Diabetes, also called diabetes mellitus, is a group of metabolic disorders that affects how your body uses your blood sugar called glucose.
When you have diabetes your blood sugar levels can become too high or too low which can cause a variety of health problems including diabetic foot problems.
One of the complications caused by these diabetic foot problems is that your toenails may fall off.
In this article, we will discuss the causes of diabetic toenails falling off, treatment options, and ways to prevent diabetic foot problems altogether.
What is diabetes?
Diabetes is a condition that affects your body’s ability to produce or use insulin.
When you have diabetes, your body either does not make enough insulin (type 1 diabetes) or can not use the insulin it does produce properly (type 2 diabetes).
Insulin is a hormone that helps your cells take in glucose to use for energy.
If your pancreas does not produce insulin or your cells develop insulin resistance it can cause your blood sugar levels to become too high which can lead to serious health problems like heart disease, stroke, kidney disease, nerve damage, and diabetic foot problems.
How does diabetes cause foot problems?
One common complication of diabetes is diabetic neuropathy, which is a form of nerve damage.
Diabetic neuropathy can cause numbness and tingling in your feet or hands and can make it difficult to feel injuries or cuts on your feet which can lead to serious foot problems like ulcers and infections.
Diabetes can also cause peripheral artery disease which reduces blood flow to your feet and can make it difficult for wounds to heal.
Peripheral artery disease happens when plaque builds up in your blood vessels causing them to narrow and resulting in poor circulation.
Due to these two diabetes complications, you are also at an increased risk of infection which can affect your feet including your toenails if it is a fungal infection.
Can my toenails fall off from diabetes?
Yes, one of the complications of diabetic neuropathy and peripheral artery disease is that they can cause your toenails to fall off.
The reason this happens is that diabetic neuropathy can cause a lack of sensation in your extremities, including your feet.
If you get a fungal infection on your toenails you may not notice the nail fungus and your toenail may fall off as a result.
Peripheral artery disease can also cause your toenails to fall off because it can reduce blood flow to your feet and make it difficult for wounds to heal.
If you have diabetes, it is important to see a podiatrist or foot doctor regularly so they can check for any foot problems, including fungal infections or diabetic neuropathy.
What are the symptoms of a fungal toenail infection?
Some common symptoms of a fungal toenail infection include:
- Thicker than normal nails
- Discoloration of your nails as they may turn brown, yellow, or white
- Nails that are crumbly, brittle, or ragged
- A foul odor emanating from your nails
If you have any of these symptoms please seek medical attention from your doctor or podiatrist.
What other medical conditions can cause a toenail to fall off?
Besides having a fungal toenail infection, two other medical conditions that can cause your toenails to fall off are injury and psoriasis.
Injury can occur from something as simple as stubbing your toe or dropping something on your foot.
If your toenail is injured, it may turn black and purple first on your nail bed underneath your nail which is called a subungual hematoma.
Your blood may build up beneath your nail for some time before the nail falls off.
Seek medical attention from your doctor, podiatrist, or health care provider if you have severe pain or throbbing pain as they can relieve the pressure by drilling a small hole in your nail.
Psoriasis is a skin condition that can cause red, scaly patches to form on your skin and nails due to a buildup of skin cells.
If you have psoriasis, you may also experience pitting of the nails which is when small depressions form on the nail surface. Other symptoms include:
- Misshapen nails
- Thicker nails
- Yellow or brown discoloration of your nails
- Buildup underneath your nails on your nail bed of a chalky-looking substance
If you have these symptoms please talk to your doctor as it is treatable.
What are the treatment options for when a toenail falls off?
Before highlighting the different treatment options there are a few things you can do when you first notice your toenail falling off including:
- Do not remove the rest of the nail if only part of it falls off
- Carefully use nail clippers to clip and detach the part of the nail falling off if it is still attached to your toe
- Use a nail file to file any rough or jagged edges
- Wash your toe with mild soap and apply an antibiotic ointment after drying it
- Use a bandage to cover the affected area and change the bandage regularly
- Seek medical treatment if you are in severe pain, your toe is throbbing, the whole nail falls off, or your toe will not stop bleeding
If your toenail falls off, there are a few different treatment options that your doctor may prescribe depending on the underlying cause.
If you have a fungal infection, your doctor may prescribe oral antifungal medication or topical antifungal medication that you apply directly to the nail and surrounding skin.
The treatment for a toenail falling off due to psoriasis involves using topical steroids on your nail and cuticles or phototherapy using UV light.
If your toenail is falling off due to injury you can elevate your foot, soak it in cold water for about 20 minutes, and take ibuprofen (Advil) for any pain you may be experiencing.
You will also want to follow the steps listed above before treating any injury to your nails.
Your doctor may also prescribe a nonsteroidal anti-inflammatory drug (NSAIDs) to help with the pain and, in rare cases, they may need to remove the nail.
What complications can be caused by a toenail falling off?
The most common complication that can be caused by a toenail falling off is an underlying infection.
If you have diabetes, an underlying infection can cause diabetic foot problems such as diabetic ulcers which are open wounds that do not heal.
Diabetic ulcers can lead to more serious issues such as gangrene and amputation. Signs of an infection include:
If you have any of these symptoms please seek medical attention immediately.
What are the best ways to prevent diabetic foot problems?
The best ways to prevent diabetic foot problems are to monitor your blood glucose levels to ensure they are in your target range and to manage your diabetes.
To manage your diabetes you may have to make some lifestyle changes such as eating a healthy diet, exercising regularly, maintaining a healthy weight, and taking all medicines as prescribed by your doctor. Other ways to prevent diabetic foot problems include:
- Checking your feet every day for any cuts, scrapes, bruises, blisters, or redness, and seek medical attention if you find any
- Washing your feet every day with mild soap and warm water and drying them thoroughly, especially between your toes
- Moisturizing your feet with lotion to keep the skin from cracking
- Wearing diabetic socks that do not have seams and fit well to help reduce friction
- Do not smoke as it decreases blood flow to your feet
- Wearing comfortable shoes that fit properly even in your own home
- Wearing clean, dry socks every day
- Trimming your toenails straight across to avoid ingrown toenails
By following these health tips you can help prevent diabetic foot problems and other diabetic complications.
Diabetes is a condition that can cause foot problems and one of the problems that can occur is your toenails falling off due to a fungal infection.
Toenails can also fall off due to psoriasis or injury too and your treatment plan will depend on the underlying cause.
There are a few things you can do when you first notice your toenail falling off including elevating your foot and carefully using nail clippers to detach part of the toenail if it is still attached to your nail among several other tips we listed above.
Be sure to see your doctor if you have any diabetic foot problems as they can lead to more serious issues such as diabetic ulcers.
You can prevent diabetic foot problems by managing your diabetes and making sure you have healthy feet by following our health tips.
If you have any questions about your toenails or diabetic foot problems, please talk to your doctor, podiatrist, or health care provider.
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Fact Checked and Editorial Process
Diabetic.org is devoted to producing expert and accurate articles and information for our readers by hiring experts, journalists, medical professionals, and our growing Diabetic.org community. We encourage you to read more about our content, editing, and fact checking methods here. This was fact checked by Jacqueline Hensler and medically reviewed by Dr. Angel Rivera.
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