What to Do About a Loose Toenail

It can be distressing to look down at your feet a notice a loose toenail that’s just barely hanging on, particularly if it’s summer and you love to wear sandals. Although that loose toenail is inevitably going to come off, another one will grow back in its place in several months. Unfortunately, the process can be slow. What causes a loose toenail and what can you do to prevent it in the future?

The two most common causes of a loose toenail are injury to the nail and fungal infection. If you’re a runner, you’ve more than likely experienced the loose toenail phenomenon at some point in your running career. It’s most likely to happen after wearing a new pair of running shoes that are too narrow through the toe area, causing your toe to be traumatized repeatedly when you run. This can be a sign that the toe box on your running shoe is too narrow.

Other athletic maneuvers that can cause a toenail injury is kicking a ball when playing soccer or kickball. In this case, the skin underneath the toenail can turn black due to bleeding under the nail secondary to the trauma of smacking the toe into the hard surface of the ball repeatedly. A loose toenail can sometimes be prevented in these cases if you have your doctor drain the blood from beneath the toenail immediately after the injury.

If you’re not an athlete and have a loose toenail, there’s a good chance it’s caused by a fungal infection. In addition to the loose toenail, you may see discoloration beneath the nail surface and the nail may become brittle in texture. Although the toenail can sometimes be saved if the fungal infection is treated before the nail becomes loose, once the nail loosens, it will usually be lost. Unfortunately, once the toenail comes off, the new nail will likely be infected with fungus just like the old one. For this reason, it’s important to talk to your doctor about antifungal treatment to completely clear the fungal infection.

What’s the best way to prevent a loose toenail? If you’re an athlete or a runner, take the time to get your running shoes professionally fitted so you reduce the risk of trauma to the nails when running. It’s particularly important to have sufficient room in the toe box area. It’s also important to keep the toenails trimmed so they’re less likely to hit the tips of your shoes during athletic movements.

To prevent fungal infection, keep your feet as dry as possible by wearing cotton socks that “breathe. Allow your shoes to dry after wearing them to reduce unwanted moisture that can be a breeding ground for fungi. It may also help to apply a layer of foot powder to further reduce moisture.

If you’re an athlete, you may have to deal with an occasional loose toenail but taking a few steps to ensure your shoes and socks are dry and fit properly can certainly decrease their frequency.