Why Are My Toenails Falling Off?

Some argue that toenails are “vestigial”. They opine that nails are useless leftovers of the evolution process.

Yes, nails and claws require a lot of calcium and may fall off, become dead, get infected, become thick and brittle, or ingrown. Indeed, we don’t get benefits from nails as much as our quadruped ancestors did.

Yet, the nails on both toes and fingers are useful to us in many ways. They provide the counter-pressure on our toes which gives us spatial awareness and balance.

Warning: While starting any new treatment or diet, seek advice from your physician or any other qualified health provider.

A beautiful set of toenails adds beauty and attractiveness to the person. Nails are indicators that reflect the healthiness of the body.

Nails protect the toes from injuries and they help in holding the toes together. They protect the tip of the toe bones and make the toes strong.

Toenail coming off the toes is difficult for us to bear and make us feel uncomfortable.

A Medical Purview Of Toenail Falling Off

The issue of toenail coming off the toe is called Onycholysis in medical terms. It simply means the separation of toenails from the nail bed.

It is not a disease by itself but a symptom of fungal infections or other ailments affecting the body. Any traumatic injury to the nail also can lead to the occurrence of onycholysis.

The dead toenail usually painlessly comes off the toes. However, inflammatory fungal infections on the nail and toes can be very painful. In such cases, even after the separation of the nails from the nail bed, the pain and soreness will continue till the inflammation is healed.

In some cases, the infected nails do not fall off the toes but they become dead and brittle. Such nails gradually get removed from the toes in small cracked bits and pieces.

Onychomycosis or Onychomadesis is the main cause of dead toenails. It is a kind of fungal infection that changes the color and structure of the nails.

In many cases, a dead nail infection is propelled by another fungal infection called an athlete’s foot which usually affects the skin around the toes and feet. The affected skin may be itchy, red, scaly, dry, cracked, or blistered. In severe cases of the Athlete’s foot, the infection spreads to the nails resulting in Onychomycosis.

Symptoms Of Onycholysis And Onychomycosis

Discoloration of the nail is the first indication of possible separation of the nails from the nail bed.

You can expect the nail to come off the toes soon if it becomes increasingly loose and shaky. Loose nails can cause a lot of pain and irritation especially when they rub against footwear or hard surface.

Here are some of the symptoms of impending nail separation from the toe:

Fungus-infected nails could come off the toes if these symptoms exist:

  • Nails have become unusually thick;
  • Pain or swelling around the nail;
  • Nail color changes to yellow, brown, or green;
  • Redness, blisters, or puss formation on skin tissues surrounding the nail;
  • A foul smell emanates from the affected nails;
  • Puss discharge from under the nail

Nails damaged by traumatic injury could separate from the toes if the following symptoms exist:

  • Discoloration of the nail to pale white or dark shades
  • Constant pain and swelling of skin tissues surrounding the nail
  • Clotting of blood under the nail bed
  • Bleeding from the toes
  • A nail becomes loose and shaky

Not all of these symptoms need to be present to indicate the impending separation of the nails from the toes. The nail may also come off the toes for underlying causes without exhibiting apparent symptoms.

Why Do Toenails Fall Off?

Some of you might be inquiring ‘why do my toenails keep falling off?’

Losing nails is painful and the reasons for this innocuous incidence are many.

According to Dr. Hazel Oon, Associate Consultant Dermatologist of the National Skin Centre (NSC), “traumatic injuries to nails, if not treated on time, can lead to the collapse of nails from the toes.”

Onychomadesis is a periodic idiopathic shedding of the nails beginning at the proximal end. The immediate reason for Onychomadesis is the temporary arrest of the functions of the nail matrix.

Onycholysis is the painless separation of the nail from the nail bed. It occurs as a result of nail infections, traumatic injuries, or as an external symptom of an internal disease.

Here are the 10 common reasons that make your nails become dead or fall off entirely from the toes.

1. Fungal Infections

It is the most common reason for many types of nail damage. Fungal infection results in discolored or yellow, thickened, damaged, or broken toenails; eventually leading to toenail falling off the toe. An infectious local irritation in the nail bed can make the nails dead and loose.

2. Injuries

Many people lose nails because of severe injuries to the nails. The nail can pry away from the nail bed when the nail is seriously damaged by heavy hits or jamming.  Toenails might also get detached because of repetitive toe stubbing. Athletes may lose toenails by wearing shoes that aren’t roomy enough.

3. Athlete’s Foot Disease

Dermatophytes infection that causes athlete’s foot disease around the toes can spread rapidly and transfer to the toenail beds, resulting in onychomycosis.

4. Hand Foot And Mouth Disease

Some people, especially children, who suffer ‘hand foot and mouth disease’ experience peeling nails, nail shedding, or nail loss, also known as Onychomadesis.

5. Chemical Reactions

Nails get affected by the side effects of excessive filling or chemical exposure in manicures and styling applications, acetone nail polish removers, or soap.

6. Water And Dampness

Prolonged and regular immersion of nails in the water or dampened surfaces leads to the erosion of nails. Water-soaked nails become brittle and breeding grounds for fungal activities.

7. Loss Of Blood Supply

Blood flows to the nail bed can get blocked due to injuries or infections. The nail matrix stops functioning when the supply of blood is stopped and this results in the separation of the nail from the nail bed.

8. Psoriasis

Severe psoriasis infection on the nails can make nails dead and then eventually be peeling it off from the toes or fingers.

9. Side Effects Of Medicines

Certain medications such as tetracycline, oxsoralen, naproxen, minocycline, etc., make a person experience unusual sensitivity to light. This can cause sunburns under the nails which may eventually lead to onycholysis. Medicines used for diseases such as chemotherapy or antimalarial are bad for the nails.

10. Iron, Calcium, And Biotin Deficiency

Iron, calcium, and biotin are important nutrients required for healthy nails. Acute deficiency in these nutrients can make the nail brittle, loose, or shedding of nails.

What Happens When Your Toenail Falls Off?

If you have lost a nail, you need not be overly worried about the issue. You can wait patiently for a new nail to grow in place of the lost nail.

It is certainly going to cause you some discomfort until your toe gets adjusted to the situation.

The toe that has lost the nail due to fungal infection or injuries will re-grow the nail again. Usually, it takes about 6 months to 1 year to regenerate the nail.

The proper re-growth of the nail depends on various factors. The epithelial cells in the nail matrix must be in healthy condition. There is no guarantee the lost nail would regrow properly if the nail matrix is also fully damaged by the infection or injury.

The cells in the epithelial cells need to receive enough amounts of protein and keratin to achieve faster growth of the nail.

The re-growth of lost nails takes place faster in children but in older individuals, it may take a longer time depending on health condition, diet, season, and location.

What To Do When Your Toenail Falls Off?

Causes And Remedies For Nail Falling Off

After the nail falls off, the first thing for you to do is to completely heal the infection or injury on the toe.

When the whole nail is detached, you could seek the help of your podiatrist to clear and remove the leftover particles of the lost nail from the toe. This would prevent further infection and allow faster growth of the new nail.

Every possible care must be taken to protect the nail bed from getting damaged or infected. If nail beds are damaged future growth of new nails becomes a distant possibility.

At the initial stages of nail infection or injuries, we should actually be trying to save the nails that are in danger of being lost.

The types of treatments to be administered for loose or fallen nails depend on the causes that have led to the problem.

Basic treatments are meant for saving the nail from coming off the toes. These are to be performed at the initial stages of the infection, injury, or other diseases that affect the nail.

For fungal infections, both topical and oral medications are prescribed. There are also many natural remedies that you can try for getting rid of nail fungal infections.

There are antifungal gels, lotions, creams, diets, and nail polishes that are beneficial in treating mild to moderate fungal infections. Topical applications of anti-fungal ointments also help in preventing the spread of infection from one toe to the other.

Laser treatment is also used to get rid of the fungus growth and infections underneath the nails.

In severe cases of fungal infection or injuries, it may become necessary to remove the deformed and painful nails. Matrixectomy is the commonly used procedure for removing the nails; this method may be also used for stifling the regrowth of the deformed nails.

Injured nails and toes are usually treated with anti-inflammatory medicines to suppress the pain, inflammation, and bacterial infections.

Timely treatment should be done for the skin tissues which are affected by diseases such as psoriasis, athlete’s foot, ‘foot and mouth disease’, etc. This will help to ward off potential threats from severe nail infections resulting in the separation of nails.

If your toenails are partially torn or broken, then you could try the following treatments to save and allow the regrowth of the nail:

  • Give maximum care and attention to the damaged nail to stop the risk of toenail falling off;
  • Vigilantly follow the medications prescribed by your podiatrist;
  • Regularly trim the nail neatly across the tip of the toes;
  • Clinically remove the partially detached nail with the help of a manicurist
  • Use topical treatments to prevent infection and faster healing of wounds;
  • Protect the nail with a bandage when you are walking around.

Tips For Preventing Nails From Falling Off

Many people lose their nails due to a lack of care and timely intervention in getting rid of nail fungal infections.

We can’t help the sudden separation of nails from the nail bed due to an accidental injury. However, nails coming off due to reasons like infections and diseases are preventable to a great extent through proper care and medication.

Let us now look at a few important necessary steps or actions you must initiate to stop loose or dead nail problems.

  • The socks and shoes that you wear should be clean and dry;
  • Your shoes must be made of breathable materials;
  • Your footwear must give stability, balance, and protection to your toes and feet;
  • Wash and clean your toes and nails daily;
  • Never keep your nails and toes soaked in water or moistening surrounding for more than 30 minutes;
  • Do not tear or rip the nails that are partially torn;
  • Medicate and bandage the damaged nails till they are fully regrown;
  • Seek medical help at the first instance of any visible symptoms of potential damage to your nail;
  • Wear industrial boots while engaging in activities and works that can injure or cause infection to your nails and toes;
  • Your shoes should have enough breathing room for the toenails;
  • Do not walk barefooted in contaminated or filthy surroundings.

The Bottom Line

Nails are important parts of our body that give protection, strength, and beauty to our toes and fingers.

Falling off the nails from the toes may cause a bit of discomfort and pain to you but it is possible to regrow the lost nails with proper care and medication.

The best possible care and preventive steps should be taken to avoid losing nails for any reason. Do not pull out the nail which is slightly loose or damaged. Let it fall off naturally.

Timely treatment and care of fungal infections and injuries to the nail can help you prevent nails from coming off the toes.

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