Onycholysis is the medical term used to describe toenail falling off. It simply means the separation of your nail from its bed. It can be caused by a traumatic injury or a fungal infection. Toenail falling off may result in symptoms such as possible disfigurement and bleeding.
Below, we will look at what causes the toenail falling off, while still attached, for no apparent reason, and its causes, e.g., cancer, running, injury, fungus, what causes your toenail to fall off with no pain, what to do at home, and possible treatment for this condition.
Your nail will initially appear to be discolored indicating that it has already started separating from its bed. It is then followed by the loosening of the nail—a process that can be very painful—and one that may call for first aid to be administered before proper treatment can be sought.
Immediate medical attention should be sought immediately to ensure that you do not sustain permanent damage. Early treatment also helps make sure that the infection will not spread to other parts of your toe.
What causes toenail falling off?
The causes of toenail falling off include:
There are different types of fungi that may cause this condition as they feed on keratin (tough protein which makes up your toenails). Around three to five percent of all Americans are affected by this condition, with eighteen percent of the global population being affected, according to CDC. The fungus can cause your toenails to:
- Crumble and start falling off
- Turn out to be thick and overgrown
- Turn white, brown, or yellow
Any toenail that falls off because of a fungal infection will usually grow back with time. The new nail may, however, become infected just like the previous one. You need to talk to a medic as the condition will rarely go away on its own.
The toenail fungus thrives in environments that are dark and moist. Wearing stockings, socks, thick nail polish, and tight shoes will enhance your chances of being affected by this condition. It is also possible to transfer this fungus from person to person, and from foot to foot.
It is possible for your toes to become jammed when you kick a ball, and this could result in you losing one of your nails. A subungual hematoma develops when your toenail is smacked repeatedly or hard. Subungual hematoma is where your toe starts bleeding below the nail leading to the toenail falling off if your case is severe.
Your trainer can assist you drain the blood present below the nail. Draining it in time will assist preserve the nail. A physical examination to check for bone fractures should be conducted if this blood has covered more than twenty-five percent of your nail.
Whatever may have caused your toenail to fall off, the replacement will most likely start growing within a couple of months. You can keep the following suggestions in mind to prevent and protect against future nail loss:
- Ensure your toenails are properly trimmed—in a straight line
- Only wear socks that are manufactured using natural fibers or synthetic materials. Such materials will allow your feet to breathe in a natural manner.
- Purchase well-fitting shoes that provide your toes with plenty of room.
Toenail falling off after injury
A minor knock to your toenail or fingernail can cause a lot of pain and discomfort. It could also cause many problems as it may make it difficult for you to participate in daily activities such as training. Providing timely treatment will help prevent infection of your toe while speeding up the healing process.
You can attempt the following at home to ease the pain of the toenail falling off after injury:
- Take over the counter medication, e.g., ibuprofen and paracetamol to ease the pain
- Apply ice and ensure that the toenail is elevated. This applies for painful injuries
- If your nail has become separated from the bed, loose, or torn, you should trim it at the location where it attaches to your nail bed as a preventive measure. Do not attempt to pull at it as a way of removing it from your nail bed.
- You should use a clean piece of cloth to apply pressure to your toenail if you spot any bleeding. The damaged area should also be cleaned using warm water and soap.
Toenail falling off from running
A 1973 survey conducted on marathon runners reported that close to fourteen percent of all marathon runners ended up suffering from loss of toenails, chafing, and blisters that went on to persist for up to seven days after the conclusion of the race. The prevalence of toenail related injuries is dependent on the terrain and distance that an individual will cover when racing as well as during training sessions.
A review conducted in 2004 by B.B. Adams found out that blue or black toenails experienced by runners come from the repeated impacts occurring with each and every step. After making your initial impact on the ground, a brief moment exists where the shoe has already come to a stop, but the foot inside is still moving. The foot will, therefore, slide forward causing the toenail to take the largest brunt of this impact.
Additional causes include:
- Wearing running shoes that are too big or too tight fitting
- Being involved in more downhill running
- Participating in very long runs
Toenail falling off cancer
Cancer treatment has its positive and negative aspects. Chemotherapy will help you fight the tumors growing inside you, but it could negatively affect the condition of your toenails. Your toenails could start falling off during or after the chemo treatment.
You will notice that the nails will keep breaking. Some will be very close to falling off. Others may also experience bleeding below the toenails.
There is not a lot that one may possibly do to prevent this as it is a side-effect of the medication being used in the cancer treatment. You could try to keep the nails filed and trimmed in a straight line. It helps reduce breakage.
Nail polish can assist in filling the ridges left behind by the toenails that have fallen off. It also assists with chafing cases.
Toenail falling off fungus
Toenail fungus is very common as mentioned earlier. It will cause the big toenail to become discolored and to start thickening. It may eventually separate from your nail bed.
There are cases where the nail may become very thick making it difficult to cut or trim. Your nail could also detach and fall off if your fungus infection is severe. Risk factors for toenail fungus include:
- Impaired immunity
- Vascular problems
- Poor foot hygiene practices
- Nail trauma
The fungus thrives in areas that are moist and very warm. Wearing damp shoes and socks, therefore, provides the fungi with an ideal environment for it to grow. Being barefoot in moist environments, e.g., locker rooms will also increase your chances of getting this condition.
Toenail fungus is a cosmetic issue that has the capability to cause a lot of pain as well as make it difficult for you to walk. It also makes you self-conscious every time you have to go barefoot or wear sandals. The nail that is diseased may cause an ulceration in your skin providing a possible entry point for the bacteria.
Toenail falling off diabetes
People suffering from diabetes are at an enhanced risk of this condition as they are already predisposed to infections and foot problems. Your diabetic feel will require a lot of attention if you are to avoid developing a serious complication. Many diabetics related amputations affect the toes and the feet.
Your feet are more vulnerable because of diabetic nerve damage caused by peripheral neuropathy. One of the longest nerves in your body runs from the spine, all the way to your legs, ending at your toes. It is what makes your toes an easy target for this condition.
Nerve damage is likely to begin when the tiny blood vessels in your feet become weakened and scarred by the presence of high blood sugar. It explains why your feet become too sensitive or numb to your touch. This is an indication that other complications are about to start taking place.
Toenail keeps falling off for no reason
It is only normal for you to start panicking when you realize that your toenails have become loose or have started falling off for no reason at all. This should not be a major source of worry or concern. Many such injuries tend to be minor and are easily treated.
Why are your toenails falling off?
While it may not be apparent initially, there is a reason why your toenails have started falling off all of a sudden. They could be injured or infected. Toenail injuries are the most common reason for a toenail falling off.
An injured toenail will lead to torn and bruised skin. The toenail cannot remain attached to a surface that is damaged. The toenail will thus ‘jump ship’ until it can find a safe place to start growing again.
Untreated fungal infections will also cause the toenail to begin falling off. Psoriasis and cancer treatments, e.g., chemotherapy may also cause the toenail to start falling off for no apparent reason.
Toenail falling off but still attached
You should always remain calm when you notice a toenail falling off but still attached to the nail bed. The toenail will eventually grow back even though it may take up to eighteen months to achieve this fete. It will be vital to know what you can and cannot do during this phase.
One crucial thing to do will be to make sure that you keep the nail loose for as long as you can. You may be tempted to try and rip it off like you would with a band aid, but do not do it. Ripping it off will only cause you more problems.
Removing the toenail that is about to fall off too soon will cause you to experience a lot of pain. It may also cause the follow-up nail to turn out to be ingrown. Your toe tip will eventually puff up when the nail is no longer on top of its bed.
Any new nail will require a flat surface to grow. Lack of a flat surface will make it to become ingrown. It is the reason it is recommended you wrap the toe using band aid.
Covering the toe helps protect against ingrown nails while also saving you from experiencing lots of pain. Pressure should be applied to the bleeding toenails until a clot begins to form. You should be gentle when applying pressure to the bleeding nail bed.
Toenail falling off no pain
Toenail psoriasis causes your nails to become separated from their beds before eventually falling off. This is an autoimmune disorder that leads to excess production of the new skin cells. Psoriasis also affects other areas such as the skin on your palms, genitals, scalp, and the soles of your feet.
About eighty percent of all people affected by psoriasis will at some point develop nail psoriasis at one point in life, according to the Brazilian Dermatology Society. Nail damage occurs when your nail plate thickens too much. Thickening makes your nails to become pitted, crumbly, turn whitish, and eventually start falling off from their beds.
Toenail falling off treatment
The treatment for toenail falling off will depend on what is causing the problem. A visit to your podiatrist will be necessary when the condition has been caused by a bacterial or fungal infection. Such an infection can be accompanied by additional symptoms that may include:
- Discharge from the toenail that is affected
- Increased pain
- Redness around the affected toenail
You can treat this condition using:
1. Oral antifungal pills
These are prescribed medication used to treat moderate to severe cases of fungal nail infections. They are only recommended for infections that may be resistant to topical treatments. The prescription medicine must be taken as directed by a physician.
2. Topical medication
They comprise of nail polish, lotions, antifungal creams and gels used in treating fungal nail infections. Topical treatments can also be used in prevent recurrent infections. Using the medication as directed will also ensure that the infection does not spread from your toenails to other locations.
3. Removing the infected toenail
There are instances where removing the whole toenail that is affected is the only solution. Removal is recommended when the infection is severe or recurrent. Your infected toenail will be removed together with the root to protect against a regrowth.
How to remove the infected toenail at home?
- Affected nail should be trimmed short and the sharp edges smoothed out.
- Use scissors to remove your detached nail. This applies for cases where a nail has become partially attached.
- Soak your nail in water or apply a cold compress for between fifteen and twenty minutes
- Apply an ointment (antibiotic) on the toe
- Use a bandage to cover your toe. It will help in protecting it against possible infections
- Practice proper aftercare techniques to reduce chances of developing an infection
Toenail falling off – what to do?
Home treatment for toenail falling off is essential as it assists in relieving pain, preventing the development of an infection, and in promoting healing. Treatment could involve waiting for a new nail to start growing, ensuring the area is dry to prevent against infections and removing the affected nail.
You will also need to treat the skin condition or nail that caused this separation. You can take the following steps when you have a nail that is following off:
- All sharp edges should be filed. You could also opt to trim the nail in question. It assists in ensuring that the nail will not get torn.
- The detached part should be trimmed off.
- Use an adhesive tape or bandage to cover your nail until it has started to grow out. The bandage will help protect your toe or finger.
- Trimming a detached nail means that you do not have to worry about tearing
- Scissors should be used to remove the detached nail
- Apply a protective layer of petroleum jelly before covering your toe. You should use a nonstick bandage to cover it.
You should consult a medic if you are not comfortable trimming the toenail on your own.
- (2017). Psoriasis
- NHS UK. (N.D). Nail abnormalities
- Mayo Clinic Staff. (2009). Nail fungus
- Berkeley Wellness. (2016, September). Preventing toenail fungus
- Disabled World. (N.D). Fingernails and toenails