Do you experience the toe nail coming off the nail bed?

The most common causes of the big toe nail coming off the nail bed is due to a traumatic injury, light rubbing of the toenail within your shoe that you never even noticed, a very severe fungal infection or in some cases we may never know the reason it fell off. The nail will almost always grow back and you shouldn’t get too worried as it is usually something that can be treated or corrected if you follow the treatment guide below. The nail usually appears discolored because it is filling up with blood underneath the nail as it is separating from the skin underneath it. Once the separation has began it is a normal process and at this point there are a few things that you can do to limit more pain or injury.

Trauma is the number one cause of nail loss
First confirm that you have actually experienced trauma, this is usually pretty evident because you stubbed your toe really hard or dropped something really heavy onto your toe. You will experience the following symptoms:

• Pain
• Bleeding under the nail bed leading to red streaks or discoloration under the nail.
• Eventual loosening of the nail from the nail bed as the blood fills under the nail and you are able to evaluate the damage.

If you suspect another cause:

• Fungal infection causing separation - The nails would have been thick, hard and discolored yellow or orange for a period of time before the nail separated. This is a very common and treatable cause of nail separation.

• Jogger’s Toe - If you spend alot of time on your feet and you think it may have been possible that your toenail has been pressuring up against the front of your shoe then this is highly possible. This results in blistering under the toenail leading to the detachment of the nail- with or without pain!

Home treatment for the toe nail coming off the nail bed
The priority in this situation is to accept that the nail has been lost and that you will need to wait until you can grow out a new nail.

1. Accept that the nail is gone and you will have to wait for it to grow back 1 millimeter per month or so. This means 6-9 months if the entire toenail has fallen off (the fingernails grow back a little bit faster). Unfortunately there is not too much that can be done to speed up the growth of the nail beyond leading a healthy lifestyle and getting lots of exercise and sun(basically anything that boosts your metabolism).
2. If the toe is really painful – apply ice for 15-20 mins until it starts to get numb. Take some anti-inflammatory medication like ibuprofen or aspirin to prevent long lasting pain. Initially elevate the foot to decrease the pain as well. Once the pain is low enough you will be able to start trimming the nail down.
3. The nail should be trimmed back as far as it is still attached, the danger here is that if you hit the nail again it will bend back and rip out with the tissue attached to it. OUCH! Avoid this serious and painful complication by trimming back early.
4. If you cannot get to all the blood underneath the nail out and it is not painful then it is ok to let it just grow out over the next 6-9 months, but if it is really painful over a period of time then you should go to the podiatrist to get the blood drained(pain is due to pressure under the nail).
5. Use a nail file, emery board or pumice stone to smooth out the remainder of the nail after it has been trimmed back so that it doesn’t get caught on your socks.
6. Apply some antibiotic ointment- neosporin and triple antibiotic ointment work very well here. Use some water to wash out the bloody area and apply the antibiotic ointment and then cover it with a band-aid.
7. If you are going to continue running or working on that foot put some heavy duty duct tape or athletic tape over the band-aid
8. If the toe is getting red hot and swollen, you experience nausea, fever or redness moving up the toe or throbbing pain that lasts past the icing, anti-inflammatory medication and elevation then you likely have an infection. Get yourself to a podiatrist or a emergency room as soon as possible.
9. Unless you damaged the nail matrix(the base of the nail) then it should grow back every time. The long term problems may be that the nail does not look exactly as it once did. It may curve more or be thicker- it is essential a scar of the nail bed. There are ways to treat it at this point. check out our guide on how to handle long nails.

Home prevention

• Treat your fungal nails or joggers toe as outlined above.
• Get fitted for for your proper shoe size
• Trim your toenails straight across
• Get proper socks
• Use athletic tape or duct tape to cover the nail

To learn more about the toe nail coming off the nail bed, please visit this link.