What is Toenail falling off

What is Toenail falling off?

The separation or detachment of the nail from the nail bed may result in the nail falling off. In medical terms, people refer to such a condition as onychoptosis or onycholysis. It usually occurs in case of repeated injury to the nail or trauma or due to fungal infection in the nail. Thickening, crumbling, discoloration or other kinds of damage to the nail precedes the complete removal of the nail from the nail bed. The primary cause of the detachment is the loosening of the nail from the skin. The condition begins by affecting the tip and gradually progresses backward.

Image Source: Dermnetnz.org

Is Nail Falling Off a Serious Condition?

The detachment of toenails is not a condition that people commonly associate with a life-threatening condition. The most common remedy is to wait for the nail to grow back that takes about 18 months. However, there are various preventive methods and treatments to avoid the separation of the nail from the nail bed as well as to speed up the growth of the detached nails.

Causes of Toe Nail falling off

• Moisture: Excessive exposure to moisture may result in the nails becoming weak, loose and eventually falling off. Similar effects are possible if an individual immerses his/her feet in water for a long time. Other theories claim that a combination of moisture and continuous micro-traumas in case wearing closed shoes can lead to the loosening of the nail. Moreover, microorganisms can get into the nail and infect it easily if the feet are in contact with water for a long time.
• Repeated Injury or Sudden Trauma: Day to day activities may cause the nail to experience trauma or injury on a regular basis. ‘Runner’s toe’ or ‘jogger’s toe’ is a condition in which the athlete’s toenail may fall off due to frequent exertion of pressure. Wearing tight shoes can also have similar effects on the nails. Improper methods of pedicure can also cause damage. Sometimes blood blisters may appear under the nails causing them to go black before they become loose and fall off.
• Bacterial Infection: Bacterial infections may grow between the nail and the nail bed causing the two to separate. In some cases, the bacteria can change the color of the nail to green. Harsh soaps, exposure to water, detergents and trauma are capable of aggravating bacterial infections. Older people are more prone to loss of toe nail due to this kind of an infection as compared to others. Image Source: Dermnetnz.org
• Psoriasis: Psoriasis refers to an auto immune condition that causes over production of new skin cells. Presence of flaky skin on the scalp, palms, genitals and soles of the feet are some of the effects of psoriasis. About 80% people suffering from psoriasis are susceptible to psoriasis of the toenail. The nail becomes thicker due to the production of new cells, causing the nails to become loose and separate from the nail bed. The nail turns white, pitted and crumbly before it falls off.
• Viral Infection: Viral infections can also cause loosening and detachment of the nail. Falling off of the nails is in close relation to human papillomavirus infection. Cycles of dropping off of the nails, re-growth followed by loss of nail once again may occur in cases where repeated trauma and injury to the toenail occurs due to viral infection.
• Eczema: Irritants and allergens may react with the skin to cause loss of toenails. In most cases, the condition affects the nail bed resulting in crumbly nails and loss of nails. Eczema affects the nails before it affects the skin. Exposure to water for a long time, contact with chemicals and harsh soaps are some of the things that worsen the state of eczema.
• Fungal Infection: Dermatophytes such as fungi and yeast feed on the tissues of the nail bed. As a result, the nail becomes loose, dislodges and crumbles before falling off. The infection causes the nail to become thick and makes it easier for it to separate from the nail bed. Other effects of the infection include discoloration, flaky appearance and damage to the nail bed. The nails may become yellowish in color accompanied with redness and swelling around the cuticle.
• Medication: Some medications such as antiviral, antibiotics and medicines for rheumatoid arthritis can cause the shedding of nails.
• Health Disorders: Anemia can make brittle, crumbly and result in their loss as well. People suffering from hyperthyroidism also face similar issues. Yellow nail syndrome is a condition in which the nails appear to cease growth and become yellow and thick and gradually fall off.

Symptoms of Toe Nail falling off

• Discoloration of the nail
• Nail may appear yellow, white or green in color
• Bruising under the nail in case of an injury
• Yellowish or black spot under the nail
• Changes in the nail bed
• Toenail may thicken
• Edges of the nails may become coarse & uneven
• Toenail becomes loose
• Secondary infections may follow in case of an injury
• Detachment is usually painless, however, the individual may experience immense pain if the nail tears away from where it was still attached to the nail bed
• Redness and swelling in the surrounding tissue
• Foul odor
• Discharge from under the nail Image Source: www.pcds.org.uk

Prevention of Toe Nail falling off

• Be careful while participating in sports
• Keep feet & nails clean by maintaining proper hygiene habits regularly
• Wear clean shoes and socks
• Wear shoes and socks made with breathable material
• Wear shoes that offer balance and stability to avoid injuries
• Dry your feet thoroughly after they come into contact with water
• Shoes must be half an inch longer than the longest toe
• Trim the toe nails straight across regularly
• Do not rip a nail that is partially torn
• Use a loose bandage to hold down a nail that is broken partially
• Try to wear shoes that have steel toe boxes while working around heavy objects

Treatment of Toe Nail falling off

• Treating the Injury: Firstly, if the nail is only partially detached, a bandage must be wrapped around it so that it does not get caught in anything and cause further damage. Other alternatives include using scissors or nail cutters to cut off the nail. The site of injury must be clean at all times to avoid infections. Drilling a hole in the nail will help to heal the wound quickly by draining the blood and this can also prevent the toenail from falling off.
• Medication: Anti fungal ointments can be applied on the site of the injury. Soaking the feet in apple cider vinegar and applying undiluted tea tree oil are also deemed beneficial in such conditions. These methods help to curb the infection and limit it from spreading.
• Avoiding Infections: Individuals must avoid walking barefoot, especially in environments that exposes their feet to moisture. Such conditions are prone to cause infections. People must wash their hands thoroughly before touching the affected area to ensure that the contagious infections do not spread. Such practices must continue even after the nail has grown back to avoid instances of infections in the future.
• Foot wear: Wearing tight or ill fitting shoes may lead to sweating of the feet, thus providing a favorable condition for the growth of microorganisms that cause infections. Individuals must avoid wearing high heels as well because they push the feet forward and exert a lot of pressure on the toes that could lead to loss of toenails. Footwear should be comfortable and allow people to move about freely.
  

  When to Visit a Doctor?

  Usually, the toe nail falls off on its own and grows afresh to take its place. However, some people may experience pain, discomfort, foul odor, swelling, redness and discharge from the nail. In such cases, individuals must seek medical help to avoid further complications.