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Toenail avulsion is the tearing away or removal of one’s toenail, which can involve only a section of the nail or the entire toenail. Often, it is torn away because of an injury of some sort. Sometimes, however, it can fall off as a result of an infection. Additionally, there are cases in which a doctor may find it necessary to remove a person’s nail. Any toenail can be torn away or fall off, but the big toenail is the most commonly affected.
Frequently, a person suffers toenail avulsion because of injury to his foot. For example, a person could drop something extremely heavy on his foot and have it torn away. A person might also stub his bare foot hard enough to lose much of his toenail. Sometimes avulsion happens right after or during the injury, but in other cases the toenail may sustain damage and fall off later.
Runners often deal with the loss of toenails. Often, the repetitive stress and friction on a runner’s big toenail lead to toenail avulsion, which may be more common in people who run for long distances or focus on downhill movement. Wearing running shoes that are too tight can also contribute to the problem, as can socks that are too tight or overly thick. Often, a runner’s big toenail turns red or black before it falls off. The change in coloring typically results from broken blood vessels or blood blisters beneath the nail.
Toenail infections are fairly common among people of all ages, and can cause toenail avulsion. These infections are marked by changes in color and nail thickening. In time, it may also start to crumble and pull away from the nail bed. At this point, even the slightest injury can cause the nail to tear away from the bed, but some infected nails fall off on their own. A new nail grows, but this doesn’t always mean the person is cured. Often, the infection includes the nail bed, and the new nail becomes infected as well.
Sometimes doctors remove a person’s toenails on purpose. This may occur as a treatment for severely infected toenails that do not respond to medication or other treatments. In other cases, a doctor may remove a toenail that curves inward at the sides or from the outer corner of the nail, causing extreme pain. Additionally, he or she may remove an injured toenail to promote healing and prevent infection.
When the avulsion does not occur because of an infection, the affected person will usually regrow a healthy nail. Often, however, he may have to wait a year or more for it to grow in fully. During that time, he may need to take care to avoid injuring the vulnerable nail bed. A person may also bandage the toenail to protect it, especially if it is bleeding. A doctor’s evaluation is usually helpful for infected toenails and those that are hanging off but not yet torn away.