What is nail avulsion?

Losing a toenail or fingernail because of an injury is called avulsion. The nail may be completely or partially torn off after a trauma to the area.

Your doctor may have removed the nail, put part of it back into place, or repaired the nail bed. Your toe or finger may be sore after treatment. You may have stitches.

You may have some swelling, color changes, and bloody crusting on or around the wound for 2 or 3 days. This is normal. Taking good care of your wound at home will help it heal quickly and reduce your chance of infection.

The wound should heal within a few weeks. If completely removed, fingernails may take 6 months to grow back. Toenails may take 12 to 18 months to grow back. Injured nails may look different when they grow back.

• If possible, prop up the injured area on a pillow anytime you sit or lie down during the next 3 days. Try to keep it above the level of your heart. This will help reduce swelling.
• Leave the bandage on, and if you have stitches, do not get them wet for the first 24 to 48 hours. Use a plastic bag to cover the area when you shower.
• If your doctor told you how to care for your wound, follow your doctor's instructions. If you did not get instructions, follow this general advice:
  • After the first 24 to 48 hours, you can remove the bandage and gently wash around the wound with clean water 2 times a day. If the bandage sticks to the wound, use warm water to loosen it. Do not scrub or soak the area.
  • You may cover the wound with a thin layer of petroleum jelly, such as Vaseline, and a nonstick bandage.
  • Apply more petroleum jelly and replace the bandage as needed.
• Do not go swimming.
• If you have stitches, do not remove them on your own. Your doctor will tell you when to return to have the stitches removed.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

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 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 acrylic-based gel polishes.
• Medicines, such as chemotherapy or antibiotics.
• 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 or longer for a fingernail and up to 18 months for a toenail to grow back.