Isla Bennett
A detached nail, whether partial or complete, is usually not a major medical concern, but it can be painful and annoying. It is often the result of an injury or infection, and in some cases, it may be a sign of a more serious medical condition. If part of a nail has fallen off, it is essential to leave the remaining part of the nail in place and trim or file any jagged or uneven edges to prevent further injury. If the underlying cause is not treated, it can prevent the nail from growing back properly, or at all. With proper medical care, a detached nail will usually grow back within a year and a half, though it may be somewhat misshapen.
| Characteristics | Values |
|---|---|
| Will the nail fall off after partial removal? | If only a part of the toenail has fallen off, the remaining part should be left in place to prevent further injury. |
| What causes a nail to fall off? | A nail falling off is usually caused by an injury or infection. Minor injuries can cause this, and the toenail will often appear black or purple as blood collects under the nail. |
| How long does it take for a nail to fall off after an injury? | It may take several weeks for the nail to fall off after an injury. |
| How long does it take for a nail to grow back? | A new fingernail will take about 4 to 6 months to grow back, and toenails take about 12 months. |
| What to do if the nail falls off? | Keep the nail bed clean and protected. If there is an infection, seek medical attention. |
| How to prevent the nail from falling off? | Keep nails trimmed short to prevent them from catching on objects and pulling off the nail bed. |
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What You'll Learn
Treatment for nail injuries
A nail injury can occur when any part of the nail, nail bed, cuticle, or surrounding skin is damaged. Treatment for nail injuries depends on the type and severity of the injury. Minor nail injuries can often be treated at home, while more serious injuries may require medical attention.
If you experience a minor nail injury, such as a small tear or bruise, you can follow these steps:
- Remove any jewellery from the injured finger, as swelling may occur, making it difficult to remove later.
- Gently wash any minor cuts or scrapes with soap and water to clean the wound and prevent infection.
- Apply a bandage or small piece of gauze to the wound to protect it and stop any minor bleeding. Avoid using sticky products directly on the nail, as they can irritate the injury.
- Change the dressing daily and keep it clean.
- Apply ice wrapped in a cloth for 20 minutes every 2 hours on the first day, then 3 to 4 times a day after that to reduce pain and swelling.
- Prop your hand or foot above the level of your heart to reduce throbbing and swelling.
- Take over-the-counter pain relievers such as ibuprofen or acetaminophen to manage pain and reduce swelling. Consult a healthcare professional before taking these medications if you have certain medical conditions, such as heart disease or kidney disease.
For more severe nail injuries, such as a partially or completely detached nail, broken bones, or a severely bruised nail bed, it is recommended to seek medical attention at an urgent care centre or emergency room. Treatment for severe nail injuries may include:
- Numbing the affected area with medicine to reduce pain and make the procedure more comfortable.
- Draining blood and fluid from under the nail by creating a small hole to relieve pressure and pain.
- Removing part or all of the nail if it cannot be saved.
- Repairing the nail bed by closing cuts with stitches and reattaching the nail with special glue or stitches.
- Prescribing antibiotics to prevent or treat infections.
- Placing a wire in the finger to stabilise a broken bone.
It is important to keep your nails short and wear properly fitting shoes to prevent nail injuries. Additionally, protecting your nails during sports activities can help reduce the risk of injury. If a nail injury is not improving after a few days, it is recommended to consult a dermatologist or healthcare provider for further evaluation and treatment.
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Preventing toenail fungus
Toenail fungus is a common condition that usually starts at the edge of the nail and gradually spreads. It can cause the nail to thicken, discolour, crumble and become brittle. While it is more common in toenails, it can also affect the fingernails. To prevent toenail fungus, follow these steps:
Keep your feet clean and dry: Fungi thrive in warm, damp environments. Wash your feet regularly and dry them thoroughly, especially after swimming, exercising, or sweating profusely. Ensure your feet are completely dry before putting on socks and shoes.
Wear appropriate footwear and socks: Choose breathable shoes made of materials like leather, canvas, or mesh. These materials allow for proper airflow and help prevent excessive sweating. Avoid wearing shoes that are too tight or made of synthetic materials that trap moisture. Wear moisture-wicking socks to absorb sweat and change your socks daily or whenever they become damp.
Practice good nail hygiene: Keep your toenails trimmed short and straight across. Avoid cutting them too short, and ensure they are shorter than the end of your toes. This helps prevent fungi and germs from collecting under your nails. Disinfect your nail clippers after each use by washing them with warm water and soap, then sanitising them.
Avoid sharing personal items: Fungi that cause toenail fungus can spread easily. Avoid sharing nail grooming tools, towels, shoes, or other personal items with others. If you notice signs of athlete's foot, such as cracked, scaly, or peeling skin, treat it promptly to prevent the infection from spreading to your toenails.
Maintain proper foot care: Give your shoes at least 24 hours to air dry before wearing them again. Fungi can live in shoes, so alternate between different pairs of shoes to prevent continuous exposure to potential fungi. If you have worn shoes during an active infection, disinfect them or discard them to prevent reinfection.
By following these steps and maintaining good foot hygiene, you can significantly reduce the risk of developing toenail fungus and maintain healthy, fungus-free nails.
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Trimming nails with onycholysis
Onycholysis is a common nail disorder where the nail plate separates from the nail bed. It typically occurs due to trauma or injury to the nail or the nail matrix, which is the area where nail growth begins. Onycholysis can also be caused by fungal infections, certain skin conditions like psoriasis, medications, an overactive thyroid, iron deficiency, or working with your fingers or toes.
If you are experiencing onycholysis, it is important to identify and address the underlying cause to prevent further nail damage and potential health risks. Treatment options depend on the cause and may include antifungal medications, creams for skin conditions like psoriasis, or changing medications that may be causing the issue.
- Keep your nails trimmed short to prevent them from catching on objects and pulling further off the nail bed.
- Clip the affected portion of the nail, cutting away the separated nail as it grows out.
- Avoid biting your nails, as this can cause further damage and increase the risk of infection.
- Be gentle when cleaning underneath your nails. Avoid using tools that can break the skin under your nails, such as cuticle sticks or nail brushes.
- Maintain frequent trimming to keep your nails short and minimize the risk of further trauma to the nail and nail bed.
- Avoid activities that can traumatize the nail, such as tapping your nails on a hard surface or wearing tight-fitting shoes.
- Wear gloves, especially when performing tasks that may expose your nails to potential irritants or chemicals.
- Consider using antimicrobial soaks, such as dilute vinegar, to minimize the risk of secondary infection.
It is important to note that onycholysis can be a sign of a more serious condition. If you notice any other symptoms or are concerned about the underlying cause, consult your healthcare provider for personalized advice and treatment options.
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Nail matrix injuries
The nail matrix is where your fingernails and toenails form. A healthy nail matrix is essential for healthy nails. A variety of conditions and injuries can damage your nail matrix. However, in many cases, your nail matrix will heal with proper care.
Causes of Nail Matrix Injuries
Several factors can cause nail matrix injuries, including:
- Fungal infections: Certain types of fungi can infect your nails, usually your toenails. Toenail fungus may manifest as thick, yellow, cracked, or cloudy nails.
- Illnesses: Serious health events or illnesses, such as a heart attack, COVID-19, or pneumonia, can interrupt nail growth and cause Beau's lines (horizontal ridges on your nails).
- Injuries: Pinching or crushing your fingers or dropping something heavy on your toes can injure your nail matrix. After such an injury, you may experience bruising, ridges, or discolouration. In severe cases, the nail may fall off.
- Medications: Chemotherapy and other medications can affect your nail matrix, leading to Beau's lines, slow nail growth, Mees' lines (white bands across your nails), or nail colour changes.
Treatment for Nail Matrix Injuries
The treatment for nail matrix injuries depends on the underlying cause. Here are some common treatments:
- Medication: Prescription antifungal pills are typically used to treat nail fungus. Certain medications can also help manage nail psoriasis and may be administered in the form of pills, injections, or topical treatments.
- Nail trephination: If you have a bruise under your nail, a procedure called nail trephination can be performed to drain the trapped blood. This procedure provides pain relief and helps the new nail grow correctly. It must be done within 48 hours of the injury, before the blood clots.
- Surgery: Subungual melanoma, a type of skin cancer that occurs under the nail, requires surgical removal. A biopsy may be performed first to confirm the diagnosis.
- Grafting: In some cases, nail bed injuries may require grafting or microsurgical reconstruction to restore the aesthetic appearance of the fingers. Grafts can be used to replace scarred areas or treat deformities caused by regrowth after trauma.
- Home care: Minor nail bed injuries can often be treated at home with bandages and ice packs. Keeping your hand or foot elevated and taking over-the-counter pain relievers, such as ibuprofen or naproxen, can help reduce pain and swelling.
It is important to note that anyone uncertain about the severity of a nail bed injury should seek medical advice. While many injuries can be managed at home, prompt medical attention may be necessary to ensure proper healing and smooth nail growth.
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Healing time for nail beds
The healing time for nail bed injuries varies depending on the severity of the injury. Minor nail bed injuries can be treated at home and will heal within a few weeks. For more severe injuries, professional treatment is required, and healing can take up to 6-9 months.
Nail bed injuries can occur due to working, playing, or repeated trauma to the nails. Longer nails are more prone to damage as they can be levered off the nail bed or run into the end of shoes. Poorly fitting shoes can also cause nail injuries through repeated trauma.
If there is no evidence of tears or lacerations to the nail bed, unattached remnants of the nail can be removed with a nail clipper, and the nail bed can be cleaned with a soapy washcloth and water. Any sharp ends should be filed down smoothly, and the nail bed can be covered with petroleum jelly or neomycin ointment and dressed with a clean bandage.
For more serious injuries, such as a subungual hematoma, which is a bruise that forms when small blood vessels under the nail bed leak, professional treatment is required. A doctor may treat this by making a small hole in the nail to drain the pooling blood, a procedure known as trephination. If there is damage to the nail bed or the nail matrix, the doctor may remove part or all of the nail and repair the nail bed with stitches.
After treatment, it is important to keep the wound clean and dressed until it heals. A new nail will grow in and replace the old nail, pushing it off as it grows. This process can take 4-6 months for fingernails and up to 12 months for toenails.
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Frequently asked questions
If part of your toenail falls off, it is important to leave the remaining part of the nail in place. Trim or file any jagged or uneven edges to smooth it out and prevent further injury. Dress the damaged nail with a bandage to protect the injury and keep the area clean.
Toenails can fall off due to injuries or infections. Injuries could include pinching or crushing your finger, or dropping something heavy on your toe. Toenails can also fall off due to toenail fungus, which may be prevented by wearing clean socks and comfortable, protective shoes.
Toenails typically grow back within a year and a half. However, if the underlying cause of the toenail falling off is not treated, it can prevent the nail from growing back properly, or at all.
