Black toenails - what to do if your toenail falls off

So you lost a toenail. It happens. 

Blame both ill-fitting shoes and training for full or half-marathons, says podiatrist Brian Fullem, the author of The Runner's Guide to Healthy Feet and Ankles: Simple Steps to Prevent Injury and Run Stronger.

Why? A constant battle between your toes and the end of a shoe can injure your nail and even cause blood blisters, forcing the nail away from the skin, he says. (Short-as-possible nails pre-long runs can help sidestep this.)

But if it’s already a lost cause (read: buh-bye toenail)? Consider this your plan:

What to do if your nail comes off in a bloody mess:

Your first step is to apply pressure to the area until the bleeding subsides, says Dr Meredith Leigh Ward, a podiatrist at Moore Foot and Ankle Specialists in Asheville, North Carolina. Follow this with an antiseptic treatment and a plaster - or visit your GP who will prescribe antibiotic cream if they see fit. You can reapply daily after a shower until the skin opening has closed (about one to two weeks, she says).

Super sore? Once a bandage and your treatment are on, soak your foot for 10 minutes in warm water and Epsom salts, suggests Fullem. “This will help draw out some of the soreness.”

What to do if the toenail has completely come off: 

“Often, after repeated micro-trauma, the nail may fall off without any bleeding or open skin lesion underneath, which can be left alone,” says Ward. Plasters and antiseptic or antibiotic treatments are good options here, too, for an added layer of protection against infection.

If you’ve got a blister, to boot? Fullem suggests sterilising a needle with alcohol and draining it.

Related: The lowdown on fungal toenail infections

What to do if the nail is kind of falling off, but not all the way:

Repeat after us: Don’t. Pull. It. Off. Doing so can cause avoidable pain as well as unnecessary additional trauma.

Instead, trim the loose nail as short as you can so that it doesn’t snag on a sock or shoe (ow!), says Ward. Also: don’t tape it back down. As Fullem puts it: “It will not re-attach.”

Related: How to look after your feet post-race

Unfortunately, you’ll just have to practice your patience for this one. “Each nail is a separate entity which takes six to nine months to grow,” he says. You’ll start to see a new nail growing in in about six weeks.

When to see a doctor about your toenail

If you notice an increase in pain, red streaking up your toe, swelling or any smelly drainage, it’s time to make an appointment with a podiatrist, as those are all signs of infection.

Fullem says “The nail sits very close to the bones of our toes, and if an infection starts in the skin surrounding the nail it can easily travel to the underlying bone and cause a severe infection if left untreated.”