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Topic Overview

What causes a detached nail?

It can be very painful to tear or rip your nail from the nail bed. A nail may separate from the nail bed (detach) for many reasons, including:

• Injuries.
  • Separation caused by injury is common in people who have long fingernails. The nail may pry away from the nail bed when it is accidentally hit or jammed.
  • Severe or repetitive toe stubbing may cause a toenail to detach. This is also common in athletes who wear shoes that aren't roomy enough.
• Fungal nail infection, which occurs when fungi invade a fingernail or toenail and the skin underneath the nail (nail bed). Toenails are more commonly affected than fingernails, and symptoms include cracked, yellow, discolored, streaked, thickened, or spotted nails.
• Skin conditions, such as psoriasis.
• Chemicals, such as acetone nail polish removers or some soaps.
• Medicines, such as chemotherapy or antimalarial medicines.
• Severe illnesses.

After a nail separates from the nail bed for whatever reason, it will not reattach. A new nail will have to grow back in its place. Nails grow back slowly. It takes about 6 months for a fingernail and up to 18 months for a toenail to grow back.

How is it treated?

Home treatment often helps relieve pain, promote healing, and prevent infection. Treatment may involve removing the nail, keeping the area dry to prevent infection, and waiting for a new nail to grow. The infection or skin condition that caused the separated nail will also need to be treated.

• File any sharp edges smooth, or trim the nail. This will help prevent catching the nail and tearing it more.
• Trim off the detached part of a large tear, or leave the nail alone.
  • Cover the nail with tape or an adhesive bandage until the nail has grown out enough to protect the finger or toe.
  • If you trim off the detached nail, you will have less worry about the nail catching and tearing.
  • If you leave the detached nail in place, it will eventually fall off when the new nail grows in.
• Use scissors to remove the detached part of the nail if the nail is partly attached.
• Soak your finger or toe in cold water for 20 minutes after trimming the nail.
• Apply an antibiotic ointment, such as Bacitracin, and cover the area with a nonstick adhesive bandage.

To prevent infection:

• Soak your foot or hand in a solution of 1 tsp (5 g) of salt dissolved in 4 cups (1 L) warm water for 20 minutes, 2 or 3 times each day, for the next 3 days. Reapply an antibiotic ointment, and cover with a fresh adhesive bandage.
• Keep the nail bed dry, clean, and covered with antibiotic ointment and an adhesive bandage until the nail bed is firm or the nail has grown back. Apply a new adhesive bandage whenever the bandage gets wet.
• Watch for signs of infection such as increasing heat, redness, pain, tenderness, swelling, or pus.
• Remove an artificial nail if it separates from the nail bed. If you leave it on, the long, artificial nail can tear the nail bed.

Have a doctor trim your nail if you:

• Aren't comfortable trimming the nail yourself.
• Have diabetes, peripheral arterial disease, or an immune system problem. These problems may cause reduced blood flow and loss of feeling in the feet. Untreated nail injuries can lead to infection, foot ulcers, and other serious problems.