Children's fingernails

11.09.2019
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Torn or Detached Nail | CS Mott Children's Hospital

Topic Overview

What causes a detached nail?

It can be very painful to tear or rip your nail from the nail bed. A nail may separate from the nail bed (detach) for many reasons, including:

  • Injuries.
    • Separation caused by injury is common in people who have long fingernails. The nail may pry away from the nail bed when it is hit or jammed.
    • Severe or repetitive toe stubbing may cause a toenail to detach. This is also common in athletes who wear shoes that aren't roomy enough.
  • Fungal nail infection, which occurs when fungi invade a fingernail or toenail and the skin underneath the nail (nail bed). Toenails are more commonly affected than fingernails, and symptoms include cracked, yellow, discolored, streaked, thickened, or spotted nails.
  • Skin conditions, such as psoriasis.
  • Chemicals, such as acetone nail polish removers or some soaps.
  • Medicines, such as chemotherapy or antimalarial medicines.
  • Severe illnesses.

After a nail separates from the nail bed for whatever reason, it will not reattach. A new nail will have to grow back in its place. Nails grow back slowly. It takes about 6 months for a fingernail and up to 18 months for a toenail to grow back.

How is it treated?

Home treatment often helps relieve pain, promote healing, and prevent infection. Treatment may involve removing the nail, keeping the area dry to prevent infection, and waiting for a new nail to grow. The infection or skin condition that caused the separated nail will also need to be treated.

  • File any sharp edges smooth, or trim the nail. This will help prevent catching the nail and tearing it more.
  • Trim off the detached part of a large tear, or leave the nail alone.
    • Cover the nail with tape or an adhesive bandage until the nail has grown out enough to protect the finger or toe.
    • If you trim off the detached nail, you will have less worry about the nail catching and tearing.
    • If you leave the detached nail in place, it will eventually fall off when the new nail grows in.
  • Use scissors to remove the detached part of the nail if the nail is partly attached.
  • Soak your finger or toe in cold water for 20 minutes after trimming the nail.
  • Apply a thin layer of petroleum jelly, such as Vaseline, and cover the area with a nonstick bandage.

To prevent infection:

  • Soak your foot or hand in a solution of 1 tsp (5 g) of salt dissolved in 4 cups (1 L) warm water for 20 minutes, 2 or 3 times each day, for the next 3 days. Reapply petroleum jelly, and cover with a fresh adhesive bandage.
  • Keep the nail bed dry, clean, and covered with petroleum jelly and an adhesive bandage until the nail bed is firm or the nail has grown back. Apply a new adhesive bandage whenever the bandage gets wet.
  • Watch for signs of infection such as increasing heat, redness, pain, tenderness, swelling, or pus.
  • Remove an artificial nail if it separates from the nail bed. If you leave it on, the long, artificial nail can tear the nail bed.

Have a doctor trim your nail if you:

  • Aren't comfortable trimming the nail yourself.
  • Have diabetes, peripheral arterial disease, or an immune system problem. These problems may cause reduced blood flow and loss of feeling in the feet. Untreated nail injuries can lead to infection, foot ulcers, and other serious problems.

Credits

Current as ofApril 1, 2019

Author: Healthwise Staff
Medical Review: William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Adam Husney, MD - Family Medicine
Martin J. Gabica, MD - Family Medicine

Current as of: April 1, 2019

Author: Healthwise Staff

Medical Review:William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Adam Husney, MD - Family Medicine & Martin J. Gabica, MD - Family Medicine


children's fingernails
Hands of Children: Fingernail Disorders in Childhood! 1/2
NAIL DISEASES IN CHILDHOOD

Nail formation is accomplished by the end of the second trimester of fetal development. The nails in postmature infants usually extend beyond the hyponychium. However, the nail plate of some infants is shorter than the distal nail pulp, resulting in a pseudo-ingrowing appearance, especially of the toenails. The nail apparatus can be affected by a wide spectrum of congenital, familial or acquired disorders.

Anoxia at delivery, premature and birth trauma may cause nail dystrophy, abnormal color and shape.

Drugs administered to the mother during the first and second trimester of pregnancy are extremely significant factors for nail formation. Phenytoin provokes hypoplasia and longitudinal pigmented bands, warfarin causes hypoplasia and alcohol causes possible anonychia of the fifth digits.

Eczema, psoriasis, lichen planus, AA, epidermolysis bullosa, herpetic whitlow and onychomycosis are the most common diseases affecting nails in childhood.

There are several nail variants at birth, considered to be normal alterations. Although nail dystrophies are quite often a cosmetic problem, sometimes may be important signs of congenital or systemic diseases.



NORMAL NAIL DISORDERS IN THE HANDS OF CHILDREN

There are at least 7 'normal' nail findings in newborns, infants and children, including: (1) Beau's lines, (2) fragile nails, (3) pits of the nail plate, (4) koilonychia, (5) v-ridging (chevron nails), (6) punctate leukonychia, and (7) periungual pigmentation.

Transverse depressions: Beau's lines.Beau's lines.

• 1 - Transverse Depressions - Beau's Lines: A total of 92% of normal infants between 8 and 9 weeks of age have a single transverse depression on the nail plate as a consequence of parturition. This depression grows out to the distal edge. Beau's line in all 20 nails presenting soon after birth appears to be associated with intrauterine distress.

Onychoschizia: splitting fingernail disorder.

• 2 - Fragile Nails With Transverse Lamellar Splitting at the Free Edge (Onychoschizia): Onychoschizia is common in the first few years and is, at most, noted on thumbs and big toes. It is unclear why this change arises, but thumb sucking, nail biting and repeated trauma are thought to be the most common exacerbating factors.

Pits: nail pitting.Fingernail pits: nail pitting.

• 3 - Pits of the Nail Plate - nail pitting:

Small and shallow or large and deep, involving few or all 20 nails, pits of the mail plate may be caused by alterations in the proximal matrix. Pits may be seen in psoriasis, atopic dermatitis or AA.

Koilonychia = spoon-shaped nails.Koilonychia.

• 4 - Koilonychia - spoon-shaped nails:

Koilonychia is defined as a concave dorsal surface, sufficient to hold a drop of water. This condition is common in neonates and early childhood, usually on the great toenails, is caused by the fact that nails at this age are thin and soft, and it spontaneously resolves in a few years. There is a correlation between koilonychia and mild iron deficiency in infants. Although koilonychia is a temporary physiological condition in infants, it may also result from several congenital and acquired causes, such as ectodermal dysplasias, trichothiodystrophia, LEOPARD (lentigines, EKG abnormalities, ocular hypertelorism, pulmonary stenosis, abnormalities of genitalia, retardation of growth and deafness) syndrome, nail-patella syndrome, thyroid diseases, Plummer-Vinson syndrome, AA, psoriasis, lichen planus and Darier's disease, or may be idiopathic or traumatic.

Punctute leukonychia.Koilonychia.

• 5 - Punctate Leukonychia:

A few or numerous small white scattered opacities may be seen in the childhood nail. A trauma in the nail matrix area, is the most probable cause of this common condition.

Periungual pigmentation.

• 6 - Periungual Pigmentation:

Light brown to ochre pigmentation on the dorsal aspect of distal digit, has been reported recently in Caucasians infants between the age of 2-6 months and regress spontaneously before the age of 1 year.

Chevron Nail (V-shaped ridging).

• 7 - Chevron Nails (V-shaped ridging):

Fingernails in early childhood often show superficial longitudinal oblique ridges, across the nail plate diagonally, from the matrix to the distal margin, forming a V-shaped pattern. Schuster proposed the term 'chevron' instead of the old term 'herring bone'. Chevron nails remain of unclear significance and regress spontaneously in early adolescence.



How can I Help my Children Stop Biting Their Fingernails?
anon325473
Post 6

I bite my nails and it's embarrassing when people see me biting or if they just see my nails and nothing! It works.

anon164947
Post 4

I bit my nails as a child and still catch myself now. My mom used all sorts of no bite polish to no avail. I now have a daughter who is only 2 1/2 years old and she also chews her nails. Her father who she has only met two or three times chews his nails too. Is this hereditary?

GenevaMech
Post 3

When I was a child, my parents helped me stop biting my nails by positive reinforcement and rewards. My parents never scolded for chewing my nails, and for the times that I stopped chewing them they took me somewhere fun. It was hard to stop chewing my nails and a little embarrassing, but with their help, I eventually grew out of it.

Comparables
Post 2

@Fiorite- Maybe it was stress that was making you pick at your cuticles. I didn't stop biting my finger nails until I started addressing the things that make me stressed out. I started finding things to do to lower my stress levels and I slowly began to forget about my fingernails. I started to do things like play the bass, take a nightly walk, and make more time for exercise, and I broke a number of bad habits.

Your moment of reflection sounds similar. It sounds like you didn't like your state of mind/being, so you made a conscious effort to change that.

Fiorite
Post 1

When I was a kid, my problem was picking at my cuticles rather than biting my nails. My mother tried all kinds of things to get me to stop picking my cuticles, but it did not work. I did not stop until I was an adult. One day I just made the conscious effort to change a few bad habits. I quit smoking cigarettes, stopped picking at my cuticles, and began to really focus on a healthy diet. There was no other reason than the fact that I was not happy with where I was at, and wanted to change that. I guess the point of my little story is that some habits simply die hard. You can only change these habits if you want to change them.

12 Disease Signs — Found On Our Fingernails

You’ve likely had a health care provider check your blood pressure, pulse or listen to your heart. They can give indications about your overall health.

Here’s another health indicator that you may not be familiar with: Your fingernails! Changes in their appearance can be an indicator of a range of conditions.

If you notice a change in your fingernails, don’t panic. Just contact your health care provider and describe the change you see. Your provider can give you a recommendation for next steps.

Here are 12 disease symptoms that can show up on your fingernails:

 

White Nails

Your fingernails will naturally have white at the tips. However, if your whole nail is white or noticeably pale, this could be a sign of:

 

Pale Nails

This can be a sign of a serious illness such as:

  • Anemia
  • Congestive heart failure
  • Liver disease
  • Malnutrition

 

Yellow Nails

Nails often turn yellow after nail polish has been used for long periods of time. However, yellow nails can also be a sign of:

 

Blue Nails

If your fingernails have a blue tint, this could be a sign that your body isn’t getting enough oxygen. It could also be a side effect from a drug you are taking, or a sign of:

  • Lung issues (such as emphysema)
  • Heart problems
  • Excessive silver consumption
  • Bacterial infection of the nail
  • Wilson’s disease (a genetic condition that causes high levels of copper in the body)

Red Streaks in the Nail

This may be the result of several conditions, including:

  • Trauma
  • Psoriasis
  • Fungal infection
  • Heart valve infection
  • Blood vessel inflammation (vasculitis)

Dark Lines Beneath the Nail

If you notice dark lines that are about as wide as a pen’s ink cartridge, this could be a sign of melanoma. This is a dangerous type of skin cancer. If you notice this, see your health care provider promptly.

Other causes of dark lines beneath the nail are more common and not dangerous. These include moles, trauma and medication induced changes. It’s also common for people with darker skin types to have noncancerous dark lines under the nails.

 

Split or Cracked Nails

If your nails become brittle or if they split repeatedly, this could reveal:

  • Thyroid disease
  • Psoriasis
  • Repeated trauma, especially frequent contact with water (e.g. hand washing, dish washing, bathing, etc.)
  • Medication side effects

When the cracking or splitting is accompanied by a yellow color, the cause could be a fungal infection.


Nail Clubbing

This happens when the tips of your fingers enlarge a little and the nails curve over the fingertips. This usually takes years to happen. This could be a sign:

 

Puffy, Red Nail Fold

The nail fold is the skin at the base of the nail where your nail grows from; it’s often called the cuticle. If your nail fold is puffy, this is due to inflammation. The most common cause of nail fold inflammation is a skin infection from bacteria, viruses or yeast. Less commonly, this can happen because of lupus or other connective tissue disorders.

Ridges on the Nails

The direction of the ridges is important to notice. If ridges are parallel to your fingers, it may simply be a reflection of aging or chronic trauma, including repeat wet/dry cycles and contact with water. Ridges may reflect a lack of vitamins or poor nutrition.

If the ridges are across the nail, this could be a sign of:

  • Diabetes
  • Severe injury
  • Past illness or medication exposure

 

Rippled or Pitted Nails

Small pinpoint depressions of the surface of the nail often occur after trauma to the surface of the nail. Sometimes they occur in patients with particular types of hair loss and arthritis. They can also be associated with underlying skin disorders including:

  • Psoriasis
  • Eczema

 

Nail Lifting

This is when the surface of the nail (called the nail plate) separates from the underlying skin (called the nail bed). There are many causes of this including:

  • Medication side effects
  • Psoriasis
  • Fungal infection
  • Trauma
  • Pregnancy
  • Thyroid disease

 

Your Next Steps

If you notice one of these conditions on your fingernails, see your health care provider. Your provider can give you guidance about additional steps that may be needed to make an accurate diagnosis.

Get more helpful health news on the Aurora Health Care Facebook page!

The information presented in this site is intended for general information and educational purposes. It is not intended to replace the advice of your own physician. Contact your physician if you believe you have a health problem.

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