It can be unnerving when your toenail falls off. But don’t panic. With proper care we can prevent infection, promote healing, and ensure that the new nail grows back healthy. Here’s what you need to know. 

Why Your Toenail Falls Off in the First Place 

Losing a toenail is usually the result of trauma or underlying concerns. Understanding why your toenail falls off is essential to guide your care. Remember, toenails are made from keratin protein. And they grow from the base of your nail, underneath the skin. 

When healthy, your nails should be smooth, consistent in color and have a certain degree of hardness. So, if you notice that a toenail is loosening, or falling off, it is likely due to an adverse event affecting the nail bed or matrix. (That’s where the nail growth begins.) 

Toenail loss can be temporary or permanent, depending on the severity of the damage. Temporary loss usually involves the nail growing back over several months. But permanent loss can occur if the nail matrix is severely damaged or destroyed. Luckily, we can usually prevent or treat the problem when your toenail falls off. The key is to promptly identify the reason for the loss and treat it appropriately. And this is how we do so. 

Determining the Cause of Toenail Loss An example of feet with runners toenail, which can cause the nail to fall off

In many cases, a direct hit or repetitive trauma can your toenail fall off. And that’s why we often see this problem in runners and athletes. These physical traumas can lead to a condition known as runners’ toe, in which blood accumulates underneath the nail, causing it to become discolored and, in some cases, to fall off. 
Dropping a heavy object on your foot or stubbing your toe can also cause sudden, severe damage to the nail bed. Over time, this can lead to your nail loosening. And, eventually, it will fall off. Also, if you frequent wearing tight shoes or high heels, you’re increasing the risk for your toenail falling off. The constant pressure can damage the nail and nail bed, leading to loss. 

When Fungus Causes Nail Loss 

Beyond physical trauma, fungal infections often stand as a common cause of toenail loss. You’re most likely t o encounter this problem if you frequently expose your feet to warm, damp environments where fungi thrive. Athlete’s foot is one fungal infection that can spread to the toenails, causing them to become discolored, thickened and brittle. Eventually, they may even fall off. 

Another common fungus is onychomycosis, specifically targeting the nail bed and nail, resulting in similar symptoms. Fungal infections may begin unnoticed, or only cause mild symptoms like small white or yellowish spots beneath the tip of your toenail. But as fungus spreads, it can cause more problems, even leading to crumbling around the edges. As such, if you suspect you have a fungal nail infection, you must call our Houston podiatrist right away. With early intervention, we can treat the problem and hopefully prevent nail loss. 

Health Conditions That Cause Nail Loss

Systemic conditions such as diabetes or peripheral arterial disease can also make your nails brittle and lead to loss. That’s because they affect your blood circulation, which in turn impact nails growth while increasing your vulnerability to infection. Even a skin condition such as psoriasis can lead to toenail loss by causing cells to build up rapidly on the surface of the skin, affecting the health and growth of your nails. 

What to Do When Your Toenail Falls Off 

Many causes of nail loss will only be temporary. But what you do after your toenail falls off can determine whether or not the loss will be temporary or permanent. So, to help you ensure healthy nail regrowth, it’s important that you follow these post-nail loss instructions that are based on the initial cause of your problem. 

Remember, the nail bed (the skin beneath your toenail) is comprised of specialized cells that soften or harden, depending on if your toenail is attached or not. If your nail has already loosened due to an injury, there may be a new nail present when the old one finally falls off. In these cases, your old nail should come off without pain or bleeding, and no specific care should be required. When the nail comes off more traumatically, though, there will be pain and bleeding. And you need to come into the office to care for your toe safely and correctly. 

Now, we also need you to forget all those nail-loss myths you’ve heard. Maybe some told you that, when a toenail falls off, it’s a normal part of the aging process. Or that you only need to worry about nail loss if you have a fungal infection. But, as we’ve just proven, those are both false statements. Also, you might think losing a toenail will always be painful. Again, that’s imply not true. As we just pointed out, some nail losses will be virtually painless, while others will cause noticeable discomfort and bleeding. The difference will likely lie in the cause of your toenail loss, and the presence (or lack thereof) of a new nail underneath. 

At this point, you should have a better understanding of why your toenail falls off. And what to do when that happens. So, remember, if you suffer a nail trauma and your nail falls off without pain or bleeding, exposing a new nail beneath? You’re probably good to go about your business on your own. (Taking care to better protect your nail in the future.) But if infections or systemic conditions are affecting your toenail health? First, try to seek medical help before your problem causes that nail to fall off. But, if that ship has already sailed, we’re here to help. Simply reach out to the office and request an immediate appointment with Dr. Andrew Schneider.