Toenail Falling Off

The condition of toenail falling off means parting of a nail from its nail bed. It is medically termed as onycholysis or onychoptosis.

Toenail falling may cause a lot of symptoms, including discomfort, bleeding, infection, and even deformity. During the initial phase, the affected nail appears discolored; then the nail gets loose and results in a lot of pain. The condition is usually caused due to serious injuries to toe or a fungal infection, etc.

Toenail falling off is treated with self-care measures, home remedies, and medications. Medical treatment is necessary in severe cases to prevent permanent harm to nail root and/or spread of the infection.

Symptoms

The signs and symptoms that accompany a case of toenail falling off are dependent on the underlying cause. A few common symptoms, as per the cause, are listed below:

• Traumatic injury to toenail: It may be accompanied by symptoms like pain, bleeding, nail discoloration, blood accumulation under nail, and separation of nail plate or loosening of toenail.
• Infection of toenail: It may cause:
  • Pain, swelling, and foul smell
  • Fungal infection begins with whitish, yellow, green, or brown discoloration of affected nail. Buildup of waste matter or debris below and on the sides of the nail plate can result in thickening of the toenail, ultimately leading to toenail falling off. Non-treatment of fungal infection can trigger crumbling of the nail edges as well as inflammation and redness or the adjacent tissue.
  • Inflammation of toenail bed tissues will adversely affect nearby nail plate. Pus will form all around the nail plate and sometimes even underneath it. This will result in discharge from below the nail, shredding of toenail, separation of toenail from nail bed, and toenail falling off.

Causes of toenail falling off

There are many causes of toenail falling off; but the two main causes are injury and fungal infection.

1. Injuries

• Toenail injuries and subsequent cases of toenail falling off is most often observed in people who engage in sports that involve skating, running, skiing, etc. Shoes and different foot gear can exert pressure on toenail, blister the skin below the nail, and ultimately result in toenail falling off.
• Repetitive or severe stubbing of toe can cause detachment of toenail.
• Acute separation of toenail from the nail plate may trigger bleeding underneath the injured nail.
• Toenail falling off is common in sportspeople and athletes who use ill-fitting shoes.

2. Fungal infection

• Fungal infection of toenail is caused by different kinds of dermatophytes. These are fungi which live off keratin present on nails and skin. The fungi can adversely affect the skin and cause athlete’s foot. Such an infection tends to rapidly spread in moist and warm environments (the kind occurring in socks and shoes), eventually migrating to the toenails and causing the toenail to fall off.
• Fungus can also directly invade and infect a toenail and/or the skin present in the nail bed, i.e., skin below the nail. In such cases, patients may experience yellowish, splintered, streaked, discolored, speckled, or thickened toenails.
• Infection of toenails is often observed to occur in families down the generations. This may be because of sharing of showers, towels, and other personal hygiene products.

3. Other causes

• Use of antimalarial drugs, chemotherapy, and/or other medications can cause toenail falling off as a side effect
• Excessive exposure to certain soaps, acetone nail polish removers, or similar harmful chemicals can also trigger separation of toenail from nail bed

Treatment of toenail falling off

New nail usually grows back in 3 to 6 months after the old toenail has fallen off. Mild cases of toenail falling off can be treated with self-care guidelines and home remedies.

• Use a nail clipper and remove the loose part of nail. This will help prevent accidental tearing of nail bed.
• Soak toe in cold water for 15 to 20 mild to ease pain
• Ensure that the affected area is kept dry to prevent infection. You may also soak the toe in warm saltwater solution to prevent infection.
• Cover the damaged toenail with an adhesive bandage to protect it from further injuries and to promote healing
• Fungal infections can be treated with topical application tea tree oil or benzalkonium chloride and/or soaking feet in warm apple cider vinegar

If toenail falling off is accompanied by pain, swelling, bad smell, immobility, pus, discoloration, tenderness, discharge, and/or redness, etc., then patients need to visit a doctor.

• For injured and bleeding toenail the doctor will apply pressure, drain possible blisters, and then apply a bandage.
• Fungal infections are treated with oral or topical medicines
• Pain killers and anti-inflammatory drugs may be given for alleviation of pain.
• Sometimes, the complete nail is removed by doctors for better healing and re-growth of nail.
• In severe cases marked by unbearable pain and nail deformation, doctors may opt for excision of toenail and the nail matrix or root. This will prevent re-growth of the nail and thus help find relief from pain.

Wearing proper fitting shoes and socks with breathable fabrics as well as good personal hygiene can help prevent cases of toenail falling off.