Why Do Toenails Fall Off?

The leading causes of toenails falling off are injury, onychomadesis, onychia, and fungal infection. This HealthHearty article traces the causes for toenail separation first, and suggests remedial measures.
HealthHearty Staff
Last Updated: Feb 8, 2018
Caring for nails is a necessity, rather than being a part of the beauty regime. But, nail problems do appear, no matter how much we care for them. Some of the common disorders are discoloration, abnormal thickening, crumbling, layering, splitting, ingrown nail, fungus, pits, and nail falling off amongst others. Coming to toenail separation, several factors are responsible for this unsightly problem, which we will discuss in this article.
Causes of Falling Toenails
While injury or trauma to the toe is an obvious cause for nail loosening and detachment, there are other probable reasons as well. One of the causes is onychoptosis, which refers to gradual shedding of fingernails and toenails due to an underlying health condition, or side effects of certain medication. Affecting one or more nails at a time, part of the nails or the entire shaft may shed periodically.
Injury and Trauma
Physical trauma to the toes is a leading cause of a toenail falling off from the nail bed. Such cases are usually accompanied with bruising and bleeding. While anyone can face this painful nail condition, sportspersons who engage in running most of the time are more susceptible to this injury than others. Also, the risks are higher for those who wear tight shoes.
While the actual causes of onychomadesis are not identified, it is considered a referred sign of some systemic illnesses. In some, it develops as an adverse reaction to certain medications. The actual affected site is the nail matrix, which no longer functions normally. Whatever the causal factor, the common symptom of this disorder is gradual shedding of the toenail, starting from the proximal end and progressing towards the free end, resulting in separation of the nail plate.
This nail disorder affects both children and adults. It is characterized by inflammation of the tissues of the nail bed, and those adjacent to the toenail plate. What happens is, pathogenic microbes (bacteria, virus, fungi) make their way in these tissues through minor cuts and injuries. Over time, the activity of microbes leads to formation of pus around the nail plate, and at times, underneath the plate. As a consequence, the affected toenail sheds and gets separated from the nail bed.
Fungal Infection
Toenail infection may be caused by a group of fungus called dermatophytes, and is medically known as onychomycosis. It is one of the most frequently occurring nail disorders, and many people seek medical help for the same. Infection begins with whitish or yellowish coloration of the affected nail. Over time, it thickens with unwanted debris getting accumulated on the sides and underneath the toenail plate.
When toenail fungus is left untreated, you will notice crumbling of the edges and layering of the nails. Very often, the skin surrounding the infected nails become inflamed, resulting in painful symptoms. Moreover, the accumulated debris leads to lifting of the affected nail plate from its bed, a condition called onycholysis. In such a case, toenail is vulnerable to falling off on its own. Even a bump with a hard object, or mild trauma, will cause it to fall off.
How to Deal with Falling Toenails?
Nothing can be more disheartening than having a toenail that is on the verge of falling off from the nail bed, especially if it is summertime, and you have already shopped for flip flops. If your toenail falls off due to an injury, practice first aid tips properly to stop bleeding. In case part of the nail is affected, cut the affected portion. Complete removal is advisable if the whole nail plate is affected due to injury. Always keep the injured site clean, to promote quick healing and minimize infection risks.
As for a fungal infection, treatment is based on preventing further spreading of fungus, while treating the symptoms. Applying tea tree oil, vinegar, and over-the-counter antifungal creams helps in curing nail fungus. Proper care is a must to restore normal health of the toenails. Avoid going barefoot in public places like gyms and swimming pools. In case of severe infection, which do not improve even after adopting home treatment options, consult a podiatrist.
Wearing comfortable and well-fitting footwear is a simple tip to reduce pressure on the toes. Putting on very tight shoes puts pressure on the toenails, and also creates a favorable environmental for fungal infection. Thus, select shoes that give space to the toenails. Fortunately, the lost toenail will grow back within a matter of few weeks or months. But, there is no trick for quick replacement of fallen toenail. The only solution is following useful tips to maintain healthy nails and avoid further problems.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.