Noah Sinclair
Healthy nails are made in the nail matrix, which is the factory where your body produces new fingernails and toenails. The nail matrix is made of special cells that constantly make new nail cells. Certain injuries, illnesses, and skin conditions can damage the nail matrix and affect how your nails look or grow. However, with proper care and treatment, nails can usually grow back, although it may take several weeks to several months to see a new nail. In rare cases, severe damage to the nail matrix can cause permanent nail loss. To promote nail growth and prevent infection, it is important to practice good nail care and address any underlying skin conditions or infections.
| Characteristics | Values |
|---|---|
| Skin around nails | Cuticles, Proximal nail fold, Hyponychium |
| Skin issues around nails | Eczema, Psoriasis, Nail matrix melanoma, Beau's lines, Paronychia, Onycholysis, Subungual melanoma |
| Nail matrix | Sterile matrix, Germinal matrix, Proximal nail fold |
| Nail growth | Nails grow back slowly, Fingernails take 6-9 months, Toenails take 12-18 months |
| Nail care | Avoid biting nails, Keep nails trimmed, Avoid chemicals and products that irritate nails, Soak nails in warm soapy water, Gently push back cuticles |
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What You'll Learn
Skin conditions such as eczema and psoriasis
Eczema
Severe eczema can affect the nail matrix, causing temporary interruptions in nail growth. Eczema can lead to various nail changes, including:
- Beau's lines: Horizontal ridges on the nails.
- Pitting: Small, pinhole-like dots or dents that can vary in size and depth.
- Texture and colour changes: The nails may exhibit alterations in texture, and colour changes such as white discoloration.
Psoriasis
Nail psoriasis is an autoimmune disease where the immune system overreacts, causing new skin cells to grow too fast. It is different from eczema and affects nails in distinct ways. Here are some key points about nail psoriasis:
- Prevalence: Up to 80% of people with psoriasis develop nail psoriasis, and it commonly affects individuals with psoriatic arthritis.
- Discolouration: The nail bed may exhibit colours such as yellow, red, pink, or brown, known as salmon patches or oil drop spots.
- Pitting: Nails may develop dents or pits, similar to eczema, but nail psoriasis also causes lifting of the nail.
- Crumbling: Nails may become brittle and crumble.
- Treatment: Treatment options for nail psoriasis include corticosteroid creams, ointments, or nail polish. In more severe cases, medicine injections or oral medications may be prescribed.
It is important to consult a dermatologist or healthcare provider for a proper diagnosis and treatment plan for these skin conditions affecting the nails. With proper care and treatment, healthy nails can often grow back, even if they have fallen off due to severe conditions.
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Nail matrix damage
The nail matrix is the "factory" where your body makes new fingernails and toenails. It is responsible for about 90% of cells that make up your fingernails and toenails, while the remaining 10% comes from the sterile matrix, which is important for keeping the nail attached to the underlying skin. The nail matrix is located at the base of the nail, and it creates new skin cells, pushing out the old, dead skin cells to make your nails. The lunula, or the white crescent shape at the base of your nail, is the only visible part of your nail matrix.
Injuries and certain health conditions can damage your nail matrix and interfere with nail growth. Minor damage to your nail matrix can cause temporary changes to your nail's appearance, such as dents, horizontal ridges or lines, pain or soreness, splits or cracks, spots or streaks of colour, and texture changes (e.g. thicker or crumbly nails). Severe injuries, such as crushing injuries or deep cuts, may result in long-term or permanent damage to the nail matrix, which may lead to lasting changes in your nail growth, including chronic thickening, uneven or irregular growth, or even complete and permanent nail loss.
In most cases, with the right treatment, healthy nails will grow back after nail matrix damage. If your nail falls off due to damage, it usually grows back with proper medical care. However, in rare cases, severe nail matrix damage may result in permanent nail loss, where some or all of the nail may not grow back.
If you notice any changes to your nails, it is recommended that you seek advice from a healthcare provider or a board-certified dermatologist. They can help determine the cause and recommend appropriate treatment.
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Nail separation (onycholysis)
Onycholysis is a common nail disorder in which the nail plate separates from the nail bed. It is usually painless but may be painful if acute or inflammatory. It is often caused by injury to the nail, but it can also be caused by fungal infections, skin diseases, nail infections, tumours, or systemic events. Onycholysis can affect a single nail or multiple fingernails and/or toenails. It is most frequently seen in adult women.
The detached nail is usually white and opaque compared to the normal transparent nail that appears pink. The nail surface may be normal or pitted, indented, or crumbly. Thickened hyperkeratotic skin may accumulate under the detached nail. Onycholysis can also cause discolouration of the nail, with nails appearing grey, green, purple, white or yellow.
If the cause of onycholysis is determined, the nails will slowly regrow. Fingernails take 4 to 6 months to fully regrow, while toenails take twice as long. Treatment for onycholysis may involve cutting away the separated nail as it grows out, taking antifungal medications, or stopping the use of certain nail products. To prevent onycholysis, it is recommended to keep nails trimmed short, avoid biting nails, and be careful when cleaning underneath nails.
It is important to see a dermatologist if you notice any changes to your nails, as they can help determine whether the change is harmless or requires medical testing and treatment.
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Hyponychium overgrowth
The hyponychium is the thick skin under your nail tip. It can overgrow and become even thicker, making nail trimming painful. You are more likely to experience overgrown hyponychium if you get gel manicures, wear acrylic nails, or bite your nails. Nail psoriasis and fungal infections can also cause skin cells to accumulate under your fingernails.
Pterygium inversum unguis (PIU) is an uncommon condition but a common cause of skin overgrowth under the fingernail. Scientists don't fully understand PIU, but they know it can be present from birth or acquired later. The acquired form is most commonly associated with autoimmune conditions such as lupus, but it can also be triggered by external factors. Psoriasis is a skin condition where skin cells grow too quickly, and it can affect any part of the body, including the nails. In the hyponychium and nail bed, the skin cells grow excessively, causing scaling and buildup. This overgrowth is called subungual hyperkeratosis. If the skin becomes very thick, it can cause onycholysis, which is the separation of the nail plate from the nail bed.
If you are concerned about hyponychium overgrowth, it is not recommended to cut the skin yourself as this risks introducing an infection. Instead, see a dermatologist, especially if the area is bleeding, discoloured, or swollen. A dermatologist can help soften the skin of the hyponychium and gently ease the skin off the natural nail from underneath. They may suggest that you soak your nails in a carrier oil such as olive oil, argan oil, or jojoba oil.
In general, if you notice any changes to your nails, it is important to see a board-certified dermatologist. They can determine whether the change is harmless or requires medical testing and treatment.
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Preventing nail reattachment
Onycholysis, or nail separation, occurs when a nail detaches itself from the nail bed underneath. While the detached nail will not reattach, a new nail will grow back in its place. This process can take up to 18 months for a toenail and about 6 months for a fingernail.
To prevent onycholysis, it is recommended to keep your nails trimmed short. Longer nails are more prone to damage as they can be levered off the nail bed. Keeping your nails short prevents them from catching on objects and pulling further off the nail bed. Additionally, avoid biting your nails and be cautious when cleaning underneath them. Tools like cuticle sticks and nail brushes can break the skin underneath, leading to infection.
Certain chemicals and products can irritate your nails or the surrounding skin, such as nail polish, nail gloss, nail hardeners, nail polish remover, and fake nails. It is advisable to avoid these products. Always wear gloves when engaging in activities that may damage your nails, such as washing dishes, playing sports, or working outdoors.
Maintaining a well-rounded diet and good general health can contribute to strong nail growth. If you experience nail separation, protect your nails from further damage. Wash your hands regularly to prevent infection and use a clean washcloth to reach beneath your nails. You can also use antifungal or antimicrobial soaks, such as lemon juice, vinegar, hydrogen peroxide, or essential oils, to help prevent infection.
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Frequently asked questions
Yes, the skin around your nails should grow back. However, it is important to determine the cause of the damage and treat it accordingly. For example, if the skin around your nails is damaged due to an infection, you should see a healthcare provider for proper treatment.
There are several factors that can cause skin damage around your nails, including:
- Skin conditions such as eczema, psoriasis, and subungual melanoma.
- Infections, including fungal infections.
- Injuries, such as pinching or crushing your finger.
- Neglecting proper nail care.
The treatment for skin damage around your nails depends on the underlying cause. Here are some general tips:
- See a dermatologist or healthcare provider to determine the cause and receive appropriate treatment.
- Practice good nail care and cuticle care. Avoid cutting or removing your cuticles, and gently push them back instead.
- Soak your nails in warm, soapy water to soften your cuticles before pushing them back.
- Use a cuticle pusher instead of cutting the skin.
- Keep your nails trimmed short to prevent them from catching on objects.
The time it takes for the skin around your nails to grow back can vary depending on the extent of the damage and the treatment provided. Nails themselves grow back slowly, taking about 6 months for a fingernail and up to 18 months for a toenail to regrow completely.
