Ava Monroe
Nails are produced by nail matrix cells that reside in the moon-shaped whitish area (lunula) at the base of the nail. If the nail matrix is not damaged, the nail is typically capable of regrowth. The nail matrix is responsible for about 90% of your nail growth, with the remaining 10% coming from the sterile matrix, which is more important in keeping your nail attached to the underlying skin. If the nail is left detached, it will eventually fall off when a new nail grows in. Nails grow at a rate of 0.13 inches per month and require 3-6 months to completely regrow. If there is damage to the nail matrix, the growing nail plate will contain a defect, and significant defects can result in a permanently deformed nail.
| Characteristics | Values |
|---|---|
| Nail growth | Nails grow a little more than one-tenth of an inch per month |
| Nail regrowth | Requires 3-6 months for fingernails and 12 months for toenails |
| Nail matrix | Where the nails form; comprised of the germinal matrix and the sterile matrix |
| Nail damage | Can be caused by working, playing, or repeated trauma |
| Nail bed damage | Can produce whitish changes in the nail due to onycholysis |
| Nail matrix damage | Can cause defects in the growing nail plate; severe damage may result in a permanent deformation |
| Nail injuries | Can cause bruising, ridges, discolouration, or nail fall-off |
| Nail infections | Can be caused by fungal infections, skin conditions, chemicals, or medications |
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What You'll Learn
Nail matrix damage
The nail matrix is the region where new nail cells are produced, and it is located beneath the base of the nail. The nail matrix has two parts: the germinal matrix and the sterile matrix. About 90% of nail growth comes from the germinal matrix, which gives the nail its natural curvature, while the remaining 10% comes from the sterile matrix, which is responsible for keeping the nail attached to the underlying skin.
Injuries and certain health conditions can damage the nail matrix and interfere with nail growth. Minor damage to the nail matrix can cause temporary changes to the nail's appearance, such as dents, horizontal ridges, lines, pain, soreness, spots or streaks of colour, and texture changes such as thickening or crumbling. Severe trauma, such as crushing injuries or deep cuts, may result in long-term or permanent damage to the nail matrix, and the nail may not grow back. In some cases, the nail may grow back with defects, such as chronic thickening, uneven or irregular growth, or permanent deformities.
If the nail matrix is damaged, it is important to seek medical attention to determine the best course of treatment. With proper care and treatment, the nail matrix can heal, and healthy nail growth can often be restored.
It is important to note that protecting your nails can reduce the risk of nail trauma. Wearing protective gloves during repetitive tasks or heavy lifting can help prevent nail injuries, and keeping nails trimmed and maintained minimizes the chance of breakage.
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Nail bed damage
Fingernails and toenails are composed of protein and fat and are not live tissue. They grow at a rate of 0.1–0.13 inches per month and require 3–6 months to completely regrow. Nails are produced by the nail matrix cells that reside in the moon-shaped whitish area (lunula) at the base of the nail. The nail matrix has two parts: the germinal matrix and the sterile matrix. The germinal matrix contributes about 90% of the cells that make up the nail, while the sterile matrix is responsible for the remaining 10%.
Nail bed injuries are common and can occur in many ways, such as when a heavy object crushes or hits the fingers or toes, or when a sharp object cuts the nail bed. These injuries can be minor, but they can also be very painful and uncomfortable, even limiting finger movement. In rare cases, they can cause nail deformities.
If there is damage to the nail matrix, the growing nail plate will contain a defect. Minor damage will produce minor defects in the nail, while more significant defects can result in a permanently deformed nail. In cases of severe nail matrix damage, some or all of the nail may not grow back. However, if the nail matrix is not damaged, the nail is typically capable of regrowth.
There are several types of nail bed injuries, including subungual hematoma, which looks like a bruise and occurs when small blood vessels under the nail bed leak, with blood pooling between the nail and the nail bed. This can be drained through a small hole in the nail, usually made with a needle, which relieves pain and helps the new nail grow in correctly. Another type of nail bed injury is a nail bed laceration, where the nail and the underlying nail bed are cut, often by a sharp object such as a knife or saw. A nail bed avulsion is when the nail and part of the nail bed are pulled away from the rest of the finger.
Treatment for nail bed injuries depends on the type of injury. Minor injuries can often be treated at home with bandages and ice packs, while more severe injuries may require medical attention and antibiotics to prevent infection. In some cases, doctors may need to remove the nail to repair the nail bed. They may also use stitches to repair any lacerations to the nail bed and reattach the nail, if possible, to provide protection and support while the new nail grows.
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Treatment for nail injuries
If the nail is still attached to the nail bed, it can be left intact. Any non-adhering parts of the nail should be gently trimmed away, and the wound should be cleaned with soap and water. If the wound is bleeding, do not apply a dry bandage or gauze, as this will stick to the wound. Instead, cover the wound with petroleum jelly, then gauze or a bandage. Repeat these steps daily while the wound heals.
If the nail is completely torn or detached from the nail bed, there is little that can be done to replace or repair it. The main concern is to prevent damage to the surrounding areas and structures. If there is significant damage to the areas around the nail, or if there are any signs of infection, swelling, increasing pain, or pus, seek medical attention.
To relieve pain and reduce swelling, apply a cool, damp washcloth to the wound and prop the injured arm or leg on pillows so that the nail is higher than the heart. Ibuprofen or acetaminophen can also help with pain and swelling.
To prevent nail injuries, it is recommended to keep nails short and trim, so they do not bend or catch on objects. Wearing properly fitting shoes and appropriate protective gear during sports can also help to prevent nail injuries.
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How to prevent nail damage
As long as there is no permanent damage to the nail matrix or nail bed, a nail should grow back normally. Fingernails grow at a rate of 0.13 inches per month and can take 3-6 months to completely regrow. Toenails grow more slowly, usually at close to half the rate of fingernails.
- Keep your nails trimmed short. This will prevent them from catching on objects and pulling off your nail beds.
- Avoid biting your nails.
- Be careful when cleaning underneath your nails. Tools like cuticle sticks or nail brushes can break the skin underneath your nails and cause an infection.
- Avoid chemicals or products that can irritate your nails or the surrounding skin, 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.
- Be careful when putting down heavy objects near your feet.
- Cut your nails properly. Trim toenails straight across to prevent ingrown toenails. Trim fingernails with a slight curve at the edges, and don't cut them too short.
- Manage any health conditions that could affect your nails, such as psoriasis. See your healthcare provider regularly to manage the condition.
- Seek medical care if you notice any color changes in a single nail, as this could be a sign of subungual melanoma, a type of skin cancer that affects the nail matrix.
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Factors that affect nail growth
The growth rate of nails varies from person to person and even from finger to finger on the same hand. Typically, fingernails grow between 0.5 and 1.2 mm per week, while toenails grow at about a third of that rate. Nails on the dominant hand and those on longer fingers tend to grow faster.
Several factors influence the rate of nail growth, including:
- Age: Nail growth slows down as we age, possibly due to a decrease in blood circulation.
- Gender: Men's nails tend to grow faster than women's.
- Hormone levels: Hormonal changes during pregnancy, puberty, and lactation can affect nail growth.
- Season: Nails grow faster during the summer.
- Overall health: Illnesses, nutritional deficiencies, and underlying health conditions can impact nail growth.
- Medication: Chemotherapy and certain medications can cause Beau's lines (horizontal ridges) or slow nail growth.
- Diet: A healthy diet contributes to stronger and quicker nail growth.
- Circulation: Poor circulation can slow nail growth by reducing the supply of nutrients and oxygen to the nail.
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Frequently asked questions
Yes, as long as there is no damage to the nail matrix or nail bed, the nail should grow back normally.
If a portion of the nail is still attached, it can be left alone. The non-adhering part of the nail should be removed with scissors, and the uncovered nail bed should be covered with petroleum jelly and dressed with a clean bandage.
Fingernails grow at a rate of 0.13 inches per month and can take 3-6 months to completely regrow. Toenails grow more slowly, usually taking about 12 months to grow back.
A severe injury, certain illnesses, medications, and skin conditions can interfere with nail growth. Peripheral artery disease, for example, causes reduced blood flow to the legs and feet, which can affect toenail growth.
