Nails are transparent keratin plates that grow from their root, located under a thin fold of skin called the cuticle.
Nail growth continues throughout life , but it is faster in fingernails than in toenails and tends to slow down with age.
The nail or the also known “nail plate” has functions such as facilitating the manipulation of objects , helping to exert greater pressure during touch and even maintaining balance when walking.
They are attached to the body by the nail bed, which is the place where the nails receive blood and nutrition from the body that allows them to grow and stay healthy. As they grow, the new cells push out the older cells. These are the ones that acquire a hard consistency and form of a plate that can later be cut without pain, because they do not have living cells.
What health information can our nails transmit?
Curiously, the nails, like the skin, transmit relevant information about our own health. In many cases, its manifestations reveal an undiagnosed pathology.
For example, pale, brittle nails reflect nutritional disorders, such as anemia . When they appear bluish, also known as cyanosis, they indicate problems with oxygenation in the blood, but there may be an underlying cause such as heart problems or Raynaud’s disease.
We have the “watch glass nails” or also called bilateral clubbing that constitute a thickening of the distal phalanges of the fingers and toes. Its most frequent causes are lung disease in 75-80% of cases and even heart disease in 10-15%. Some of these diseases can be cystic fibrosis, COPD, congenital heart disease, etc.
Causes of a nail falling off
The word “ onycholysis ” is made up of Greek roots and means “separation of the nail from the finger”. Onico which means ‘nail’ and lysis which means “destruction”
The complete detachment of a nail or onycholysis, consists of the painless and inflammation-free separation of the nail bed plate in the proximal area, with a new nail appearing below. It can affect both toenails and fingernails.
Main causes for which a nail detaches
Digital trauma is one of the most frequent emergencies attended in the emergency services. They mainly affect children and young adults, and are mostly caused by typical trauma such as a slamming door or being hit with a hammer.
Some cancer treatments can cause damage or changes to the nails. As is the case with chemotherapy. If you are receiving treatment in cycles, your nails may start to grow more slowly between cycles, but may produce white horizontal lines on the nail plate, called Beau’s lines .
Beau’s lines are surface indentations that can appear when growth in the area is interrupted by injury and/or disease. These lines are harmless and will usually disappear once the treatment is over.
Unfortunately, psoriasis does not only affect the skin, but can affect other parts such as the joints and nails. There is nail psoriasis that affects more than half of people living with psoriasis.
Small dimples, yellow-orange spots, small stretch marks, thickening and even falling of the nail can be observed, causing pain in the person’s daily life.
Another of the causes by which a nail can detach is nail tumors . In particular, there is a worrying sign known as Hutchinson’s sign. It is a black, gray or brown discoloration that extends around the nail. This sign may indicate the appearance of a melanoma. There may also be other types of cancer in the surrounding tissues but not in the nail and causing it to fall.
Infections are also a common cause of nail detachment. We call paronychia the infection of the skin that occurs around the nails. Biting your nails or pulling out what we commonly know as a hangnail can cause a bacterial or even fungal infection (candida)
Because of the infection, the nail may look chipped, misshapen, or have an unusual color. The main alarm symptom is pain, redness and swelling. Occasionally pus-filled blisters may appear.
These are just some of the most common causes of nail loss. If we want to minimize the risk of damage, we must pay attention to maintaining a self-care routine to prevent possible complications. Don’t forget that observing can help identify possible health problems. Consult a specialist if you have any doubts.
Elika Hoss, MD., 2021. Paronychia https://medlineplus.gov/spanish/ency/article/001444.htm
Meseguer Yebra, P., & Meseguer Yebra, C. 2013. When nails fall off: onychomadesis. Primary Care Pediatrics, 15(58), e67-e70.
Núñez, PM, Alonso, ER, González, JM, & González, MP 2020. Nail trauma, what is it? and how to treat it? Family medicine. SEMERGEN , 46 (2), 140-144.
Toribio, M., & Galnares, E. 2009. Acropaquias. Family Medicine-SEMERGEN , 35 (8), 415-417.