Sophia Delgado
Fingernail tenting, also known as onycholysis, is a condition in which the nail separates from the nail bed. It is often caused by injury, fungus, or psoriasis, but can also be a result of fungal infections, medication, or a reaction to chemicals. Onycholysis is usually not painful, but it can be contagious if caused by a fungus. The condition can last for several months or over a year, and treatment involves addressing the underlying cause to encourage the growth of a new nail.
| Characteristics | Values |
|---|---|
| Medical name | Onycholysis |
| Common causes | Injury, nail fungus, nail psoriasis, fungal nail infection, iron deficiency, pellagra, thyroid disease, medication, or chemical reaction |
| Symptoms | Nail lifting, white discoloration, fatigue, feeling cold, dizziness, weakness, headaches, sore tongue, fast heartbeat, redness, purple, gray or white skin, irritation, and swelling |
| Treatment | Treatment of the underlying cause, keeping nails short and trimmed, and avoiding activities that might harm them |
| Prevention | Avoid cleaning under nails with a sharp object, avoid skin-to-skin contact with infected persons, and avoid touching infected surfaces |
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What You'll Learn
Injury
Fingernail tenting, or onycholysis, is when the nail separates from its nail bed. This condition is often the result of an injury to the nail or nail matrix (the area where nails start to grow). Injuries can occur in various ways, including:
Blunt Trauma
Smashing your finger in a door, hitting it with a hammer or another heavy object, or cutting it with a knife or sharp object can cause nail separation. Such injuries can cut, tear, smash, or bruise the nail, leading to onycholysis.
Water Exposure
Keeping your nails submerged in water for extended periods can contribute to fingernail tenting. This is because excessive water exposure can weaken the nail plate and nail bed, making separation more likely.
Manicures
Regular manicures can also be a culprit. The force applied during trimming, buffing, and polishing can be significant, causing micro-traumas to the nail matrix and nail bed. Over time, this can lead to onycholysis.
Nail Tapping
Even something as seemingly harmless as tapping your nails on a hard surface repeatedly can cause nail tenting. The constant impact can create small tears or weaken the nail bed, leading to separation.
Tight Shoes
Wearing shoes that are too tight can cause injuries to your toenails and the surrounding skin. This can lead to onycholysis, where the nail separates from the nail bed.
If you experience onycholysis due to an injury, it is important to monitor for any signs of infection. While onycholysis itself is usually not painful, the underlying cause may be irritating or painful. If you notice any unusual symptoms or if the condition does not improve, it is recommended to consult a healthcare professional for further evaluation and guidance.
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Fungal infection
Fingernail tenting, or onycholysis, can be caused by fungal infections. This occurs when a fungus gets between your nail and nail bed, usually through cracks or cuts in your finger. This can cause nails to become thick and yellow and may show white spots and streaks. The infection may affect part of the nail, the whole nail, or multiple nails.
Fungal nail infections can cause a deformed nail that detaches from the bed, an unpleasant odour, and a fragile or bulky appearance. The nail may also thicken and stop growing. This could be a sign of something more serious going on inside your body. Lung disease and rheumatoid arthritis can cause yellow nails, for example.
It is important to pay attention to your nails and be aware of any changes. If you notice any signs of a fungal infection, such as nail tenting, it is recommended to see a healthcare professional as soon as possible. They can evaluate your symptoms and perform tests to diagnose the issue.
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Iron deficiency
Spoon-shaped nails, or koilonychia, can be a sign of iron deficiency. This condition causes nails to become thin and concave, dipping down in the middle so that they resemble spoons. If you observe this shape in your fingernails or toenails, it is recommended that you consult a doctor.
Nails can provide important clues about a person's health, and changes in nail shape, colour, or texture can indicate underlying issues. In the case of iron deficiency, spoon-shaped nails may be accompanied by other symptoms, such as fatigue, pale skin, and a sore tongue.
While spoon-shaped nails are a common sign of iron deficiency, it is important to note that they can also be caused by other conditions, including inflammatory skin diseases like psoriasis, hypo- or hyperthyroidism, and autoimmune disorders. Additionally, vitamin B12 deficiency may also cause changes in nail appearance, such as discoloration.
If you suspect that your nail tenting is due to iron deficiency, it is important to consult a healthcare professional for proper diagnosis and treatment. They may recommend dietary changes or supplements to address the deficiency and improve nail health.
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Nail psoriasis
Anyone can get nail psoriasis, but you may be more likely to develop it if you are over 40, already have psoriasis or a family history of psoriasis, or have psoriatic arthritis. In people with psoriasis, new skin cells grow and move to the skin surface every three to four days, creating a skin rash. In some people, psoriasis affects their nails in addition to their skin or other parts of their body.
There is no cure for nail psoriasis, but treatments can help alleviate symptoms. Treatment plans may include topical or systemic therapies, corticosteroids, calcipotriol (derived from vitamin D), and tazarotene (derived from vitamin A).
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Chemotherapy
Nail changes from chemotherapy may be longer-term, with some patients experiencing thick and painful nail growth after treatment. In some cases, nails never return to how they were before chemotherapy. Nails may also develop colourless ridges known as Beau's lines, which tend to be more horizontal than vertical. Beau's lines themselves are harmless and should grow out with the rest of the nail once treatment is finished. Nails may also curve inward, forming a spoon-like shape known as koilonychia, which is different from clubbing, a process associated with lung cancer.
To manage nail changes during chemotherapy, patients can try keeping their hands and feet well-moisturized with fragrance-free creams or ointments, wearing soft, padded shoes or slippers, and cotton socks with all their shoes. It is also recommended to keep nails short and smooth and to speak with a healthcare provider about nail health and any symptoms of nail changes. Soaking the fingers or toes in a mixture of equal amounts of white vinegar and water can help treat nails that are lifting from the nail bed.
It is important to see a doctor if nail changes cause symptoms such as pain or odour, as this could indicate an infection. While nail ridging is normal and not symptomatic, patients should seek medical care if they develop a new dark line on a single nail, as this could indicate nail melanoma or skin cancer under the nail.
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Frequently asked questions
Nail tenting, also known as onycholysis, is a condition in which the nail separates from the skin beneath it, or the nail bed. It is usually not painful but can be contagious if caused by a fungal infection.
Nail tenting can be caused by a variety of factors, including injury to the nail, fungal infections, nail psoriasis, reaction to medication or chemicals, and iron deficiency.
If you notice nail tenting, it is recommended to consult a dermatologist or healthcare provider to determine the underlying cause. Treatment may involve addressing the specific cause, such as treating a fungal infection or managing iron deficiency. Keeping your nails short and trimmed can help manage the condition, but aggressive clipping is not recommended.
Yes, nail tenting may be accompanied by other symptoms, including fatigue, feeling cold, dizziness, weakness, headaches, a sore tongue, and a fast heartbeat. In some cases, the skin around the nails may appear infected, exhibiting redness, purple, gray, or white discoloration, irritation, and swelling.
