Peeling Nails or Nails Falling Off? Onychomadesis after Hand, Foot, and Mouth in Kids 212

First, my 6 year old lost a finger nail. I thought maybe he squished it or snagged it on something and just said nothing because he’s a tough boy. The next day, the nurse called me to ask if I knew about his finger. I assumed it was the same one and said yes, but when he got home, I found he was missing yet another nail. The whole thing was just gone. I assumed maybe he had brittle nails for some reason—iron deficiency maybe—and put him on a multi-vitamin. Fast forward about 3 days, my 2 year old’s entire big toe nail just falls off. No blood, no pain, it was just gone, like his nail peeled off. I looked at all three kids, and they all had nails peeling off! Alright, now I was freaked out. What the hell was happening? Was it a fungus? Why were my kid’s nails falling off?
Peeling Nails Nails Falling Off shedding nails Onychomadesis hand foot and mouth
Well, now we have to go back in time, to about a month ago, when my entire household had a bad case of hand, foot, and mouth. As it turns out, peeling nails, nail shedding, or nail loss, also known as Onychomadesis, is a little known complication of hand, foot, and mouth typically presenting about 3 to 4 weeks after infection, but may occur anywhere from 1 to 10 weeks after.

What is Onychomadesis and why does it happen?

Onychomadesis is a fancy medical word for the occurrence of peeling nails which may break or fall off completely shedding at the nail bed. You may notice the nail turns white before falling off, and there may or may not be a new nail beginning to grow in below it. Onychomadesis is caused by a temporary stop or slowing in nail growth, in this case, the hand, foot, and mouth virus itself interrupts nail growth so as the nail grows up and out, there is a gap, so to speak, in the nail bed, which causes the nail above it to fall off. In minor cases, only slight indention or lines on the nails may be seen. As hand, foot, and mouth primarily attacks the feet and hands, it makes sense that it may also affect the nail bed—this just certainly was not something I had ever heard of and it did not happen the first time my kids had hand, foot, and mouth. It’s suggested that only certain strains of hand, foot, and mouth cause peeling nails, shedding or nails falling off.

What do I do if my kid has peeling nails or nails falling off?

Yeah, there’s some horror movie gross-out with this one, seriously, it is disturbing, but all my kids communicate well, and they all said that it did not hurt. In fact, when I removed the remainder of one nail falling off, my 2 year old didn’t even flinch. So while peeling nails shedding off may look painful and very yucky, it likely isn’t causing your child pain. Your best bet is to simply keep your child’s hands clean and leave them alone. New nails will grow in and rather quickly actually. The condition is not permanent, so if it keeps happening, you should definitely speak with your pediatrician. There are other causes of nail peeling, nails falling off, or nail shedding, but honestly, they are quite uncommon. Even fungal infections tend to only damage nails, not make them just sort of fall off.

Anyway, I will say this whole experience was rather educational. The wonderful thing about kids—and even crappy situations like lost nails in kids—is that you learn something new everyday.

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212 thoughts on “Peeling Nails or Nails Falling Off? Onychomadesis after Hand, Foot, and Mouth in Kids

  • Annie

    Thank you for this! My daughters nails are peeling off, and I have been freaking out! She did have hand, foot and mouth about 4 weeks ago so now it makes sense! Thanks!!

    • Life with Gremlins admin

      Just until the growth interruption gap grows out, so once that initial nail either falls off or the indentions grow up enough to be cut off.

  • Ideas Unlimited

    My granddaughter (6yrs)after her vacation to thiland and alot of swimmig came back with some boils on the palms and feet.If it were a case of hf and m the doctor could not detect.After about 2 weeks her nails started falling one by one.The new ones that are growing are rather thin and near the skin.My question is weather this is the typical pattern .And will they become normal as before.

    • Life with Gremlins admin

      It sounds right to me. How soon kids see nail shedding after the HFM really depends on their nail growth rate. If so her nails should grow back completely and it shouldn’t happen again (unless she contracts a different HFM strain. You can’t get the same strain twice, but you can get different strains.)

  • Marsha B

    So glad that I found this article! All three of my children, ages 13, 14 and 18 years, had HF&M this summer, all about a week apart from each other. Their illness was MUCH worse than described online….they all had a painful and itchy rash that lasted for about a week. Fast forward to several weeks post-illness: 2 of the 3 are loosing several fingernails and toenails! Just crazy! I think more education is definitely needed….several doctors that I spoke to were unaware of this newer strain.