Sophia Delgado
Onycholysis, or nail lifting, is a common nail disorder where the nail separates from the nail bed. It is usually painless but may be painful if acute or inflammatory. The detached nail is usually white and opaque compared to the normal nail that appears pink. The portion of the nail that has separated from the nail bed cannot reattach itself. Treatment focuses on new nail growth and keeping the nail attached to the underlying nail bed. If a portion of the nail is loose and detached from the nail bed, it should be removed.
| Characteristics | Values |
|---|---|
| Medical Term | Onycholysis |
| Description | When a nail separates from the nail bed underneath it |
| Cause | Injury, fungal infection, skin condition, reaction to medication, psoriasis, eczema, thyroid disease, diabetes, etc. |
| Symptoms | Nail appears white or yellow, thickens, shows white spots and streaks, becomes crumbly, etc. |
| Treatment | Use nail clippers or nail scissors to remove the affected nail, keep the nail bed dry, use antibacterial soaks, wear gloves, avoid nail products, change medications, etc. |
| Recovery Time | 4-6 months for fingernails, 8-12 months for toenails |
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What You'll Learn
See a podiatrist if you need help cutting your nails
Onycholysis is a common nail disorder in which the nail plate separates from the nail bed, typically resulting in a well-defined area of white opaque nail. It is often caused by trauma, skin disease, nail infections, tumours, or systemic events. While there is no cure for the section of the nail that has detached from the nail bed, and it cannot reattach, treatment can keep new nail growth attached to the nail bed.
If you are experiencing onycholysis, it is important to keep your nails trimmed short to prevent them from catching on objects and pulling further off the nail bed. However, you should be careful not to cut your nails too short, as this can damage the nail bed and cause pain. If you are unable to cut your nails yourself due to conditions such as nerve damage, circulation problems, or simply a lack of feeling in your toes and feet, it is recommended that you see a podiatrist for professional help.
Podiatrists are specialist doctors who provide diagnosis and treatment for issues involving the feet and lower legs. They can assist with toenail care and perform nail excisions if necessary. For example, if you are experiencing ingrown toenails, which occur when the skin gets in the way of the toenail, a podiatrist can help with proper filing, shaping, and cutting to remove the nail and prevent its ingrown regrowth. Ingrown toenails can be very painful and can lead to infection if left untreated.
Additionally, if you are suffering from certain conditions such as diabetes, it is advisable to let a podiatrist cut your toenails. Diabetics are at risk of reduced feeling in their toes and feet, and a tiny cut may go unnoticed, leading to infections such as diabetic ulcers, sores, and fungal issues. A podiatrist can safely cut your nails in a sterile environment, reducing the risk of infection and providing treatment with antifungal creams and sprays if needed.
Therefore, if you need help cutting your nails due to any condition that makes it difficult to manage them, or if you are simply uncomfortable doing it yourself, consider seeking the help of a podiatrist to ensure safe and proper nail care.
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Wash the nail and surrounding skin with mild soap and water
Onycholysis is the medical term for when a nail separates from the nail bed. It is usually caused by an injury, fungal infection, or reaction to medication. The detached section of the nail will not reattach, so treatment focuses on keeping the nail bed dry and clean to prevent infection and aid new nail growth.
Washing the nail and the surrounding skin is an important step in treating onycholysis. This should be done with a mild soap or cleanser and water. Wash the affected area gently once a day, taking care not to cause further trauma to the nail or nail bed. Rinse the soap off carefully, ensuring that no residue is left behind. Dry the area thoroughly but gently, as the skin underneath the nail may be delicate and prone to breakage.
It is important to keep the nail bed as dry as possible throughout the healing process. Water getting under the nail can cause bacteria and yeast to build up, leading to infection. This is why wearing gloves is recommended for activities such as washing dishes or gardening. Cotton gloves can be worn under vinyl gloves for extra protection during wet work.
To further reduce the risk of infection, antimicrobial soaks such as dilute vinegar can be used. This will help to keep the area clean and minimise the chances of secondary infection. It is also advised to avoid harsh nail products, such as nail polish, nail gloss, and artificial nails, as these can irritate the nail and surrounding skin.
While onycholysis typically does not cause any pain, it is important to monitor the area for any signs of infection. If the nail bed becomes infected, it is recommended to seek professional medical advice to receive appropriate treatment.
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Keep the nail bed dry
Onycholysis, or nail lifting, is a common condition where the nail separates from the nail bed. It is important to keep the nail bed dry to prevent the condition from worsening or becoming infected.
The nail bed is the skin underneath the nail, and when the nail lifts, it creates space for dirt, debris, and water to get underneath. When water gets under the nail, bacteria and yeast can cause the area to become infected. Therefore, it is crucial to keep the nail bed dry.
- Wear gloves: When doing activities that involve water, such as dishwashing or cleaning, wear rubber gloves to protect your nails from moisture. Cotton gloves can also be worn under vinyl gloves for added protection.
- Avoid water immersion: Try to avoid immersing your nails in water for extended periods. If you work with your hands in water, wear gloves to create a barrier.
- Keep nails trimmed: Keeping your nails short and trimmed helps prevent them from catching on objects and lifting further from the nail bed. It also reduces the surface area that can come into contact with water.
- Avoid harsh chemicals: Stay away from harsh chemicals and products that can irritate the nails or the skin surrounding them. This includes nail polish, nail gloss, nail hardener, nail polish remover, and artificial nails. These products can contribute to onycholysis and create further separation from the nail bed.
- Expose nails to dry air: If onycholysis affects your toenails, ensure your feet are exposed to dry air as much as possible. Wear clean socks and well-fitting shoes to keep the area dry and comfortable.
By following these steps, you can help keep the nail bed dry and promote healing while managing onycholysis.
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Avoid nail products that can cause irritation
Onycholysis, or nail lifting, is a common nail disorder in which the nail plate separates from the nail bed. It is often caused by injury or fungal infection, but can also be a reaction to certain nail products.
To avoid nail product irritation, it is important to be aware of the potential irritants found in nail products and opt for hypoallergenic alternatives. Here are some tips to avoid nail product irritation:
- Avoid nail enamels (varnish/polish) and nail enamel removers, as they contain strong solvents that can strip the nail enamel and lead to irritant contact dermatitis.
- Stay away from artificial nails, acrylic nails, and gel nail polishes, which often contain acrylates and methacrylates that can cause allergic contact dermatitis, redness, itching, and swelling.
- Be cautious of nail hardeners, as they may contain formaldehyde resin, which can cause allergic reactions.
- Choose nail products labelled as "hypoallergenic," which are formulated to minimize the risk of allergic reactions.
- Opt for gel nails or dip powders, which are safer alternatives for sensitive skin.
- If you experience any irritation, redness, itching, or swelling, discontinue use immediately and consult a physician.
By following these guidelines, you can help prevent nail product irritation and maintain healthy nails and skin.
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Treat the underlying cause, e.g. injury, fungal infection, or medication
Onycholysis, or nail separation, can be caused by a variety of factors, including injury, fungal infection, and medication. While there is no way to reattach a nail that has detached from the nail bed, addressing the underlying cause can prevent further separation and promote healthy nail growth.
If an injury, such as bumping or hitting your nails, wearing tight shoes, or prolonged exposure to water, has caused nail separation, it is essential to protect the affected nail. Keep the nail trimmed short to prevent it from catching on objects and pulling further off the nail bed. Avoid biting your nails and be cautious when cleaning underneath them, as tools like cuticle sticks and nail brushes can cause breakage and infection. Wear gloves during activities that may damage your nails, such as washing dishes or gardening.
Fungal infections are another common cause of nail separation. Fungi can enter through cracks or cuts in the nails, leading to thickening, discoloration, and white spots or streaks. Treatment options include oral antifungal medications, such as terbinafine (Lamisil®), itraconazole (Sporanox®), and fluconazole (Diflucan®). Topical antifungal creams, ointments, or gels can also be applied directly to the nails. It is important to complete the full course of antifungal treatment to effectively eliminate the fungal infection.
Certain medications can also contribute to nail separation. For example, chemotherapy, tetracycline, nonsteroidal anti-inflammatory drugs (NSAIDs), psoralens, and oral retinoids (vitamin A derivatives) can cause photosensitivity, increasing the risk of onycholysis. If you are taking any of these medications, consult your healthcare provider for advice on managing nail health and consider using sunscreen or protective gloves when exposed to sunlight.
In summary, treating the underlying cause of nail separation is crucial to prevent further issues and promote nail health. Depending on the cause, this may involve protecting injured nails, treating fungal infections, or consulting a healthcare provider about medication-related side effects.
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Frequently asked questions
Onycholysis is the medical term for when a nail separates from the nail bed underneath it. It typically only affects one nail.
If you have onycholysis, it is important to determine the underlying cause. You should consult a doctor or a podiatrist, especially if you have certain health conditions such as diabetes, peripheral arterial disease, or a suppressed immune system. Treatment options may include trimming the nail, wearing gloves, avoiding nail irritants or products, changing medications, using supplements, or taking medication.
No, once a nail has fully detached from the nail bed, it cannot reattach. Treatment will focus on new nail growth and keeping the nail attached to the underlying nail bed.
