Causes of Toenails to Fall Off & Its Treatment, Management

Caring for our finger and toenails is very essential and should always be a part of the bathing regime. However, even after this, toenail problems do appear and dealing with it at the right time is very important. A falling toenail can be unsightly and can cause you embarrassment. In medical term, it is called as onycholysis or onychoptosis. It is painful yet a common condition. Once your toenail falls off, you will have to wait until it starts to grow in its place. Depending on the cause and how much, if any, of your toenail remains, you might need additional treatment to make sure your toenail grows back properly. There are multiple reasons for toenails to fall off and each reason has their own symptoms too. Let us look into it in details.

Simple foot injuries can cause your toenail to fall off. Getting your toe injured by a heavy object, tight-fitting shoes, or incorrect pedicure techniques can be the reasons for toenails getting damaged and eventually it’s falling off. There is a condition called as “jogger’s toe” or “runner’s toe” where the athletes’ toenails fall off due to frequent running and jogging. Some studies also say that blood blisters may turn the toenail black which slowly lifts the toenail up and it will eventually fall off. A condition known as subungual hematoma which causes blood coagulation under the injured toenails can also lead to falling off toenails. As the blood builds up under your nail, the toenails may separate from its nail bed. However, the toenails might take several weeks to completely fall off.

Fungal infection is also one of the most common reasons for the falling off of the toe nails and detaching them off nail beds. Fungi and yeasts also known as dermatophytes can enter the nail bed and eat away the tissue. This can dislodge the nail and the nail may start crumbling or fall off. Onychia is a medical condition caused by microbes, such as bacteria, fungi, or virus, making their way into the tissues of the nail bed and the tissues that are adjacent to your toenail plate.

Symptoms include:

• Toenails become thicker noticeably
• Toenails become yellow or white
• Dry, brittle, or ragged toenails
• Foul smell coming from toes
• Unusual shape of nails.

The risk of fungal infection in the toenails also increases when you have diabetes due to poor circulation in your feet. The nails also become dry with age which makes them more prone to crack, thus allowing fungus to enter the nail bed.

The exact cause of onychomadesis is not defined; it is considered as either a referred sign or symptom of a systemic illness or it could be an adverse side effect to some medications. The area of the toe which actually gets affected is the nail matrix, the tissue that forms the nail. Once it affects the nail matrix, it will no longer function normally.

Psoriasis is an autoimmune condition of the skin wherein skin cells keep building up. Although, it is more common on the skin, psoriasis can affect toenails as well. In many cases of nail psoriasis, the condition is mild and do not cause many problems. However, sometimes the building up of skin cells in the nail bed can lead to your toenails falling off.

Symptoms of psoriasis are similar to that of fungal infection which includes:

• Pitting
• Thickening
• Unusual nail shape
• Yellow or brown color
• Chalky buildup under nail.

Another skin condition that can make you lose one or more toenails is dermatitis or eczema which is caused by allergic reactions to different allergens or irritants. Some people suffer from dermatitis and it affects the nail bed resulting in the symptoms of onycholysis like loss of fingernails, toenails and even crumbly nails. Few studies suggest the exposure to soaps and harsh chemicals for a long time, prolonged immersion of nails in water, as well as repetitive trauma to be some of the reasons for the damage to the nails. Sometimes more than often, the symptoms of eczema can be seen on the nails even before they appear on the skin.

Uncommon Causes of Toenails Falling Off: Although uncommon but factors like anemia, thyroid problems or some medications can also cause falling off of the toenails.

• It’s a disheartening sight when your toe nails fall off. Consulting a doctor may be the best possible way but there are also some home and natural remedies to help you give you the first aid.
• If your toenail is damaged and is showing signs of injury like bruising and discoloration, you can’t do much to repair the damaged nail. However, applying crushed ice on the affected area immediately after a toenail injury happens, minimizes the chances of nail separation.
• Always keep the injured sites clean whether you have a toenail falling off or not. This helps in minimizing acquiring of an infection and also promotes quicker healing.
• If you have severely injured your toenail, your physician can drill a small hole through the nail so the blood that has accumulated under the nail drains off. This will help to prevent toenail falling off.
• Tea tree oil serves as an antifungal and gives the similar result as that of clotrimazole which is a pharmaceutical antifungal.
• Few drops of the oil can be dropped on a cotton swab without it being diluted and then wipe the affected area with it. Repeat 2-3 times a day for months and you can see the improvement.

However identifying the underlying cause and treating the cause remains the main treatment like taking appropriate medications.