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My Toenail Fell Off, Now What?

Overview

A detached toenail is a common condition, but it can be painful. It’s usually caused by an injury, fungal infection, or psoriasis. However, chemicals, certain medications, and serious illness can also make your toenail fall off.

Once your toenail falls off, it can’t reattach itself and keep growing. You’ll need to wait for the new nail to grow back in its place. Depending on the cause and how much, if any, of your toenail remains, you might need additional treatment to make sure your toenail grows back properly.

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What to do

What to do after your toenail falls off

Regardless of what caused your toenail to fall off, there’s a few things you can do right after it happens to avoid any other problems.

Here are some quick tips:

  • If only part of your toenail has fallen off, don’t try to remove the rest of it.
  • If the detached part of your toenail is still attached to your toe, use nail clippers to carefully trim it off to prevent it from catching on your sock or clothing. Your doctor can help you do this if you’re not comfortable doing it on your own.
  • Use a nail file to smooth any jagged or sharp edges.
  • Clean your toe, making sure you remove any debris, and apply an antibiotic ointment.
  • Cover the area where your toenail fell off with a bandage.
  • Seek immediate treatment if your entire toenail falls off or the area around your toenail won’t stop bleeding.
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Causes

What causes a toenail to fall off?

Injury

Simple foot injuries can cause you toenail to fall off. Car accidents, sports, and dropping something on your foot can all damage your toenail.

If you injure your toenail, it might look black or purple under your toenail. This is due to something called a subungual hematoma, which causes blood to collect under your injured toenail. As blood builds up under your nail, it may separate from your nail bed. It can take several weeks for your toenail to completely fall off.

Contact your doctor if the subungual hematoma covers more than a quarter of your toenail. If you feel throbbing or intense pain near the hematoma, your doctor can use a heated needle or wire to make a small hole in your toenail to relieve the pressure.

Otherwise, you can treat your injured toe at home by:

  • soaking it in cold water for 20 minutes
  • elevating it
  • clipping any sharp or jagged edges of the remaining nail
  • cleaning any exposed part of your nail bed and applying an antibiotic ointment
  • applying a fresh bandage daily for the next 7 to 10 days, or until the skin hardens
  • taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), to help with the pain

Depending on which toenail fell off, it can take anywhere from six months to two years for the nail to completely grow back. Make sure to closely trim the rest of your toenails and wear well-fitting shoes to prevent any future injuries.

Fungus

Fungi can grow between your nail bed and toenail, eventually making your toenail fall off.

Symptoms of a fungal toenail infection include:

  • noticeably thicker toenails
  • white or yellowish-brown discoloration on your toenails
  • dry, brittle, or ragged toenails
  • foul smell coming from toes
  • unusual toenail shape

If you have athlete’s foot, it can turn into a fungal toenail infection. Diabetes also increases your risk of a fungal infection in your toenail due to poor circulation in your feet.

As you age, your nails become dry. This can also make them more likely to crack, allowing fungus to enter your nail bed.

Fungal toenail infections can be hard to treat, depending on how severe the infection is. In mild cases, the infection will usually clear up on its own. If you have diabetes, it’s important to tell your doctor about any type of infection in your feet because reduced circulation can make the problem worse.

Treating fungal toenail infections usually involves oral or topical antifungal medications. Depending on the severity of your infection, your doctor may prescribe both. Oral antifungal drugs are usually much more effective than over-the-counter topical treatments. They also reduce the risk of your new toenail getting infected as well.

You may need to take medication for up to 12 weeks. You won’t see results until your new toenail has completely grown in. Oral antifungal medications can produce many side effects, so tell your doctor about any unusual symptoms you have while taking them, such as a rash or fever.

You can also try home remedies to treat a fungal toenail infection. In rare cases, you may need surgery to permanently remove the affected toenail.

You can prevent fungal toenail infections by:

  • keeping your feet dry
  • changing your socks often
  • wearing breathable shoes
  • keeping your nails neatly trimmed
  • disinfecting your nail clippers
  • wearing shoes in damp communal areas, such as spas or locker rooms

Psoriasis

Psoriasis is an autoimmune condition that causes the skin cells to build up. While it often appears on the skin, it can affect the toenails as well. Many cases of nail psoriasis are mild and don’t cause many problems. However, sometimes the buildup of skin cells in your nail bed can cause your toenail to fall off.

Symptoms of psoriasis on your toenail include:

  • pitting
  • thickening
  • unusual nail shape
  • yellow or brown color
  • chalky buildup under nail

Try to avoid removing extra skin under your nail with a sharp object, which can make your toenail more likely to detach. Instead, soak your feet in warm water and smooth the edges of your remaining toenail with a file. Keeping your toenails and feet moisturized can also help.

Your doctor may prescribe topical steroids to rub into your toenail and cuticle. They may also suggest phototherapy. This treatment involves exposing your affected toes to UV rays. In rare cases, you may need to have the rest of your toenail removed.

Nail psoriasis and nail fungus can look very similar. Here’s how to tell them apart.

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Takeaway

The bottom line

If your toenail falls off, it’ll usually grow back within a few months to a year. However, depending on the cause and the size of the lost toenail, it could take up to two years.

Contact your doctor if your toenail won’t stop bleeding or you have severe pain. You can reduce your risk of losing a toenail in the future by keeping your feet clean and your toenails smooth and short. 

Article resources
  • Adigun C. (n.d.). Fingernail and toenail injury.
  • How nails grow. (n.d.).
  • Managing nail psoriasis. (n.d.).
  • Mayo Clinic Staff. (2017). Nail fungus: Diagnosis and treatment.
  • Nail fungus. (n.d.).
  • Nail psoriasis. (n.d.).
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