Home Joint Health Why is My Big Toenail Falling Off?

Why is My Big Toenail Falling Off?

Written by Charmaine Canlas, RPh

Our toenails can cause significant discomfort if we don’t take care of them properly. A toenail can fall off for various reasons.

Toenails fall often because of injury from minor accidents, sports, or fungal infections. In rare cases, a toenail falling off can be caused by illnesses or side effects of medications.

A hanging or detached toenail is removed to allow a new nail to grow. A broken nail that is hanging cannot be reattached anymore.

Toenails are prone to injury and may take a while to grow. It protects our toes from heavy impacts and should be maintained regularly.

When you find your toe peeling off, you must first know its cause. There are proper ways to remove and treat your toenails.

What to Do When Your Toenail Is Falling Off

toenails

Is it normal for a toenail to fall off?

The cells in your toe skin can produce nails by pushing out and compacting skin cells. This method creates a protective barrier made of keratin or nails.

Toenails often fall in athletes and runners when their feet are battered because of strenuous training. However, toenail loss can also occur due to minor injuries.

Some illnesses, medication, and chemicals can manifest toenail loss as a disease symptom.

When you notice a loose toenail, it may cause mild pain and bleed under the nail. If it is due to fungi, discoloration, swelling, and discharge are consistent symptoms.

The big toenail is most prone to injury. Constant pressure on it can cause the lifting of the nail off the nail bed.

However, it may be caused by diseases or rare conditions if other symptoms occur.

Other causes can include allergy to chemicals such as nail products, diseases that cause poor circulation like Raynaud’s disease, and as a symptom of syphilis.

What causes toenails to fall off?

1) Injury

A fingernail and toenail injury occurs when a direct blow or a crushing force is targeted on the nail. A big toenail falling can happen more often than you think.

Simple activities can cause this injury, such as sports, hitting your big toe on sharp edges, dropping something on it, or pulling your socks too fast.

Subungual hematoma is injuries on the nail bed where bleeding develops under the nail. It causes pain, collection of blood, and discoloration of the nail. This is common in marathon runners.

Toenail growth will delay and be painful at first. If you feel throbbing or severe pain, the hematoma will need to be drained.

An injured toenail with an open wound can be infected. Additionally, fungal infections will develop between the injured toenail and the nailbed.

2) Fungal infection

Fungal infections or onychomycosis is a common cause of losing a toenail. A toenail fungus feeds on the keratin in the skin and nails.

Separation of the toenail is caused by the fungus growth between the nailbed and the toenail.

A big toenail falling is more common in fungal infections than on fingernails because the nail fungus thrives in warm and moist environments.

Symptoms that occur include:

  • Brittle nails that can crack or chip
  • Discoloration
  • Thickening of the nail

A fungal infection that is left untreated may become painful, and the nail that grows will be infected. Furthermore, a fungal toenail infection may accompany a fungal skin infection or athlete’s foot.

Different types of fungi like yeasts or mold can cause fungal toenail infections. Fungus and bacteria can enter small cracks and chips around the nail and skin.

Losing a toenail from fungal infections should be treated with oral antifungal medications and topical antifungal medications.

3) Psoriasis

Psoriasis is a chronic inflammatory disease affecting the skin, nails, and joints. Nail psoriasis is the involvement of the nail bed.

Additionally, it can be a visible indicator of possible joint inflammatory damage.

Symptoms of psoriasis:

  • Discoloration
  • Subungual hyperkeratosis
  • Unusual nail shape
  • Pitting and onycholysis

Although many cases are mild, managing nail psoriasis can be complicated because of the slow recovery.

If it persists, your doctor will prescribe topical steroids. The skin condition psoriasis attacks healthy skin cells and nail cells.

What to do if your toenail falls off?

If your toenail is hanging or falls off, it is crucial to keep it clean until you perform proper care. Recovery time will vary because the nail grows depending on the cause and size of the loss toenail.

For injuries with subungual hematoma, you can puncture a small hole with a needle to relieve pressure and allow the blood to drain. A bandage is placed, and the foot should be kept clean and dry.

Remedies you can do at home for toenail injuries include:

  • Clipping with nail clippers or filing jagged edges
  • Cleaning the nail bed
  • Soaking your foot in cold water
  • Elevating the foot
  • Covering it with antibiotic ointment
  • Applying a bandage daily for 7-10 days
  • Take over the counter pain killers or NSAIDs
  • Don’t wear tight shoes

If the cause of your toenail loss is from a fungal infection, psoriasis, or other diseases, you will need a diagnosis from a doctor to receive treatment and medications.

How do you remove a toenail that’s about to fall off?

A hanging or detached toenail that’s about to fall off is safe to remove and will grow back after a few months to a year.

However, you don’t need to remove the toenail if only a quarter or half has fallen off. You will need to sanitize the nail and prevent further injury regularly.

If the toe nail injury is minor, clean the area of the injury and remove the rough edges of the remaining nail. Do not force to remove the toenail but instead prevent any infections until you get treatment from a healthcare provider.

Eventually, if the nail does not fall off, a podiatrist recommends removing the nail and treating the area to prevent infection.

Although if the entire toenail has fallen on its own, the exposed nail bed should be treated to prevent more pain or infection.

When to see a doctor?

Seek treatment if you have an injury and experience subungual hematoma that extends over a quarter or half of your toenail.

Your doctor can recommend x-rays if you suspect a fracture.

People with athlete’s foot, diabetes, or autoimmune condition should be cautious and inform their doctor to prevent infections.

Fungal infections, bacterial infections, and psoriasis are concerns that should be treated by a doctor.

Certain medications will be prescribed for treating a toenail.

If the damage is serious, call your doctor for the right treatment and aftercare.

When to get urgent care if your toenail falls:

  • Intense pain and swelling occurs
  • You can’t trim the toenail by yourself
  • If you deep cuts and need stitches
  • If you have an unusual toenail shape
  • If it won’t stop bleeding
  • If the entire toenail falls and exposes the nail bed

Conclusion

A toenail falling off can be a sign of injury, infection, or a medical condition.

The symptoms can be mild to severe, depending on their cause. If you find your toenail loose, you can keep it clean and protected before medical treatment or until it heals.

Removing the toenail should be done by a doctor especially on a severe injury or if the nail is difficult to remove.

It is crucial to remove the whole toenail that is hanging loose off the nail bed.

Moreover, a toenail injury can develop into a fungal toenail infection if it is not appropriately maintained.

Toenails will take a while before they completely grow back. The nails grow slowly and may take up to several months to a year.

Common causes such as minor injuries can be treated at home. However, medications and treatment may be required for some uncommon cases.

Contact your doctor if the reason is from a significant injury, infection, or disease.

To prevent future injuries and infection, keep your feet clean, wear well-fitting shoes, and cut your toenails short. The information provided here is for educational purposes only.

Talk to a healthcare provider to provide medical advice for treatment and diagnosis of any disease.

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