Background: Human nail clippings are increasingly used in epidemiological studies as biomarkers for assessing diet and environmental exposure to trace elements or other chemical compounds. However, little is known about the growth rate of human nails.

Objective: To estimate the average growth rate of fingernails and toenails and examine factors that may influence nail growth rate.

Methods: Twenty-two healthy American young adults marked their nails close to the proximal nail fold with a provided nail file following a standardized protocol, and recorded the date and the distance from the proximal nail fold to the mark. One to three months later, participants recorded the date and distance from the proximal nail fold to the mark again. Nail growth rate was calculated based on recorded distance and time between the two measurements.

Results: Average fingernail growth rate was faster than that of toenails (3.47 vs. 1.62 mm/month, P < 0.01). There was no significant difference between right and left fingernail/toenail growth rates. The little fingernail grew slower than other fingernails (P < 0.01); the great toenail grew faster than other toenails (P < 0.01). Younger age, male gender, and onychophagia were associated with faster nail growth rate; however, the differences were not statistically significant.

Conclusion: Nail growth rates have increased compared with previous estimates conducted decades ago. Toenail clippings may reflect a long exposure time frame given the relatively slow growth rate.