Causes of a Loose Toenail or Fingernail

Having a loose toenail or fingernail can be a troubling symptom, especially if you don't know what caused it. Usually, getting a loose nail is a gradual process that only impacts part of the nail. However, in certain cases, like if there's been trauma to the nail, the entire nail can come loose rather quickly.

This article explores the reasons why a nail may detach from the nail bed. It will also cover what to do if your nail is loose and what treatment options are available.

Basic Nail Anatomy

The nail, also called the nail plate, is tightly connected to the skin beneath it, known as the nail bed. The half-moon shape at the base of the nail, beneath the cuticle, is known as the lunula. The lunula is part of the nail matrix, which is where the growth of the nail occurs.

Any damage to the nail matrix can cause a nail to separate from the nail bed and become loose.

What Are Common Causes of Nail Loosening?

Common causes of your nail loosening or detaching from the nail bed may include:

• An infection
• Trauma
• Your footwear
• A health condition
• An allergic reaction
• Certain cancer treatments

Fungal Infection

Nail fungal infections, called onychomycosis, can affect the nail or nail bed. While this type of infection is commonly found in toenails, it can also occur in fingernails.

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Symptoms of this slow-growing nail fungal infection may include:

• Nail thickening
• Nail discoloration
• Debris under the nail
• Nail loosening

The area where the nail is loose may have a white appearance where it has separated from the underlying nail bed.

Trauma

Nail trauma can lead to nail loosening, and possibly even complete loss of the nail. Nail trauma may occur if:

• Something heavy was dropped on the nail
• Something crushed the nail
• A door was slammed on the nail

Bleeding beneath the nail may cause enough pressure for the nail to loosen and possibly even fall off. Be sure to reach out to your doctor if you experience nail trauma, especially if there is bleeding.

Shoewear

It is possible for shoes to cause repeated trauma to your toenails. This may occur while:

• Running
• Walking long distances
• Hiking
• Participating in an endurance sport

With trauma, blood may build up beneath the nail and cause red, purple, or black discoloration. This is known as a subungual hematoma, or black toenail. Quite often, you will lose the nail as it grows out.

Repeated long-term rubbing of the toe against the tip of the shoe may also result in the nail edge coming loose without any bleeding beneath the nail.

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Other Causes

A loose and/or lifted nail may be caused by:

• An allergic reaction to manicure/pedicure products
• Nail psoriasis, a long-term skin condition
• A photosensitivity (light sensitivity) reaction to a medication
• Hyperthyroidism, which is when your thyroid gland is overactive
• Treatment for cancer, known as chemotherapy

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How Do You Treat a Loose Nail?

To treat a loose nail, it's best to see a foot and ankle doctor called a podiatrist, or a skin, hair, and nail doctor called a dermatologist. Your doctor may be able to diagnose your condition based on its appearance, but they may also run some tests. Treatments will vary based on the underlying issue.

• For fungal infections, your doctor may cut away loose portions of the nail, and possibly prescribe anti-fungal medications.
• For nail trauma, you may need to visit an urgent care clinic to drain the blood, cut the nail, or remove the nail. They may also prescribe antibiotics if the nail becomes infected.
• For nail psoriasis, your doctor may give you a topical or oral medication, and/or a steroid injection in the nail.

Will the Nail Grow Back?

After losing a nail or part of it, you may wonder if your nail will grow back and what it will look like. Typically, the exposed nail bed will heal within a few weeks and the nail will grow back. However, it can take 12 to 18 months for the nail to grow back and it may look different. If the nail matrix is damaged then the nail may grow back abnormally or not at all.

Summary

Reasons why you may have a loose nail include:

• An infection
• Trauma to the nail
• Your shoes
• A health condition, such as psoriasis or hyperthyroidism
• An allergic reaction
• Chemotherapy treatment

Treatment for a loose fingernail or toenail will vary based on the underlying cause. If you have a loose nail, it's best to reach out to your doctor. They may suggest certain medications or procedures based on your symptoms.

If your loose nail falls off or is trimmed short, it will likely grow back. However, keep in mind this can take up to 18 months and your nail will probably look different.