Toenails are tough, resilient, and flexible, providing protection against injury for the sensitive soft tissues surrounding the toe. Yet they are far from impermeable or impervious to damage, and as a result they can occasionally detach from the nail bed below. The two most common reasons for a toenail falling off are injuries and fungal infections.
We’ll start with injuries. Sometimes the precipitating cause is obvious—say you dropped a heavy book on your toe, or stubbed it on a sturdy table leg. However, more often small impacts over time are the principal problem. For example, if you’re a regular runner and your shoes are too tight, your nails get compressed and slam forward against the front of your shoe with each and every step you take.
If the toe sustains significant trauma, whether suddenly or over time, blisters and bleeding can build up under the nail—this is called a subungual hematoma. This can ultimately cause the nail to separate from the nail bed and fall off.
Fungal infections are a little different. Here, fungi known as dermatophytes enter the space between your toe and nail and feast on the tough keratin of the nail. They do a lot of physical damage, too—infected toenails may appear discolored (usually yellow), thickened, brittle, crumbly, or even ragged.
It’s not a given that a toenail plagued by fungus will eventually fall off, but serious infections that significantly thicken the nail and create a lot of built-up debris underneath can eventually lead to full separation.
In either case, your toenail will grow back after falling off, although if you have a fungal infection that isn’t receiving treatment, the new nail is likely to be damaged by the fungus very quickly, even as it grows in.
If your toenail has fallen off, or you think it might, it’s always a good idea to stop by the team at Family Foot and Ankle Center. Whether the cause is fungal nails, bleeding under the nail, or something else entirely, there’s a good chance you need treatment to drain fluid, eliminate or prevent an infection, and relieve pain and discomfort. To schedule at any of our Greater Cincinnati locations, please call (888) 689-3317 today.