Nails are complex structures that protect our fingertips and toes. Sometimes, they don’t grow back as expected after an injury or change. Understanding the underlying reasons for impaired nail regrowth can help address the issue effectively.
Understanding Nail Growth
Nails grow from a specialized area called the nail matrix, hidden beneath the skin at the proximal nail fold. This matrix continuously produces new nail cells. As new cells form, they push older cells forward, causing them to flatten, harden, and become translucent due to keratin, a tough protein.
This continuous process forms the nail plate, which then slides along the nail bed. The nail matrix’s health is directly tied to nail growth. Fingernails typically grow about 3.5 millimeters per month, while toenails grow roughly half as fast. If a fingernail is lost, it can take three to six months to fully regrow, and a toenail may take 12 to 18 months.
Common Reasons for Impaired Nail Regrowth
Several factors can disrupt nail growth, leading to a nail not growing back or exhibiting abnormal growth.
Trauma or injury
Trauma or injury to the nail unit is a frequent cause of impaired nail regrowth. Damage to the nail matrix, such as from crushing injuries or severe impacts, can disrupt or permanently halt growth. Severe trauma may lead to lasting deformities if the matrix is significantly damaged. If the nail completely separates from the nail bed (avulsion), regrowth is still possible, but it depends on the extent of matrix damage.
Fungal infections
Fungal infections, also known as onychomycosis, are a common cause, particularly for toenails. These infections can discolor the nail, often white, yellow, or brown, and may lead to thickening, brittleness, or crumbling. Fungi can affect the nail plate and matrix, impeding normal growth.
Bacterial infections
Bacterial infections, such as paronychia, involve inflammation and swelling around the nail fold. These infections occur when bacteria enter through broken skin near the cuticle, causing pain, redness, and pus. If severe or chronic, the inflammation can interfere with nail growth.
Underlying medical conditions
Underlying medical conditions can manifest as nail abnormalities and slow growth. Systemic diseases like psoriasis, eczema, and thyroid disorders can affect nail health. Iron deficiency can cause nails to become spoon-shaped or brittle. Poor circulation can also lead to changes in nail appearance and growth.
Certain medications
Certain medications may have side effects that impact nail growth. Chemotherapy drugs are known for causing nail changes, including temporary cessation of growth or abnormalities like Beau’s lines. Other drugs, including some antibiotics and retinoids, can also affect nail growth or cause the nail to separate from the nail bed.
Aging
Aging naturally influences nail growth. As individuals get older, nail growth slows, and nails may become dull, brittle, and thicker, particularly toenails. Nail growth can decline by about 0.5% per year after age 25.
When to Seek Medical Attention
Seek medical advice if you notice persistent or concerning changes in your nails. Consult a general practitioner if a nail has changed shape, color, or fallen off without a clear reason. Signs of infection, such as persistent pain, swelling, redness, warmth around the nail, pus, or a foul odor, warrant a doctor’s visit.
Significant discoloration, changes in nail texture, or a nail not growing back after several months (for fingernails) or a longer period (for toenails) are reasons to seek medical evaluation. If there is no obvious injury but growth is impaired, or if you suspect a fungal or bacterial infection not resolving with self-care, a healthcare provider can diagnose and recommend appropriate treatment. Concerns about underlying health conditions potentially affecting nail health should prompt a medical consultation.
Tips for Healthy Nail Regrowth
Once underlying medical issues have been addressed, several practices can support healthy nail regrowth and overall nail health.
Protecting nails from further injury and harsh chemicals is important. Wear gloves for household chores or when handling cleaning products. Avoiding the use of nails as tools can prevent damage to the nail bed.
Maintain good nail hygiene. Keeping nails clean and dry helps prevent bacterial and fungal growth. Regular trimming, cutting nails straight across, and gently filing them can promote healthy growth.
Moisturization is also beneficial for nail health. Applying lotion or oil to the nails and cuticles helps keep them hydrated, preventing dryness and brittleness.
A balanced diet contributes to overall health, including nail health, by providing essential nutrients. Adequate protein, vitamins, and minerals support nail strength. Patience is important, as nail regrowth is a slow process.