Sophia Delgado
Nails have a good regeneration capacity, but they grow slowly. Fingernails may grow one-tenth of a millimeter each day, so it can take about 4 to 6 months for a lost fingernail to grow back. Toenails grow at about half or one-third the rate of fingernails, so it may take up to 18 months for a lost toenail to grow back. In cases of severe nail matrix damage, some or all of the nail may not grow back.
| Characteristics | Values |
|---|---|
| Nail regeneration capacity | Good |
| Nail growth rate | Slow |
| Fingernail growth rate | One-tenth of a millimeter per day; 4-6 months for regrowth |
| Toenail growth rate | One-half or one-third of the fingernail growth rate; 6 months to 2 years for regrowth |
| Nail matrix | The "factory" where the body makes new nails; heals with proper care |
| Nail bed healing time | 7-10 days |
| Nail separation causes | Injury, fungal infection, skin conditions, chemicals, medicines, severe illnesses |
| Nail separation prevention | Keep the nail bed dry, clean, and covered with petroleum jelly and an adhesive bandage |
| Nail injury treatment | Nail trephination, surgery, antibiotics, stitches, glue, special material |
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What You'll Learn
Nail injuries and treatment
A nail injury can occur when the nail is cut, torn, smashed, or bruised, or when the nail is torn away from the skin. Mild nail injuries can be treated at home, but more serious injuries may require a trip to an urgent care center or the emergency room.
Treating Mild Nail Injuries at Home
If any part of your nail is hanging off, gently trim away the part not connected to your skin. Then, gently clean the wound using soap and water. If the wound is bleeding, don’t put a dry bandage or gauze on top, as it will stick to the wound. Instead, apply petroleum jelly to keep your wound moist and then cover with gauze or a bandage. Repeat these steps every day while your wound heals. Do not put sticky products on your nail. Make sure to only apply sticky products, such as an adhesive bandage or medical tape, to the skin around your nail so you don’t irritate the injury further.
Prop the arm or leg with an injured nail on pillows so the nail is higher than your heart. This will help reduce swelling. Taking ibuprofen or acetaminophen can help relieve pain and reduce swelling when your nail injury is new.
Treating Serious Nail Injuries
For more serious nail injuries, you should go to an urgent care center or the emergency room. They will stop the bleeding and clean the wound. Usually, the nail and finger or toe will be numbed with medicine before it is treated. For a larger bruise, your provider will create a small hole in the nail to allow blood and fluid to drain out and relieve the pressure and pain. If the bone is broken or the bruise is very large, the nail may need to be removed and the nail bed repaired. Part or all of the nail may be removed. Cuts in the nail bed will be closed with stitches. The nail will be reattached with a special glue or stitches. If the nail cannot be reattached, your provider may replace it with a special type of material. This will remain on the nail bed as it heals. Your provider may prescribe antibiotics to prevent infection.
Nail Injuries and Regrowth
A severe injury could cause your nail to fall off. Once your nail matrix heals, your nail will usually start to grow again. It may take several weeks before you see your new nail appear. In cases of severe nail matrix damage, some or all of your nail may not grow back. Nails grow back slowly. It takes about six months or longer for a fingernail and up to 18 months for a toenail to grow back. The new nail will probably have grooves or ridges and be somewhat misshapen. This may be permanent.
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Nail matrix and nail growth
The nail matrix is the "factory" where your body makes new fingernails and toenails. It is where new nail plate cells are created, and as these new cells are formed, older cells are pushed forward and the nail plate grows. The nail matrix is responsible for nail growth.
The nail matrix has two parts: the germinal matrix and the sterile matrix. The germinal matrix is under the base of the nail, while the sterile matrix lies underneath the nail. You can't see most of your nail matrix. The lunula, the white crescent shape at the base of your nail, is the only visible part of your nail matrix. However, some people don't have visible lunulas, which is normal.
The length and shape of the matrix determine the thickness and shape of nail growth. A longer nail matrix will result in a thicker nail, while a flatter matrix will produce a flatter nail. Any trauma to the area of skin protecting the matrix can easily damage the soft cells beneath, which can cause occasional white spots, ridges, or grooves on the nail plate.
Injuries and some health conditions can damage your nail matrix. A severe injury could cause your nail to fall off. Peripheral artery disease (PAD), for example, causes reduced blood flow to your legs and feet, affecting your nail matrix and slowing nail growth. Certain skin conditions, such as severe eczema and psoriasis, can also interfere with nail growth. Fungal infections, which can be treated, are another common cause of nail matrix damage.
In many cases, your nail matrix will heal with proper care, and your nail will start to grow again. It may take several weeks for a new nail to appear. However, in cases of severe nail matrix damage, some or all of your nail may not grow back.
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Nail infections
Fungal nail infections are another common type of nail infection. They occur when fungi invade a fingernail or toenail and the skin underneath the nail (nail bed). Toenails are more commonly affected than fingernails, and symptoms include cracked, yellow, discoloured, streaked, thickened, or spotted nails. Fungal nail infections can make the nail easy to break and crumble and are treated with antifungal nail medicine or tablets.
To prevent nail infections, it is important to keep the nail bed dry, clean, and covered with petroleum jelly and an adhesive bandage. Trimming toenails straight across can help prevent ingrown toenails, and cutting nails properly can reduce the risk of nail infections.
In the case of a detached nail, it is essential to watch for signs of infection, such as increasing heat, redness, pain, tenderness, swelling, or pus. Home treatment can help relieve pain, promote healing, and prevent infection. This may involve removing the nail, keeping the area dry, and waiting for a new nail to grow. Filing any sharp edges and covering the nail with tape or a bandage can help protect the finger or toe until the nail grows back.
Nail injuries, such as bruises under the nail, can be relieved through a procedure called nail trephination, which drains trapped blood and helps the new nail grow correctly. Severe nail injuries may require surgery, such as in the case of subungual melanoma, where the affected area in the nail matrix and under the nail needs to be removed.
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Ingrown toenails
To prevent ingrown toenails, it is important to practice proper nail trimming techniques. Toenails should be cut straight across without tapering or rounding the corners. Keeping the nails even with the tips of the toes is recommended, as trimming them too short can increase the risk of ingrown toenails. Additionally, wearing properly fitted shoes that do not place excessive pressure on the toes is crucial in preventing this condition.
If you develop an ingrown toenail, it is essential to treat it promptly. Soaking the affected foot in warm water 3 to 4 times a day and keeping it dry at other times can help manage the condition. It is also advisable to wear comfortable shoes with ample room for the toes. If the ingrown toenail becomes severely painful or infected, it is important to seek medical attention. In such cases, a healthcare provider may recommend partial or complete removal of the nail to alleviate discomfort and prevent further complications.
The regrowth process for toenails typically takes longer than for fingernails, ranging from 6 months to 18 months. During this time, it is important to keep the nail bed clean, dry, and covered with petroleum jelly and an adhesive bandage until the nail regrows and protects the toe. Ingrown toenails can usually be managed effectively with proper care and treatment, allowing the nail to grow back without deformation.
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Nail separation from the nail bed
A nail may separate from the nail bed (detach) for many reasons, including injury, infection, or certain skin conditions. The medical term for this condition is onycholysis. It is somewhat common and usually occurs when the nail is separated from the skin underneath it. Onycholysis can be caused by nail trauma, an allergic reaction, or an underlying condition such as psoriasis, hyperthyroidism, or type 1 diabetes. Toenails are more commonly affected than fingernails, and symptoms include cracked, yellow, discoloured, streaked, thickened, or spotted nails.
Onycholysis is typically not painful, but it can be painful if it is acute or inflammatory. The affected nail may change colour to yellow, greenish, purple, white, or grey. It is important to determine the cause of onycholysis and treat the underlying issue. While it is crucial to keep nails short, aggressive clipping is not recommended. Instead, frequent trimming is advised to prevent the nail from catching and tearing. Cover the nail with tape or an adhesive bandage until the nail has grown out enough to protect the finger or toe.
The detached portion of the nail will not reattach. Treatment focuses on new nail growth and keeping the nail attached to the underlying nail bed. This process can take several weeks to several months, depending on the severity of the condition and the rate of nail growth. In cases of severe damage to the nail matrix, some or all of the nail may not grow back. However, with proper medical care, healthy nails can often grow back.
To promote healing and prevent infection, it is essential to keep the nail bed dry, clean, and covered with petroleum jelly and an adhesive bandage. Watch for signs of infection, such as increasing heat, redness, pain, tenderness, swelling, or pus. If left untreated, onycholysis can lead to the nail plate becoming shorter or narrower, and in severe cases, it can result in scarring of the nail bed.
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Frequently asked questions
Yes, nails have good regeneration capacity. However, it may take a while—up to 6 months for fingernails and 18 months for toenails.
Keep the nail bed dry, clean, and covered with petroleum jelly and an adhesive bandage. Watch for signs of infection such as increasing heat, redness, pain, tenderness, swelling, or pus.
Nails can fall off due to injury, such as stubbing your toe or dropping something on your foot. They can also fall off due to fungal infections or other health conditions.
