Dr. Jacoby explains if a toenail can re-grow once it has fallen off after an injury.
Young age group I think the health of the nail is enough that it will come back. It will come back normal. As we age that process is somewhat attenuated.
I think if the nail bed itself is lifted off and has a subungual hematoma, in other words collection of blood, that blood has to be drained. There are several ways to do that – you just make a hole in the nail bed itself, which really doesn’t hurt. You can use a safety pin or something like that and let the pressure out. If the pressure isn’t relieved, it is very painful and you will eventually lose the nail and also have a secondary infection.
People who continually lose their nails, here in Arizona for instance, people who hike the Grand Canyon, very common to lose all the toenails, but they don’t know they are going to lose the toenails as they are doing the activity because on an inclined plain the toe is going forward and the nail is staying stationery and it cause a microscopic ripping of the nail bed and the nail plate, fills with fluid, secondary blood and about a week later the nails self-lyse, in other words they fall off – very common here in Arizona.
If a nail falls off spontaneously for whatever reason, the nail will come back because the matrix where the nail grows from is the portion that will probably still be good. The problem that we see is that the nail bed itself, being unprotected, starts to change shape. So the nail that’s coming in rides across this like tongue and grooves type like surface and if it catches or is offline then it will dig into the nail and you will get an ingrown toenail and the term for that is onychogryphosis or cryptosis, and when that happens then we might get a secondary bacterial infection.
First I think you make sure that it’s clean and protected. I think a BAND-AID® or some type of emollient such as Vaseline® would probably be good, something to protect it and prevent it from drying out.
About Dr. Richard Jacoby, D.P.M.:
Dr. Richard Jacoby, D.P.M., graduated from the Pennsylvania College of Podiatric Medicine. He completed his residency at Parkview Hospital, Philadelphia, specializing in foot and ankle surgery. Board certified by the American Board of Podiatric Foot and Ankle Surgeons, he is currently president of Valley Foot Surgeons in Scottsdale, Arizona. In addition, Dr. Jacoby is chairman of the board of Healthcare Networks of America.
Dr. Jacoby has been named the 2010 President of The Association of Extremity Nerve Surgeons.