Dealing with a Detached Toenail

Toes without their toenails is like red beans without rice, or a trip to New Orleans without some gumbo or jambalaya—some things are just meant to be together. That said, detached toenails are surprisingly common, often painless, and don’t have to send you into a panic as long as you take a little extra care.

Broadly speaking, toenails fall off in one of two ways—due to an injury, or due to an infection. The “injury” route is certainly the one that makes us cringe—stubbing or jamming your toe, dropping a heavy object on your foot, etc.—and probably what we think of first when we hear the words “detached toenail.” Ripping your toenail off in an accident is a highly unpleasant experience, to be sure. But actually, infection is the more common cause of a toenail falling off. Fungal toenails, psoriasis and other skin conditions, and medicines such as chemotherapy pills can cause the nail to separate from the nail bed and simply detach.

Once the toenail has come off, your only choice is to wait for a new one to grow back—a slow process that can take a year and a half or longer. While you’re waiting, you’ll have to take some extra precautions to avoid further infection or injury. For a partially removed nail, file or trim sharp or jagged edges to prevent further catching and tearing. While the toenail is growing back, you’ll want to keep the toe clean and dry to prevent re-infection, and protect it with breathable yet sturdy footwear, until the nail grows back.

Any underlying medical condition will of course need to be treated—oral antifungals and laser treatment are often effective for toenail fungus, and with the barrier of the nail removed, topical medications may also work well. In the first few days, try soaking your feet in a salt solution (1 tsp per 4 cups water), applying antibiotic ointment, and covering with a dry bandage when finished.

Swelling, discoloration, discharge, odor, or any other troubling symptoms should trigger a visit to Gulf South Foot & Ankle. You should also see us if you have a potentially complicating condition, such as diabetes, that puts you at greater risk for infection. Stop on by in Metairie, LA, or call us at (504)-708-4810 to schedule an appointment.