A toenail falling off, whether all at once or gradually, can be both surprising and uncomfortable. This can happen for many reasons. Injury is a common cause, whether from stubbing your toe, dropping something heavy on it, or repeated friction from tight shoes. Athletes, especially runners, may lose a toenail from ongoing pressure and impact. Health related issues can also play a role. Psoriasis can lift or damage the nail, fungal infections can make it brittle, and illnesses such as diabetes can slow healing and increase the risk of nail loss. Less commonly, a subungual exostosis, a small bony growth beneath the toenail, often at the tip, can push the nail upward until it detaches. Whatever the cause, knowing how to care for the nail bed right away can make a big difference in comfort and recovery.
What to do immediately
Let’s get the basics out of the way. Wash your hands, then clean your toe with mild soap and water, making sure to remove any debris. Pat the area dry, apply a thin layer of antibiotic ointment, and cover the area where your toenail fell off with a bandage. Choose a non-stick dressing and change it daily or whenever it gets wet or dirty. Wear roomy, protective footwear.
If only part of your toenail has fallen off
DO NOT try to remove the rest of it. If the detached part of your toenail is still attached to your toe, use clean nail clippers to carefully trim only the loose portion so it doesn’t catch on socks or clothing. Then, use a nail file to smooth any jagged or sharp edges. One of our doctors would be happy handle this for you if you’re unable or simply not comfortable doing it yourself.
Don’t use sticky dressings!
It’s also important not to wrap the exposed nail bed with plain gauze or a regular adhesive bandage. These can stick to the wound and make dressing changes difficult and painful. Use a non-stick pad with paper tape or a cushioned adhesive designed not to adhere to the wound.
When to seek immediate treatment (call our office ASAP)
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Your entire toenail falls off or bleeding won’t stop with gentle pressure
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You have diabetes or poor circulation
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There are signs of infection (increasing redness, warmth, swelling, pus) or lingering / worsening pain after a couple of days
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The base or sides of the nail are pulling away or already detached from the nail bed or nail folds
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You have a deep cut that might need stitches
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You see blood pooling under ¼ or more of the remaining nail
Be patient with regrowth
As hard as this might feel, try not to pick at the old nail as a new one appears (if one does). Toenails grow slowly. It can take a year or more for a new nail to fully return, and it may look thicker, ridged, or slightly deformed compared to the original.
In some cases, particularly if the nail bed was severely damaged, scar tissue formed, or certain medical conditions affect nail growth, a toenail may never grow back. While this is not always alarming, it’s worth having our team evaluate the area to make sure there’s no ongoing injury, infection, or underlying issue that needs treatment.
If you’re unsure why your toenail came off, worried about how it’s healing, or just have questions about what to expect next, please reach out to us. Don’t leave concerns unspoken! Getting the right answers early can help your toe heal comfortably and reduce the risk of future problems.
