Did you stub your toe? Is your nail very loose? In this blog we discuss how to manage a loose toenail.
What Causes A Loose Toenail?
Anything from dropping a heavy object on the nail, running, getting stood on or simply stubbing your toe can cause the nail to become loose. This is usually due to a subungual haemotoma where blood pools under the nail, changes it to a purple/black colour and causes the nail to separate from the nail bed.
Nail fungus is another reason why nails can become loose or detached. When fungus takes over a nail, it can cause it to detach from the nail bed, especially in severe cases where the nail is a dark yellow/brown colour.
Psoriasis is a condition where too many skin cells build up, this can occur under the nails causing them to loosen or fall off. If the nail is detached, it will not reattach, you need to wait for a new nail to grow from the base.
Chemotherapy can also cause nails to fall off, as a side effect of treatment.
How To Look After It At Home
Avoid wearing tight shoes which lack width and depth and put pressure on the nail. Instead wear wide, round toed footwear with enough space to wiggle your toes comfortably.
Avoid sports and activities where possible after injury as this will give time for the the area to heal.
Trim the free edge of the loose nail that could get caught in socks- only if you are comfortable trimming the nail and it is not painful to do so. You must be careful not to split the nail, or leave any sharp edges.
Gently filing the nail can work in some cases, but in others the movement of the file can cause exaggerated movement of a loose nail, causing more harm than good.
Bathing the feet in lukewarm salt water is advised daily to prevent infection. If the skin becomes white or soggy, you should give the bathing a break for a few days and reduce the time the feet are in the water when the skin returns to a normal colour. 10-20 mins in water is sufficient.
Simple non-adherent (non-sticky) dry dressings are recommended, to prevent the nail becoming traumatically ripped off by sticky dressings or socks/hosiery. An adherent (sticky) dressing or tape in contact with the nail will cause the nail to pull from the nail bed and likely result in blood and pain which we don’t want. We would like the nail to fall off on its own terms, where possible.
People with medical conditions such as diabetes or who have a weakened immune system should see a podiatrist for an assessment and should not self-treat.
When Will The Nail Fall Off?
The time frame of the nail falling off depends on the cause and the severity of the trauma. A sudden, severe trauma may cause the nail to fall off quickly in traumatic cases. Most commonly the nail takes a few weeks to fall off. However, in some cases such as fungal nail infections or psoriasis, the nail may not fall off. You may need to seek professional care from a podiatrist.
What Can A Podiatrist Do For Me?
The podiatrist will take a full history to understand the cause of the loose nail.
They will check your pulses in your foot to make sure it safe to proceed with treatment.
They will check where the nail is attached to see if it is possible to remove the nail during the appointment.
The podiatrist may remove the nail and prepare the nail bed with a scalpel, aiming to allow the nail to grow back smoothly and attached.
In some cases, it may be advised to dress the nail and continue looking after it at home, until the nail is ready to fall off on its own accord.
If the area is hot, red, swollen it should be assessed by a podiatrist as it could be infected. You may need a course of antibiotics from your GP. Your podiatrist can advise you on this.
Will It Grow Back?
It can take up to 18 months for a toenail to grow back, depending on the nail and the reason why it fell off. In most cases, the nail regrows without a major issue. However, it may not regrow normally and can grow thicker.
References
- Photo by Gabrielle Henderson on Unsplash
