Caleb Foster
Nails are made of protein and fat and are not live tissue, but they do grow back, even if they fall off. The nail matrix is the factory where your body makes new nails. Certain injuries and illnesses can damage your nail matrix and affect how your nails look or grow. However, with the right treatment, you can often see healthy nails grow back. If there is no permanent damage to the nail matrix or nail bed, the nail should regrow and appear completely normal.
| Characteristics | Values |
|---|---|
| Nail regeneration | Nails have good regeneration capacity but grow slowly |
| Fingernail growth rate | One-tenth of a millimeter each day or 0.13 inches per month |
| Toenail growth rate | About half or one-third the rate of fingernails |
| Time for fingernails to grow back | 3-6 months |
| Time for toenails to grow back | 6 months to 2 years |
| Factors influencing nail growth | Ageing, diseases, trauma, fungus, or other health conditions |
| Nail matrix | The "factory" where your body makes new fingernails and toenails |
| Nail damage | Caused by working, playing, repeated trauma, or manicures |
| Nail bed infection | Occurs when there is no treatment, or the individual has diabetes or a compromised immune system |
| Nail trephination | A procedure to drain trapped blood under the nail, providing pain relief and aiding nail growth |
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What You'll Learn
Nail injuries and treatment
Nails are composed of protein and fat and are not live tissue. They grow at a rate of about one-tenth of an inch per month, requiring 3-6 months to fully regenerate. Toenails grow more slowly, typically taking up to 18 months to completely regrow. Aging, diseases, and certain conditions like anemia, overuse of nail polish, weak nails, kidney disease, heart disease, diabetes, rheumatoid arthritis, and liver issues may slow the rate of nail growth.
Nail injuries are common and can occur when the nail is cut, torn, smashed, bruised, or detached from the skin. Treatment depends on the type and severity of the injury. Minor nail injuries can often be treated at home. Here are some general guidelines for treating nail injuries:
- If any part of the nail is hanging off, gently trim away the detached portion, taking care not to cut the attached part.
- Clean the wound gently with soap and water, especially if there is bleeding. Avoid placing a dry bandage or gauze directly on an open wound as it may stick.
- Apply petroleum jelly or antibiotic ointment to keep the wound moist and protected, then cover it with gauze or a bandage. Repeat this process daily during the healing process.
- Relieve pain and reduce swelling by elevating the injured hand or foot above the level of your heart. You can also apply a cool, damp washcloth to the wound or take over-the-counter medications like ibuprofen or acetaminophen.
- Keep your nails short to prevent further nail injuries.
- Ensure your shoes fit properly and have a wide toe box to prevent rubbing and toe stubbing.
- When playing sports, wear protective gear, such as properly fitted shoes, to safeguard your nails.
For more severe nail injuries, it is recommended to seek medical attention at an urgent care center or emergency room. Doctors can provide treatment options such as:
- Nail trephination or creating a small hole in the nail to drain accumulated blood and relieve pressure and pain.
- Removing the nail surgically if necessary and repairing the nail bed.
- Closing cuts in the nail bed with stitches and reattaching the nail with special glue or stitches.
- Prescribing antibiotics to prevent or treat infections.
- In cases of subungual melanoma, performing a biopsy and removing the affected area in the nail matrix and under the nail.
Remember, it is important to follow your healthcare provider's instructions for proper wound care and postoperative care to ensure the best healing outcome.
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Nail matrix and nail bed
Nails have a good regeneration capacity, but they grow slowly. Fingernails may grow at a rate of around 3 to 4 millimetres a month, or one-tenth of a millimetre each day, and toenails at about half that rate. It usually takes 3 to 6 months for fingernails to regrow completely, and 18 months for toenails.
The nail matrix is the "factory" where your body makes new fingernails and toenails. It is located at the base of the nail and creates new cells that allow your nail to grow. The nail matrix has two parts: the germinal matrix and the sterile matrix. About 90% of nail growth comes from the germinal matrix. The lunula, the white crescent shape at the base of your nail, is the only visible part of your nail matrix. The nail matrix creates new skin cells, pushing out the old, dead skin cells to make your nails.
The nail bed is the skin beneath the nail plate, where the nail adheres to the finger. It is the area under the nail plate, where the nail plate rests. The nail bed is composed of a monocellular basal layer and a spinous layer, and is devoid of a stratum granulosum. The nail bed dermis has one uniform compartment of collagen bundles and elastic fibres. It also has a rich vascular network that is oriented longitudinally. Nerves and blood vessels in the nail bed supply nourishment to the entire nail unit.
Injuries to the nail bed or disorders that affect the matrix can affect nail growth. Trauma to the nail can cause the production of new nail cells to stop for as long as three weeks, and nail growth may resume at a faster rate after about 100 days. 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, and more significant defects can result in a permanently deformed nail.
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Nail infections
In most cases, nails will grow back after they fall off, although it may take several weeks or months. However, if there is severe damage to the nail matrix, part or all of the nail may not grow back. The nail matrix is the part of your body that produces new nails.
Bacterial infections, such as paronychia, can occur when bacteria enter the skin through cuts in the cuticle or nail fold (the skin around the nail). People with underlying skin conditions, those who work with water, and those exposed to irritants like detergents and chemicals are at a higher risk of developing paronychia. Symptoms include pain, swelling, and tenderness around the nail, as well as redness and warmth in the affected area. Pus may also accumulate under the skin, forming a white to yellow, pus-filled abscess.
Fungal nail infections can be treated with antifungal medications, which may need to be taken for several months. For severe infections, or when antifungal treatments are ineffective, nail removal may be necessary. Bacterial infections are typically treated with antibiotics. In some cases, drainage of pus or biopsy and removal of the affected area may be required.
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Nail separation (onycholysis)
Onycholysis, or nail separation, is a common nail disorder where the nail plate separates from the nail bed. It typically affects a single nail, but it can also occur in multiple nails. The affected nail usually appears white and opaque compared to the normal transparent nail that appears pink. The nail surface may be normal or pitted, indented, or crumbly.
Onycholysis is often the result of an injury to the nail or the nail matrix (the area where nails start to grow). However, it can also be caused by fungal infections, bacterial infections, skin diseases, nail infections, tumours, or systemic events. Additionally, certain medications, such as chemotherapy and non-steroidal anti-inflammatory drugs (NSAIDs), can induce onycholysis.
The treatment for onycholysis depends on the underlying cause. If a bacterial or fungal infection is present, appropriate antibacterial or antifungal treatments are prescribed. In some cases, cutting away the separated nail as it grows out may be recommended.
It is important to note that onycholysis can make the nail bed susceptible to secondary infections, which can cause discolouration of the nail. Therefore, it is advisable to keep the nail bed dry and avoid potential irritants such as nail enamel, enamel remover, solvents, and detergents.
The prognosis for onycholysis is generally good, with complete regrowth of fingernails occurring within 4 to 6 months and toenails taking twice as long. However, if onycholysis persists for an extended period, the likelihood of new nail growth reattaching decreases due to permanent damage to the underlying nail bed.
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Toenail growth rate
Toenails grow back, but at a slower rate than fingernails. Toenails grow at a rate of about 1.62 mm per month, which is about half the rate of fingernail growth. This means that a lost toenail may take up to 18 months to fully regrow, although this timeframe can vary depending on various factors.
Several factors can influence the growth rate of toenails. Age, for example, is a factor, with older individuals typically experiencing slower nail growth. Nutrition also plays a role, as malnourishment can lead to slower nail growth. Additionally, the season may have an impact, with people in colder climates tending to have slower nail growth.
Certain medical conditions and injuries can also affect toenail growth. For instance, individuals with diabetes or compromised immune systems are at a higher risk of developing fungal infections that can affect the toenails and slow their growth. Severe injuries, such as a detached toenail, can also impact the growth of the nail. In some cases, a severely damaged toenail may not grow back at all or may regrow with minor or significant defects.
To promote healthy toenail growth, it is important to take care of your nails and protect them from injury. Proper nail care includes trimming toenails straight across to prevent ingrown toenails. Additionally, maintaining a well-rounded diet and good general health can help to produce strong nails that are less prone to damage.
In the case of toenail injuries or infections, proper medical care and treatment are essential for optimal toenail growth and recovery. This may include seeking professional care from a physician or podiatrist, following postoperative care instructions, and taking prescribed medications. With proper care and time, most toenails will regrow, although it may take several months or longer for a fully regrown toenail.
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Frequently asked questions
Yes, nails have good regeneration capacity. However, the rate of growth depends on the extent of the damage and whether it was a toenail or a fingernail. Fingernails can take 2-6 months to grow back, while toenails can take 6-18 months.
Keep the wound dry and covered. Clean and dress the nail bed daily with antibiotic ointment and a bandage. Take biotin supplements to promote cell growth.
If your nail has fallen off, it is best to keep the wound dry and covered. You should also complete a course of prescribed medication, such as painkillers and antibiotics. It is also recommended to slowly resume daily activities and keep the affected area elevated while resting.
Nails can fall off due to trauma, infection, or other health conditions. Trauma can include nail biting, cuticle biting, or blunt force. Infections are usually fungal and occur when fungus gets between your nail and nail bed.
