Toenail Falling Off

Are you suffering from a great deal of pain due to your toenails falling off? It may be a scary sight to see your nail bed without the nail. Do not worry, the nail will grow back and the pain will subside. Toenails falling off, medically referred to as onycholysis or onychoptosis, occur as a result of separation of the toenail from the nail bed. The nail may at first look discoloured or disfigured and this changed appearance will be followed by detachment of the nail from the nail bed.

Causes and Symptoms of Toenails Falling off?

Falling of toenail is observed very commonly and may be caused due to reasons as simple as running for a long period of time wearing shoes that are really tight and uncomfortable. You may see some bleeding from the nail bed due to falling of toenails. The most common reasons for falling of toe nail are:

Injuries

Your toenails may fall off if you have injured your toe. You may bruise your toenails, especially if they are long, due to constant stress caused to the nail owing to the use of uncomfortable shoes. Injuries may also occur if you hit your toes against a hard surface, like a door or a wall or due to carelessness while walking. You are more prone to toe injuries if you are an athlete or a sportsperson. Injuries may cause damage to the blood vessels in your toes and your toenails may turn blue or black due to reduced blood flow. Nail injuries may be dangerous as it may lead to infections. You may also observe bleeding under the injured toenail.

Fungal infections

Your toenails may start falling off if you have a fungal nail infection, like athlete’s foot or tinea pedis. Toenail infections are caused due to a group of fungi called dermatophytes which feed on the keratin present in your nails. The fungal infection not only affects your toenails but also the skin on your feet. If you have a fungal infection in your toenails, your nails will turn yellow or green in color and start to form cracks. In some cases, fungal infections may lead to formation of thick toenails that become disfigured and eventually fall off. You may observe redness around the affected toenail. In some cases, you may notice a bad smell coming out of the nail bed. This is usually due to accumulation of pus or blood under the nail bed. Toenails are very prone to fungal infections due to the moist and warm atmosphere created surrounding the toes when the shoes are put on. These infections are contagious and you may end up getting infected if you share footwear or hygiene products with people who are already suffering from fungal infections in toenails.

Toenail falling off after ingrown toenail surgery

Ingrown toenails are generally formed due to fungal infection, injuries or reduced blood flow to the lower extremities. Ingrown toenails are most commonly observed in elderly people or in people with diabetes or peripheral vascular diseases. It is very common to notice toenail falling off after surgery for removal of ingrown toenail due to the damage caused to your nail matrix.

Underlying medical conditions and side effects to medicines

Sometimes, you may observe that your toenails are falling off for no reason such as fungal infection or injury. Do not ignore it, even if you do not face any discomfort due to the falling off of toenails. In such situations, it is advisable to visit a physician to analyse the underlying cause. Skin diseases such as psoriasis may cause your toenails to fall off. You may notice pitting, cracking or complete loss of toenail if you have discoid or systemic lupus, thyroid or some endocrine condition. Toenails may fall off as a side effect of certain medications such as antimalarial medicines or chemotherapy. Vitamin deficiency, especially vitamin A and E, or nutrition related disorders such as bulimia or anaemia can make your toenails weak and they may eventually fall off.

Treatment

• If your toenails have fallen off, you may wonder how long it will take for the nail to grow back. Be patient! It may take some time, maybe even six to eight months for the toenail to grow back. In the meanwhile visit a physician to find out the exact reason that caused your toenails to fall off.
• If your toenails have fallen off due to a fungal infection, you will have to take oral antibiotics along with application of topical antifungal ointments to treat the infection. Even if the fungal infection has cleared off, there is a possibility that it may come back once the new nail has grown. It is advisable to talk to your doctor if you have a fungal infection on your toe.
• If your toenail is deformed or half- broken and the infection is spreading to rest of the toes, the doctor may have to remove your toenail completely to avoid further infection and to reduce the pain.
• If there is accumulation of pus or blood in a blister under the affected toenail or nail bed, the doctor may have to drain it out and bandage the infected toe.
• If your toenails have fallen off due to an injury, you may have to get an examination done to rule out the possibility of toe bone fracture. You may be asked to take painkillers or anti- inflammatory medicines to reduce the pain.
• If your toenails have fallen off due to medical conditions such as psoriasis or lupus, it is important to treat the underlying medical condition as well.
• If you are a diabetic it is advisable to consult your doctor, even if it is not causing any pain or discomfort.

Home Remedies

• In most cases, home remedies help in alleviating pain and helps in quicker healing.
• If there is blood or pus oozing out of the affected nail bed, you should first clean it using a sterile cotton ball and clean water before cutting it off or soaking your feet in water.
• If only a part of your toenail has fallen off, cut the sharp edges carefully using a nail trimmer to prevent further injury. You may wrap the remaining toenail with a bandage till the nail has grown out enough.
• If you are unable to cut or trim your nail by yourself, it is advisable to visit a podiatrist to get it trimmed. For any reason, do not try to forcefully pull out or cut your half-broken toenail.
• Apply ice pack or soak your toes in cold water for 10-15 minutes after trimming the nail to reduce the pain. You may apply an antibacterial ointment to the toe after patting it dry. Always keep your toes clean and dry to prevent further infections.
• If your toenails have fallen off due to a fungal infection, you may soak your feet in warm water containing salt (1 tsp in 1L water) or vinegar for 15-20 minutes. You may apply an antibiotic ointment after patting your feet dry. After application of the ointment, you can apply an adhesive bandage on your affected toe. This procedure can be done twice daily.
• You should keep your nail bed clean, dry and covered with antibacterial cream or powder till the tenderness in the nail bed is gone and/ or the nail has grown back. Do not keep the same adhesive bandage on for a longer period of time, especially if it gets wet. This may worsen the situation by promoting the growth and spread of fungal infection.
• Keep a check on you affected toe. Watch out for signs of worsening of infection like pain, redness, pus, inflammation or tenderness. If you observe any of these symptoms, visit your physician immediately.

How to Prevent your Toenails from Falling off

You can keep yourself away from the pain and discomfort of detached toenail by taking a few simple precautionary measures:

• Wear shoes that are comfortable and breathable
• Wear clean socks that can absorb the sweat generated in your feet
• Be very careful while walking or running, especially if you are a diabetic
• Do not share your shoes or footwear with anyone
• Do not enter locker rooms or public washrooms barefoot
• Maintain good hygiene habits at all times
• Do not keep your feet moist for a long period of time
• Always cut your toenails straight across
• Avoid use of artificial nails
• Do not apply nail polish or chemical products on your nails habitually. They make your nails weak and brittle causing them to fall off eventually
• Use clean and sterile instruments while getting a pedicure done
• If your nail is partially detached, do not try to pull it out forcefully
• Maintain healthy lifestyle and include a meal rich in vitamins in your daily diet.