Ava Monroe
Fingernails and toenails are made of a tough rigid protein called alpha-keratin, which is also found in the claws, hooves, and horns of vertebrates. The growth rate of nails is related to the length of the terminal phalanges (outermost finger bones). The index finger's nail grows faster than that of the little finger, and fingernails grow up to four times faster than toenails. Nails protect the distal phalanx, the fingertip, and the surrounding soft tissues from injuries. However, nails can be prone to various issues, including onycholysis (separation from the nail bed), onychauxis (abnormally thick growth), and retronychia (ingrowth of the proximal nail plate into the proximal nail fold).
Characteristics and associated values of over-laying finger nail
| Characteristics | Values |
|---|---|
| Medical term | Onycholysis |
| Description | The separation of the nail plate from the nail bed |
| Cause | Injury to the nail, fungal infection, bacterial infection, nail psoriasis, reaction to medication or chemicals, hyperthyroidism, iron deficiency |
| Symptoms | Nails that peel away from nail beds, thick and yellow nails with white spots and streaks, fatigue, dizziness, weakness, headaches, sore tongue, fast heartbeat, skin around nails looks infected |
| Treatment | Clip away the detached nail, wash the nail and surrounding skin with soap and water, keep the nail bed dry, apply an adhesive bandage, treat the underlying cause |
| Prevention | Avoid manicures, wearing tight shoes, keeping nails in water for too long, biting nails, picking at cuticles, cutting nails too short |
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What You'll Learn
- Onycholysis, or nail lifting, is the separation of the nail from the nail bed
- Hyponychium thickening can occur due to gel manicures, acrylic nails, or nail biting
- Paronychia is a nail infection that can be acute or chronic
- Iron deficiency and hyperthyroidism can cause onycholysis in all nails
- Regular manicures can cause onycholysis by applying force to trim, buff, and polish nails
Onycholysis, or nail lifting, is the separation of the nail from the nail bed
Onycholysis, or nail lifting, is a common condition where the nail separates from the nail bed. It usually affects only one nail and can last for several months or over a year. While onycholysis typically causes no pain, it can be contagious if caused by a fungal infection.
The condition can occur due to various reasons, the most common being trauma or injury to the nail or the nail matrix (the area where nails start to grow). Even slight trauma, when repeated over time, can cause onycholysis. For example, daily tapping of long fingernails on a hard surface or keyboard, or getting regular manicures that involve forceful trimming, buffing, and polishing. Keeping nails in water for too long or wearing shoes that are too tight can also cause this condition.
Chemical exposure is another cause of onycholysis. Chemicals in nail products like nail polish, gloss, hardeners, removers, and artificial nails can lead to nail separation. Additionally, certain medications, such as chemotherapy drugs, oral retinoids, and medicines from the psoralen, tetracycline, or fluoroquinolone groups, can also cause onycholysis, especially when combined with sun exposure.
Fungal infections are a further cause of onycholysis, where fungi get between the nail and the nail bed through cracks or cuts in the finger or toe. These infections cause the nails to thicken and turn yellow, with possible white spots and streaks.
Other medical conditions associated with onycholysis include iron deficiency, hyperthyroidism, and skin conditions like psoriasis, eczema, and lichen planus.
Treatment for onycholysis depends on the underlying cause. If caused by injury, the nail will typically grow out, and the detached portion can be cut away as it grows. For fungal infections, oral antifungal medications may be prescribed. In cases where harsh nail products are the cause, discontinuing their use may resolve the issue.
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Hyponychium thickening can occur due to gel manicures, acrylic nails, or nail biting
The hyponychium is the thick skin under your nail tip. It can sometimes overgrow and thicken, making it difficult and painful to trim your nails. This thickening can occur in one, some, or all fingers. It can be caused by various factors, including gel manicures, acrylic nails, or nail-biting.
Gel manicures, for instance, may contribute to hyponychium thickening due to the chemicals in the gel. While this link is not yet fully proven, it is a potential factor to consider. Similarly, the application of acrylic nails can lead to hyponychium thickening. In both cases, the artificial enhancements may restrict the natural growth of the hyponychium, leading to overgrowth and thickening.
Nail biting is another habit that can cause hyponychium thickening. The repeated action of biting and chewing on the nails can irritate and damage the hyponychium, leading to its thickening over time. Additionally, nail biting may increase the risk of introducing bacteria or viruses into the area, potentially causing infections that contribute to the thickening.
Other factors that can lead to hyponychium thickening include nail psoriasis and fungal infections. Nail psoriasis is a condition where skin cells grow rapidly, leading to scaling and buildup under the nail. This can cause the hyponychium to thicken and may require treatment with topical corticosteroids.
Fungal infections, such as onychomycosis, can also thicken both the nail and the underlying skin tissue. This occurs when fungi infect the fingernail, starting with the hyponychium and then spreading to the nail plate and bed. Treatment for fungal infections typically involves antifungal medication, with systemic (oral) options being the most effective, although they may have side effects.
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Paronychia is a nail infection that can be acute or chronic
Paronychia is a common nail condition that causes inflammation of the fingers or toes in one or more of the three nail folds. It can be acute or chronic. Acute paronychia symptoms appear over a few hours or days, with the infection only affecting the nail fold and not extending deeper into the finger or toe. These symptoms usually last less than six weeks and go away with treatment.
Acute paronychia is typically caused by bacterial infections, with pathogens such as Staphylococcus aureus, Streptococcus pyogenes, and Pseudomonas. It can also be caused by the cold sore virus, Herpes simplex, and the yeast, Candida albicans. Infections occur when the protective nail barrier is breached, often through a break in the skin between the proximal nail fold/cuticle and the nail plate. This can happen when the nail is bitten or the nail fold is picked.
Chronic paronychia, on the other hand, is a gradual process that develops over time. It usually lasts six weeks or longer, and several fingers or toes can be infected simultaneously. The affected nail fold is swollen and lifted off the nail plate, allowing the entry of various microorganisms, particularly Candida albicans and Gram-negative bacilli, pseudomonas. Chronic paronychia is mainly caused by irritants from occupational or environmental exposures, such as detergents and chemicals, rather than infections. It is characterized by red and tender skin, with occasional pus under the cuticle, and a thickened and distorted nail plate with transverse ridges.
Paronychia is usually treated with antibiotics and pus drainage if necessary. It is important to keep the affected area clean and bandaged. To prevent paronychia, maintain good nail hygiene, avoid biting or chewing nails, and keep your hands moisturized to prevent excessive dryness and skin cracking.
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Iron deficiency and hyperthyroidism can cause onycholysis in all nails
Onycholysis is a condition where the nail plate (or nail) separates from the nail bed (the skin on which it rests). It usually only affects one nail and is often painless. However, it can last for several months or even over a year. Onycholysis can be caused by various factors, including injuries, fungal infections, and reactions to chemicals or medications.
In rare cases, onycholysis can affect all nails, and this may be due to iron deficiency or hyperthyroidism. Iron deficiency occurs when an individual does not consume enough iron in their diet, which can also lead to anemia. Hyperthyroidism, on the other hand, is when the thyroid gland produces and releases excess hormones. It can cause a range of symptoms, including rapid heartbeat, unexplained weight loss, increased appetite, and anxiety disorders.
The link between onycholysis and hyperthyroidism has been observed in several cases, suggesting a potential association between the two conditions. In one case study, a 38-year-old man with onycholysis was found to have hyperthyroidism due to Graves' disease. Additionally, onycholysis has been referred to as "Plummer's Nails" when it occurs in the context of hyperthyroidism.
While the exact mechanism of how hyperthyroidism affects nail health is not fully understood, it is believed that elevated thyroid hormone levels can influence the appearance and structure of nails. For instance, individuals with hyperthyroidism may experience changes in their nails, such as "spoon-shaped" nails or clubbing. Similarly, iron deficiency can impact nail health, potentially leading to onycholysis in all nails.
If you suspect that your onycholysis is related to iron deficiency or hyperthyroidism, it is important to consult a healthcare professional. They can help determine the underlying cause and provide appropriate treatment options, such as thyroid replacement medication for hyperthyroidism or dietary changes and supplements for iron deficiency.
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Regular manicures can cause onycholysis by applying force to trim, buff, and polish nails
Onycholysis is a common condition where the nail plate separates from the nail bed. It usually affects only one nail and lasts for several months or over a year. While it is generally not painful, it can be contagious if caused by a fungal infection.
Onycholysis can be caused by various factors, including injuries or trauma to the nail. Regular manicures can also cause onycholysis due to the force applied during trimming, buffing, and polishing. Manicurists often use significant force during these processes, which can lead to the nail plate lifting away from the nail bed. Additionally, the adhesion of acrylic nails to the nail plate can be stronger than the adhesion of the nail plate to the nail bed, contributing to onycholysis.
The use of certain chemicals in nail products can also be a factor. Nail polish, nail gloss, nail hardeners, nail polish removers, and fake nails contain chemicals that can irritate the nail and surrounding skin, leading to onycholysis. Even the process of nail polish binding to and being removed from the nail plate can result in keratin degranulation, impacting the nail's structure.
Furthermore, long nails, whether natural or artificial, can be more prone to accidents and catching on objects, which can further lift the nail plate from the nail bed. It is recommended to keep nails trimmed short to prevent such incidents and reduce the risk of onycholysis.
In addition to mechanical factors, infections can also contribute to onycholysis. If the seal between the nail plate and nail bed is broken, pathogens can enter and infect the nail bed, leading to onycholysis. These infections can be fungal or bacterial and are more commonly seen in toenails due to the warm and dark environment created by shoes.
It is important to be cautious when performing manicures and to prioritize nail health to minimize the risk of onycholysis.
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Frequently asked questions
Over-laying fingernail, or onycholysis, is a common condition where the nail separates from the nail bed. It is usually painless and starts at the tip and/or sides of the nail. It is often caused by injury or trauma to the nail and can be treated by clipping away the detached nail and keeping the area clean.
Onycholysis can be caused by various factors, including fungal infections, nail psoriasis, reaction to chemicals or medications, and iron deficiency. It is also commonly seen in people with certain medical conditions such as eczema, thyroid disease, and infections.
Treatment for onycholysis depends on the underlying cause. In general, it is recommended to keep the nail bed dry and clean, avoid harsh products and manicures, and clip away any detached nails. If the condition is caused by a fungal infection, your healthcare provider may prescribe antifungal medication. It is important to seek medical advice if you are concerned about onycholysis or if the condition does not improve with treatment.
