Toenails!!!…huh…yeah. What are they good for? Absolutely nothing!!! (Apologies to Edwin Starr, the Temptations, and Bruce Springsteen).
But it’s true, we don’t do much with our toenails. Our fingernails are still essential: itches demand scratching, they enable us to pick up small objects, and folks with a creative bent can paint them up like 10 tiny blank canvases on which to display their personality.
But our toenails? In the remote past, having claws on our back feet helped us dig, served as climbing pitons, and provided defensive weaponry. But now? Not so much. Toenails have evolved to protect the tips of our toes and often become troublesome.
Why and how your toenail falls off:
A lot of the trouble with toenails occurs when they get detached from their nail bed
Toenail detachment can happen because of fungal conditions or psoriasis. Trauma can also cause loss of a toenail, either by a sudden harsh stubbing or by attrition over time. Here we’ll describe the causes of a toenail falling off and what to do when the loss of a toenail has already occurred or has become inevitable.
1. Fungal infections under the toenail
- Fungi thrive in environments that are warm and moist, and that’s often the climate inside your socks.
- Athlete’s foot can morph into a fungal infection under the nail.
- Diabetes can increase the risk of a fungal infection by restricting circulation in your feet.
Whatever its source, a fungus growing between your toe and its nail can erode the connective tissue between the two, eventually resulting in a complete detachment.
Symptoms of a fungal infection
-
- A flaky surface
- White or yellow streaking on a toenail
- Crumbling on the edge of the nail
- An unpleasant smell
How to prevent fungal toenails
You can increase your chances of avoiding fungal infections by keeping your feet dry, changing your socks frequently, wearing shoes with ventilation, keeping your toenails trimmed, disinfecting your nail clippers, and wearing protective footwear in damp communal areas, like spas or locker rooms.
Treatment of fungal toenails can include toenail removal
A fungal infection under a toenail can be stubbornly resistant, so a permanent cure can be a lengthy process. Most courses of treatment include oral medication and/or topical ointments.
Laser therapy is also an effective treatment for fungal toenails. In rare cases, the fungus may be so pervasive and resistant that a permanent resolution may require surgical toenail removal. See your podiatrist for the treatment appropriate for your particular condition.
2. Psoriasis
Psoriasis is a skin condition caused by the immune system mistakenly attacking healthy skin cells, leaving scaly red patches. It usually appears on surface skin, but can also affect the area under your toenails. Psoriasis can cause a scaly accumulation of skin cells under the toenail. Eventually, the pressure can separate the nail from its bed.
The symptoms of psoriasis under a toenail are quite similar to the symptoms of a fungal infection, so an accurate diagnosis requires the attention of a podiatrist. Medicated creams can be prescribed to alleviate the symptoms, and phototherapy, involving intense spectrums of light, is sometimes helpful.
3. Blows to the toes
If you bang your toenail hard enough or often enough, that trauma can cause a toenail to fall off, either suddenly and violently, or by the attrition of repetitive micro-impacts over time.
A toe can be the subject of trauma in a variety of contexts, such as contact sports, the fall of a heavy object, or a particularly harsh stubbing. Any application of sudden force to a toe (and it’s usually the big toe) can cause ruptures of blood vessels in the nail bed. The accumulation of blood (called a subungual hematoma) between the toenail and its nail bed will cause a dark blue or black toenail. As the blood continues to collect under the nail, the increasing pressure will gradually detach the toenail. This process can take several weeks.
Dedicated runners are at increased risk of a toenail falling off from running
The constantly repeated impact of a toe hitting the front of a running shoe can accomplish over an extended period of time the same result as a single sudden traumatic blow. The most effective way to prevent toenails from falling off from running is by making sure that your running shoes fit perfectly, neither too short nor too long.
Triage treatment for toenails
If your toe and its nail have somehow become a bloody mangled mess, get to your podiatrist immediately.
If your toenail is partially detached, here’s what to do (heroics not necessary)
Your toenail is not going to reattach itself, so don’t bother trying to tape it down. Next, resist the urge to just get it over with. Even if it appears inevitable that the nail will eventually be lost, do not stoically rip it off.
Clip off all of the detached portions and file down any rough edges. Clean the affected area, apply some antibiotic ointment to prevent infection, and then cover the toe with a bandage. Repeat the process as healing and regrowth progress. If any complications arise, see your podiatrist.
How long does it take for a toenail to regrow?
It can take about a year to a year and a half for a toenail to completely regenerate itself. During this process, keep your feet dry, change your socks frequently, and keep the new nail smooth, to prevent ragged edges from catching on your socks.
If you’re suffering from troublesome toenails, don’t hesitate to make an appointment with UFAI. The doctors at University Foot and Ankle Institute are here to help.
Why choose UFAI for detached toenails?
UFAI’s nationally recognized podiatrists offer the most advanced foot and ankle care, together with the highest success rates in the nation. We are leaders in the research and treatment of all foot and ankle conditions.
At University Foot and Ankle Institute, we take our patients’ safety seriously. Our facility’s Covid-19 patient safety procedures exceed all CDC recommendations.
For more information or to schedule a consultation, please call (877) 736-6001 or make an appointment now.
University Foot and Ankle Institute is conveniently located throughout Southern California and the Los Angeles area as our foot doctors are available at locations in or near Santa Monica, Beverly Hills, West Los Angeles, Manhattan Beach, Northridge, Downtown Los Angeles, Westlake Village, Granada Hills, and Valencia, California.
When not tending to patients at University Foot and Ankle Institute, Dr. Jafary utilizes his surgical expertise assisting those less fortunate. As a member of the Yucatan Crippled Children Foundation, he has traveled to Mexico several times and performed hundreds of limb correction surgeries on children with disabling foot and ankle disorders. Dr. Jafary also participates in Podiatry Overseas, which takes him to underserved countries to treat patients with lower extremity deformities.
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