Mystery of the missing toenail

December 27, 2019 12:08 PM

I just lost a toenail, but I didn't hit my toes, my shoes don't put pressure on the nails and I'm pretty sure I don't have any sort of infection. Are there any other reasons a toenail could fall off?

You are not my podiatrist, etc.

The nail was on my left foot, on the toe next to my big toe - the "index toe," if you will. As stated, I did not bump or stub my toe, there isn't any pressure from my shoes and my feet and other toenails show no signs of a fungal or any other kind of infection. The toenail I lost was not discolored, nor is my nail bed. I didn't feel any kind of pain. All my other toenails are fine. I am in my 40s and generally in good health.

There's a very thin, new toenail growing on the toe and it currently occupies about half the space of the original one. The nail bed underneath appears pink and healthy.

I'm living in a situation where I only have access to emergency medical care, and this doesn't qualify, so I can't ask a podiatrist. I've googled around and since I don't have a history of the main reasons for losing a toenail (injury, improper shoes, infection) I am wondering what other possible reasons there are for losing a toenail.

posted by all the light we cannot see to Health & Fitness (11 answers total)

It can take quite a long time after injury to actually lose a toenail. I lost a thumbnail months after I slammed it in a car door, it I knew it was coming it just took forever.

It could be nutritional in nature, though with those things you'd notice all your nails are brittle.

Bodies are sometimes wierd. Something could have happened that your toe decided to oust it but you just don't remember or it wasn't particularly painful. Honestly i just wouldn't worry about it.
posted by AlexiaSky at 12:28 PM on December 27, 2019

I lose toenails when my autoimmune problems flare up. I've also had the thinner new nail underneath happen, for me the new nail grows out thicker over time
posted by kristicat at 2:15 PM on December 27, 2019

I lost a toenail last year for no apparent reason, one day I just noticed it seemed loose and then it fell off a couple days later. A new nail was already starting to form underneath and it has grown in with no incident. The only thing I can think of with mine is that I do tend to minorly stub my toes on furniture sometimes, and I think I must have stubbed that one a while back and forgotten.

So I can't say for sure why it fell off, I can just say that it happened, like you I had no other symptoms, and it grew in just fine without medical attention.
posted by Serene Empress Dork at 2:22 PM on December 27, 2019

This happened to my teeny tiny pinky toenail this November, it was weird. I brought it up when I visited my parents for Thanksgiving (we are a family that openly discusses medical woes) and my dad said "oh! Yeah that just happens sometimes!" He regularly sees a dermatologist and other specialty doctors for plenty of things and has evidently asked about this before. It's annoyingly one of those mysterious things but if there's no pain, your cuticle is still functioning (growing a new nail) and you're keeping an eye out for other symptoms it's not anything to worry about specifically. Of course visit your regular doctor for preventative care checkups when you can, but it was probably the result of an unmemorable bonk to the toe.
posted by Mizu at 3:26 PM on December 27, 2019

The fact that you had another nail already growing underneath, which has finally overthrown its old toenail overlord, suggests the initiating event here was months ago, so even something that might have been momentarily eventful is lost to short-term memory now. There are very few circumstances in which this is even a symptom of a serious problem. Hair and nails are weird, and as you get older they get even weirder.

You've got this question here as a bookmark, but if you have a Google calendar or whatever you might put a note that this happened, so if it happens again months from now you can start tracking it for later investigation.
posted by Lyn Never at 5:15 PM on December 27, 2019

If it's anything systemic, I think you would see a pronounced trough, roughly corresponding to the length of your new nail, on your other nails, possibly including fingernails.

If there's a smooth arc from cuticle to tip of your other nails, I think you're fine, but if you do have such a trough, I think you should see a doctor and make sure your vitamin B12 levels are checked as part of the visit. Failing that, I would take a high potency B12 supplement for a while, one week of 10,000 mcg a day, and two weeks off, which is what I was prescribed for pernicious anemia.
posted by jamjam at 5:39 PM on December 27, 2019

Yes, you probably had an injury back when the little nail you have now had not yet started growing. That's how it works when you lose your toenails to chemo. When the fast growing cells that produce your toenails get sick from the chemo they miss a growth cycle or two, but you can't see it. The toenails you have are solid and firmly connected. It's only later, after your toe nails start to grow again that you find the place where the growth paused, and the older part of your nail will fall off. It's likely to have been weeks since the insult happened, maybe even months depending on how fast your nails usually grow.
posted by Jane the Brown at 7:55 PM on December 27, 2019

Are you a runner? I am and lose toenails constantly. If not, how are your shoes fitting? Did you break in any new shoes within the past 6mos? Even if they feel like they fit, sometimes new shoes can add weird pressure on different toes.
posted by floweredfish at 1:19 AM on December 28, 2019

I am not a runner. I have mobility issues that affect my ability to walk (nothing to do with my feet) and I spend most of my time in open sandals. My closed-toed shoes are comfy sneakers I have owned for several years.
posted by all the light we cannot see at 8:12 AM on December 28, 2019

I wonder if you had a mild case of hand, foot, and mouth disease? It can feel like a cold and you might not even notice a spot/sore or two but it can cause spontaneous nail loss. It happened to my kid and another friend who is an adult.
posted by jeszac at 11:17 AM on December 28, 2019

Thanks for all the possible explanations, everyone. It remains a mystery, but the nail seems to be growing back nicely.
posted by all the light we cannot see at 9:33 PM on January 15, 2020