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Do toenails grow back if its all ripped off?

Quick Answer

Yes, toenails often do grow back after being completely ripped off, but it can take several months for the nail to fully regrow. The toenail root is still alive underneath the nail bed and will start growing a new nail. However, there are times when a toenail won’t grow back or will grow back abnormally if the nail root is severely damaged.

What Happens When You Rip Off a Toenail?

Ripping off a toenail completely is an extremely painful experience. When you rip off a toenail, you are removing the entire visible nail plate from the nail bed. Underneath the toenail, there is a nail root that sits within the nail matrix at the base of the nail bed. This nail root contains cells that rapidly divide and enable the toenail to grow.

When you rip off the nail, you are removing the dead and hardened nail plate, but the nail root remains intact. As long as the nail root is undamaged, it will start generating new nail plate cells, and the toenail will begin to grow back.

The Toenail Regrowth Process

After a toenail has been removed or ripped off, this is the general regrowth process:

Timeframe Regrowth Process
1-2 weeks A small amount of new nail growth may start to be visible at the base of the nail bed.
4-8 weeks About 1/4 of the new nail has visibly grown back. The new part of the nail will look distorted or misshapen.
3 months At least 2/3 of the nail has grown back, and the nail is reaching the nail tip.
6-12 months The nail has fully regrown, although the new nail plate may look abnormal or distorted at first. The nail’s appearance typically improves over time.

It takes about 6 months for a fingernail and 12 months for a toenail to fully regrow. However, in some cases it may take up to 18 months for a toenail to completely grow back.

Factors That Affect Toenail Regrowth

Several factors can influence how quickly and successfully a ripped off toenail is able to regrow:

Damage to the nail root/matrix – If the nail root at the base of the nail bed is severely damaged when the nail ripped off, the nail growth may be permanently impaired. The nail root may only partially regrow, resulting in nail deformities.

Damage to the nail bed tissue – The nail bed provides structure and nutrition to support nail growth. If this tissue is damaged, it can disrupt normal nail regrowth.

Poor circulation – Reduced blood flow to the feet and toes can slow the rate of nail cell production and regrowth. Certain conditions like diabetes and peripheral artery disease can impair circulation.

Nutrition – Vitamins and minerals like calcium, zinc, biotin, and iron support nail health and growth. A nutrient-deficient diet may therefore slow toenail regrowth.

Toenail fungus – A fungal toenail infection can attack the nail root and bed and prevent proper nail regrowth. The new nail may be brittle, discolored or distorted.

Age – Toenails grow more slowly as we age. Older adults may find it takes longer for a toenail to fully regrow compared to younger people.

Will the New Toenail Grow Back Normally?

In many cases, yes—the new toenail is able to regrow back normally over time if the nail root remains undamaged after the initial nail ripping.

However, it is also fairly common for the new nail to initially grow back with some abnormalities, such as:

– Thickening or distortion of the nail plate
– Deformities in nail shape
– Horizontal ridges or grooves on the nail surface
– Improper reattachment of the nail plate to the nail bed

This happens because when the nail plate is forcefully ripped off, it can disrupt the nail matrix where nail cells are formed. Damage to this area can affect the growth and appearance of the new nail.

With proper care, many of these abnormalities often improve on their own within 6 to 12 months as more normal-appearing nails grow out. But in some cases, the cosmetic defects are permanent if the nail root suffered severe, irreparable damage when the nail ripped off initially.

Can a Toenail Fail to Grow Back?

In most cases, the toenail root is able to heal after the nail plate tears off, allowing regrowth of a new nail. But sometimes, a toenail fails to grow back normally or at all, a condition called “nail dystrophy.”

This can happen for several reasons:

Severe Damage to the Nail Matrix

The nail matrix found along the base of the nail bed contains specialized epithelial cells that stimulate rapid nail growth. If the nail matrix suffers severe trauma when the nail plate rips off, the nail growth center can be permanently impaired. The matrix may only be able to stimulate partial or abnormal nail growth.

Chronic Nail Bed Injury

Repeated injury to the nail bed, such as from poorly fitted shoes, can create scar tissue and inhibit the nail plate from reattaching properly during regrowth. The constant trauma disturbs the nail matrix and prevents normal nail regeneration.

Underlying Medical Conditions

Certain medical conditions are associated with failure of toenails to properly regrow, including:

  • Psoriasis
  • Systemic lupus erythematosus
  • Lichen planus
  • Peripheral vascular disease
  • Raynaud’s disease

The inflammation and reduced blood supply from these conditions can damage the nail root and disrupt nail growth. Fungal infections of the nail may also spread to the matrix and impair nail regeneration.

Allergic Reaction

Rarely, a severe allergic reaction can develop after a toenail is ripped off, triggering chronic inflammation and granuloma tissue that prevents proper nail regrowth.

Treatment for Toenails That Won’t Grow Back

If a toenail fails to grow back normally after several months, these treatment approaches may help:

– Prescription antifungal medication – for fungal nail infections impairing growth
– Steroid injections – to reduce inflammation and stimulate nail growth
– Medicated nail lacquers containing tazarotene or cyclosporine
– Nail bed grafting – surgically implanting new nail matrix tissue
– Partial nail removal – permanently removing the damaged part of the nail
– Plastic nail prosthetic – artificial nail attached to the nail bed

In some cases where the nail damage is untreatable, the toenail may need to be fully and permanently surgically removed to relieve discomfort.

Preventing Toenail Regrowth Problems

You can reduce the risk of regrowth issues after ripping off a toenail by:

– Cleaning and disinfecting the nail bed after nail removal to prevent infection
– Bandaging the toe to protect the nail bed from friction and repeated injury
– Wearing proper fitting shoes to avoid chronic toenail trauma
– Treating any underlying medical conditions impairing nail growth
– Maintaining a nutritious diet to support nail matrix health
– Abstaining from picking or peeling the nail during regrowth

The Takeaway

In most situations, a toenail is able to grow back after it has been completely ripped off, provided the nail matrix remains intact. However, the regrowth process takes many months, and the new nail may initially have an abnormal appearance or texture. With proper nail bed care and barring underlying medical conditions, the nail can fully regenerate, although some cosmetic defects may remain permanent. Consulting a podiatrist can help determine the prognosis and best treatment when a toenail fails to properly regrow after trauma.