When a toenail is lost, either through injury or medical removal, a common concern is whether it will grow back. In most cases, it will. This natural process replaces the lost nail, restoring its function and appearance. Understanding the biological mechanisms involved can provide reassurance about its regrowth.
The Science of Nail Regrowth
Toenails develop from a specialized area at the base of the nail known as the nail matrix. This matrix, largely hidden beneath the skin, produces new cells that become the nail plate. As new cells are continuously generated, they push older cells forward, leading to visible nail growth. The nail matrix is responsible for approximately 90% of nail growth, creating layers of specialized skin cells that harden with keratin.
Toenails grow at a slower rate than fingernails, typically advancing about 1.5 to 2 millimeters per month. A complete toenail regrowth takes approximately 12 to 18 months after being lost or removed. While initial regrowth may be visible within a few months, the full formation of a healthy nail can extend up to two years, depending on various factors.
Factors Influencing Regrowth
Several elements can affect how a toenail regrows, influencing its speed, appearance, and overall success. Damage to the nail matrix is a concern, as severe injury to this area can delay regrowth or cause the new nail to grow back with an irregular shape or texture. If the matrix is too damaged, in rare instances, the nail might not grow back at all.
Underlying medical conditions impact the regrowth process. Conditions such as diabetes or poor circulation can slow nail growth and increase the risk of complications like infections. Fungal infections are a common impediment, as they can cause the nail to become thick, discolored, and brittle, potentially preventing normal regrowth if left untreated. Age also plays a role, with nails growing slower in older individuals compared to younger people. Nutritional deficiencies, certain medications like chemotherapy, and systemic illnesses such as psoriasis or thyroid disorders can influence nail health and growth rates.
Caring for a Missing Toenail
Proper care of the exposed nail bed after toenail loss promotes healthy regrowth and prevents complications. Immediately clean the area with mild soap and water to remove any debris. Applying an antibiotic ointment and covering the area with a sterile bandage protects the sensitive nail bed from injury and infection. This protection is important during the initial 7 to 10 days, allowing the skin of the nail bed to harden.
Protect the toe from further trauma during the regrowth period. Wearing appropriate footwear that does not pinch the toes and avoiding high-impact activities minimizes irritation. Monitor the area for signs of infection, such as increased pain, redness, swelling, or pus, as these symptoms warrant prompt medical attention. If the nail bed does not appear to be healing, or if new nail growth is not observed within a few weeks, consult a podiatrist for guidance and to address any underlying issues.