A long-time client, who gets tips with an acrylic overlay, recently came in for her regular fill appointment. The week before her appointment, she had torn off her pinkie fingernail by catching it on a door. Her entire nail ripped off the nail bed along with the partial tip. Some of the nail that was under the cuticle (at the matrix) was ripped out as well. At the fingertip area, the nail bed already has replaced some layers of nail. The cuticle has “fused” itself to the nail bed. The upper corner of the cuticle seems to have a small piece of nail still attached. My client said that when the nail ripped, it was hanging at this point so she pulled it off. My client said her nail bed drained a white clear fluid (no pus) for a couple of days. She applied Neosporin and wrapped her pinkie with a bandage. The nail is not infected. I advised my client to see her doctor but she refused. I did not treat or apply anything to the nail. Please let me know what I should advise my client to do and if it is likely that her nail will grow back.
You advised your client wisely by suggesting she see her doctor. It seems, judging from your letter, that a significant trauma injured the nail unit. Whether or not the nail will grow back cannot be determined at this time. It depends on the growth of the damaged nail center (matrix), and the scarring secondary to the injury. Surely, if your client follows your suggestion and seeks medical treatment, the chances of getting back a normal, healthy nail will be increased.