrix is permanently damaged, the nail may not grow back at all. However, it is rare for the nail matrix to be permanently damaged.
To promote nail growth and speed up the healing process after a nail injury, it is recommended to keep the injured area clean and dry, apply a cold compress to reduce swelling and inflammation, and take biotin supplements to promote cell growth. Keeping your hand or foot elevated can also help reduce blood flow to the injury, thereby decreasing swelling and bruising.
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Toenails regrow slower than fingernails
Nails are produced by the nail matrix cells that reside in the whitish moon-shaped area (lunula) at the base of the nail. The nail matrix is the "factory" where your body makes new fingernails and toenails. Certain injuries and illnesses can damage your nail matrix and affect how your nails look or grow. However, with proper medical care, even if your nail falls off, it usually grows back.
Overall health also impacts nail growth. Nail growth can slow down if you are sick, immunocompromised, or malnourished. Hormones also affect regrowth, so your toenails and fingernails might grow quicker during pregnancy. Nails grow from underneath your skin at the matrix, which is the root of your nail. As new cells form in the matrix, older cells move up and push through your skin. The cells on the surface die and harden, turning into nails.
To promote nail growth, you can take biotin supplements, which contribute to faster nail growth by helping your body metabolize protein-building amino acids. Small clinical trials have shown that biotin supplementation may improve the firmness, thickness, and hardness of brittle nails.
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Illnesses and injuries can affect nail growth
Injuries to the nail matrix can cause nail fall-off. Such injuries include pinching or crushing your finger or dropping something heavy on your toe. Nail trauma can also cause bleeding between the nail and the nail bed, resulting in a subungual hematoma, which can be very painful. Toenails are also susceptible to fungal infections because fungi thrive in warm, wet environments. Shoes and socks provide the perfect conditions for fungi to grow. Toenail fungus is contagious and can be transferred to your nail after visiting a nail salon or by walking barefoot in a locker room.
Illnesses such as a heart attack, COVID-19, or pneumonia can interrupt new nail growth and cause Beau's lines (horizontal ridges in your nails). Severe eczema can also affect your nail matrix and temporarily interfere with nail growth, resulting in Beau's lines, pitting, texture, or colour changes. Nail psoriasis can cause white lines, pitting, and crumbling. Subungual melanoma, or nail matrix melanoma, is a type of skin cancer that affects the nail matrix. It is characterized by brown or black discolouration on the nail.
Other illnesses that can affect nail growth include iron deficiency, diabetes, and hormonal changes during pregnancy. Overall health can impact nail growth, and nail growth can slow down if you are sick or malnourished. Certain medications can also affect nail growth, such as chemotherapy, which can cause Beau's lines or slow nail growth.
In most cases, with proper treatment, healthy nails will grow back. Nails typically grow back within 3-6 months, although toenails may take up to 18 months to regrow.
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Nail bed injuries are common
Toenail injuries are especially common, and they can take longer to heal than fingernail injuries. Stubbing your toe or dropping something on your foot can damage your toenail. Depending on the severity, your toenail may turn black and fall off. Toenail regrowth can take anywhere from 6 months to 2 years.
Fungal infections are another common cause of toenail issues. As shoes and socks provide the perfect environment for fungi to thrive, toenails are highly susceptible to these infections. Fungal infections can cause yellow or dark discolouration, brittleness, and thickening of nails.
Nail injuries can often be treated at home. To care for a minor nail injury, you should remove any jewellery from your hand, gently wash any cuts or scrapes, and apply a bandage if needed. You can also apply a cold compress for up to 20 minutes to reduce swelling and inflammation. For pain relief, over-the-counter anti-inflammatory drugs can be taken.
However, for more serious injuries, it is important to seek medical attention. A doctor can perform a minor surgical procedure to relieve pressure and pain caused by bleeding between the nail and the nail bed. They may also prescribe antibiotics to prevent infection. In some cases, stitches or special glue may be required to reattach the nail.
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Frequently asked questions
If the nail bed is damaged, the nail will take longer to grow back. Toenails take anywhere from 6 months to 2 years to grow back, and fingernails take 3-6 months.
You can apply a cold compress for up to 20 minutes to reduce swelling and inflammation. Keeping your nail elevated will also reduce blood flow to the injury, decreasing swelling and bruising.
Yes, your nail will grow back. However, it can take 12 to 18 months for the fungus to grow out. You can treat nail fungus with over-the-counter or prescription products.
Serious health events like a heart attack, COVID-19, pneumonia, or peripheral artery disease can interfere with nail growth. Chemotherapy and other medications can also cause Beau's lines (horizontal ridges) or slow nail growth. In most cases, these changes go away after you finish the medication.
