Caleb Foster
Onycholysis, or nail separation, occurs when a nail detaches from its nail bed, typically due to trauma, fungal infections, or allergic reactions. While it is usually painless, it can be unsightly and cause discomfort. So, should you remove a nail that has separated from the nail bed? The answer is yes, but with caution. Removing the nail can help relieve pain, promote healing, and prevent infection. However, it is crucial to keep the nail bed dry, clean, and protected until a new nail grows back, which can take several months. Additionally, the underlying cause of onycholysis should be addressed to prevent recurrence.
| Characteristics | Values |
|---|---|
| Medical term | Onycholysis |
| Cause | Nail trauma, allergic reaction, fungal infection, chemotherapy, medication causing light sensitivity, nail psoriasis, iron deficiency, pellagra, graft-versus-host disease |
| Symptoms | Nail discolouration, wavy white line, nail deformation, unpleasant odour, nail fragility, nail bulkiness, fatigue, feeling cold, dizziness, weakness, headaches, sore tongue, fast heartbeat |
| Treatment | Keep nail bed dry, clean, and covered with petroleum jelly and an adhesive bandage, remove artificial nails, trim nails short, avoid nail biting, wear gloves for certain activities, wear clean socks and comfortable protective shoes, oral antifungal medication, topical antifungal medication |
| Regrowth time | 4-6 months for fingernails, 8-18 months for toenails |
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What You'll Learn
- Onycholysis: the medical term for nail separation
- Treatment: keep the nail bed dry and covered until a new nail grows in its place
- Prevention: keep nails short, avoid biting, and wear gloves for protection
- Causes: fungal infections, iron deficiency, and nail trauma
- Symptoms: discolouration, wavy white lines, and nail deformity
Onycholysis: the medical term for nail separation
Onycholysis is the medical term for nail separation, specifically when the nail separates from the nail bed or the skin underneath it. It is somewhat common and usually occurs due to nail trauma or an allergic reaction. However, it can also be caused by fungal infections, certain medications, nail psoriasis, iron deficiency, or pellagra (a condition associated with low levels of vitamin B3).
Onycholysis is characterised by a deformed nail that detaches from the nail bed, an unpleasant odour, and a fragile or bulky appearance. While onycholysis is typically not painful, it can indicate a more serious underlying condition such as a yeast infection, thyroid disease, or vitamin and mineral deficiencies. Therefore, it is recommended to consult a doctor to determine the cause and receive appropriate treatment.
Treatment for onycholysis focuses on promoting new nail growth and preventing further issues. Keeping nails trimmed short can help prevent the nail from catching on objects and pulling further off the nail bed. It is important to avoid biting nails and to be careful when cleaning underneath them, as tools like cuticle sticks and nail brushes can break the skin and cause infection. Additionally, it is advised to wear gloves during activities that may damage nails, such as washing dishes or playing sports, and to keep nails and the surrounding skin away from irritating chemicals and products, including nail polish, nail gloss, and nail hardeners.
In some cases, removing the affected nail as it grows out may be recommended. This can be done by clipping or cutting away the separated portion of the nail. However, it is crucial to be cautious to avoid damaging the nail bed. For onychomycosis, a fungal infection, chemical avulsion may be considered instead of surgical nail removal. This involves the weekly application of 40% urea and 1% bifonazole.
Overall, the treatment approach for onycholysis depends on the underlying cause. By addressing the cause and following appropriate nail care practices, individuals can effectively manage onycholysis and promote the regrowth of healthy nails.
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Treatment: keep the nail bed dry and covered until a new nail grows in its place
If your nail has separated from the nail bed, it will not reattach. You will have to wait for a new nail to grow back in its place, which can take about six months or longer for a fingernail and up to 18 months for a toenail.
To keep the nail bed dry, clean, and protected until a new nail grows, follow these steps:
Keep the nail bed dry
- It is important to keep the nail bed dry to prevent infection.
- If the wound is bleeding, do not put a dry bandage or gauze on top as it will stick to the wound.
- Instead, apply petroleum jelly to keep the wound moist, then cover it with gauze or a bandage.
- Repeat this process daily while the wound heals.
- Apply a new adhesive bandage whenever the bandage gets wet.
Cover the nail bed
- Cover the nail bed with tape, an adhesive bandage, or a light dressing until the nail has grown out enough to protect the finger or toe.
- Keep your fingertips covered while your nail grows back.
- If you trim off the detached nail, you will have less risk of the nail catching and tearing.
Prevent infection
- Watch for signs of infection, such as increasing heat, redness, pain, tenderness, swelling, or pus.
- Treat the infection or skin condition that caused the nail separation.
- File any sharp edges smooth to prevent catching the nail and tearing it further.
- Keep your nails trimmed short to prevent them from catching on objects and pulling further off the nail bed.
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Prevention: keep nails short, avoid biting, and wear gloves for protection
Once a nail has separated from its nail bed, it will not reattach. A new nail will have to grow back in its place, which can take about six months or longer for a fingernail and up to 18 months for a toenail. To prevent nail separation, it is recommended to keep nails short, avoid biting them, and wear gloves for protection.
Keeping your nails short will prevent them from catching on objects and pulling further off your nail beds. It also makes it harder to bite them. To keep your nails short, trim them every few days using nail clippers or nail scissors. Be careful when cleaning underneath your nails, as some tools, like cuticle sticks or nail brushes, can break the skin underneath your nails and cause an infection.
Biting your nails can be a hard habit to break. Some ways to stop include keeping your nails looking nice, such as by getting a manicure, or applying nail polish. You can also try bitter-tasting nail polish, which discourages many people from biting their nails. Covering your nails with tape or wearing gloves can also prevent biting. If you don't want to restrict your fingertips, you can try wearing latex finger cots, which only cover the fingers, or getting your natural nails covered in acrylics.
Wearing gloves can also protect your nails from chemicals and products that can irritate them or the skin around them, such as nail polish, nail gloss, nail hardener, nail polish remover, and fake nails. It can also protect your nails when doing activities that may damage them, like washing dishes, playing sports, or working outside.
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Causes: fungal infections, iron deficiency, and nail trauma
Onycholysis, or nail separation, can be caused by several factors, including fungal infections, iron deficiency, and nail trauma.
Fungal infections occur when fungi get between the nail and the nail bed, typically through cracks or cuts in the finger or toe. These infections cause nails to thicken and turn yellow, and they may also exhibit white spots and streaks. Treatment options for fungal infections include oral and topical antifungal medications. Oral medications may include terbinafine, itraconazole, and fluconazole, while topical treatments come in the form of creams, ointments, or gels applied directly to the nails.
Iron deficiency, often associated with anemia, can also lead to nail separation. Anemia causes a person's nail bed to become pale, and they may develop spoon-shaped nails (koilonychia). Treating anemia, such as through increasing iron intake, helps resolve these nail irregularities.
Nail trauma, such as nail bed injuries, can also cause onycholysis. This can happen when the nail is crushed or subjected to a high-impact injury, resulting in a subungual hematoma—a bruise-like appearance due to blood pooling between the nail and the nail bed. In some cases, the nail may lift away from the nail bed. Minor nail bed injuries often heal on their own, but more severe cases may require professional treatment to ensure proper healing and smooth nail growth.
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Symptoms: discolouration, wavy white lines, and nail deformity
Onycholysis is a common condition where the nail separates from the nail bed. It is characterised by symptoms such as discolouration, wavy white lines, and nail deformity. While it is important to address onycholysis, it is crucial to understand that the detached section of the nail will not reattach to the nail bed. Instead, the focus should be on facilitating new nail growth and preventing further complications.
Discolouration of the nails can manifest in various forms, such as dark streaks, white streaks, or changes in nail colour. This discolouration can be indicative of underlying medical conditions that require attention. For example, yellow nail syndrome is characterised by thickened nails that turn yellow or yellow-green. Nails affected by fungal infections typically become thick and yellow, sometimes displaying white spots and streaks.
Wavy white lines are often observed in onycholysis and are indicative of an abnormal border between the pink area of the nail and the white edge. The white areas may exhibit variations in thickness, appearing thicker in certain sections and thinner in others. This abnormal border can be a notable indicator of nail separation.
Nail deformity can occur due to crushing injuries to the base of the nail or the nail bed, potentially resulting in permanent deformity. Additionally, certain infections, particularly those affecting the heart valve, may cause red streaks in the nail bed, known as splinter hemorrhages.
It is important to note that nail abnormalities, including onycholysis, can result from various factors such as injuries, viral warts, infections, and certain medications like chemotherapy drugs. Addressing the underlying cause is essential for effective management. Treatment options for onycholysis may include keeping the nail bed dry, clean, and covered with petroleum jelly and an adhesive bandage until the nail has regrown. Trimming the nail or removing it as it grows out can also help prevent catching and further tearing.
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Frequently asked questions
Onycholysis is the medical term for when a nail separates from the nail bed or the skin underneath it. It is somewhat common and usually occurs due to nail trauma, fungal infections, or an allergic reaction to chemicals in nail polish, nail gloss, nail hardener, nail polish remover, or fake nails.
If you experience onycholysis, it is recommended to keep the nail bed dry, clean, and covered with petroleum jelly and an adhesive bandage. You should also trim off the detached part of the nail as it grows out. It is important to treat the underlying cause of the onycholysis, which may include an iron deficiency or a serious yeast infection.
It is generally recommended to remove a nail that has separated from the nail bed to prevent it from catching and causing further tearing. However, it is important to be careful when removing the nail to avoid damaging the nail bed. If you are uncomfortable trimming the nail yourself, have diabetes, peripheral arterial disease, or an immune system problem, it is advised to seek medical assistance.
