
The skin attached to the nail above the fingertip is called the hyponychium. It is a thick skin that can sometimes overgrow, making it difficult and painful to trim nails. This condition is called Pterygium Inversum Unguis (PIU) and can be present from birth or acquired due to autoimmune conditions or external factors. Other causes of skin overgrowth under the fingernail include fungal infections, nail psoriasis, and frequent manicures or pedicures. While it is normal for some people to have skin attached above the fingertip, it is important to monitor any changes in colour, texture, or shape, as these could indicate an underlying disease or condition.
| Characteristics | Values |
|---|---|
| Name of the condition | Pterygium inversum unguis (PIU) or Hyponychium Thickening |
| Cause | Gel manicures, acrylic nails, nail biting, nail psoriasis, fungal infections, lupus, or other unknown factors |
| Symptoms | Pain when trimming nails, bleeding, discolouration, or swelling |
| Treatment | Avoidance of certain manicures, corticosteroids, antifungal medication, or other treatments prescribed by a dermatologist |
| Prevention | Keeping nails short, using a fingernail brush to push back the skin, moisturizing, and avoiding picking at the skin |
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What You'll Learn
- The skin attached to the nail can be pushed back with a cuticle pusher or fingernail brush
- Overgrown skin attached to the nail can be caused by gel manicures, acrylic nails, or nail biting
- Peeling skin on fingertips can be caused by dry skin, harsh weather, or excessive handwashing
- Onycholysis is when a nail separates from the skin on which it rests, and can be caused by injury or fungus
- Pterygium inversum unguis (PIU) is an uncommon condition that causes skin overgrowth under the fingernail

The skin attached to the nail can be pushed back with a cuticle pusher or fingernail brush
The skin attached to the nail can be pushed back with a cuticle pusher or a fingernail brush. A cuticle pusher is a specialised nail care tool designed to gently push back the cuticles, the thin layer of skin at the base of your nails. It is typically made from plastic, stainless steel, or wood and features a flat or rounded end. Before using a cuticle pusher, it is important to wash your hands thoroughly with soap and warm water for at least 20 seconds to remove bacteria. Additionally, the cuticle pusher should be cleaned before and after use to prevent the spread of bacteria. When using the pusher, hold it at a 45-degree angle to your nail and use light pressure to slowly push the cuticles back towards the skin. Be careful not to press too hard, as this can damage the nail bed or skin.
Fingernail brushes are another tool that can be used to push back the skin attached to the nail. These brushes are designed to remove dirt and debris from under the nails and can be used as part of your regular manicure routine. Fingernail brushes typically have stiff bristles and can be used wet or dry. When using a fingernail brush to push back the skin, it is important to be gentle and avoid applying too much pressure, as this can cause pain and damage to the nail and surrounding skin.
Both the cuticle pusher and the fingernail brush can be effective tools for pushing back the skin attached to the nail. However, it is important to use them correctly and gently to avoid any potential damage or pain. Additionally, regular moisturising of the cuticles can help to keep them soft and flexible, making it easier to push them back and promoting healthy nail growth.
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Overgrown skin attached to the nail can be caused by gel manicures, acrylic nails, or nail biting
The thick skin under your nail tip is called the hyponychium. It is generally good as it safeguards the nail from harmful substances and prevents infections. However, it can become a problem if it overgrows, which can be caused by gel manicures, acrylic nails, or nail biting.
The hyponychium can thicken and cling to the back of your nail bed due to skin overgrowth. This can be caused by frequent gel manicures or leaving your acrylics on for too long. The chemicals in gel manicures may also be a factor, although this is not yet proven. It is recommended to take breaks between manicures and opt for treatments that protect your natural nails, such as BIAB nails.
If you are a nail biter, you are also more likely to experience overgrown hyponychium. This is because nail biting can lead to PIU (Pterygium Inversum Unguis), where the hyponychium attaches to the underside of the nail as it grows. PIU is an uncommon condition but a common cause of skin overgrowth under the fingernail. It can be present from birth or acquired later, with the acquired form associated with autoimmune conditions such as lupus.
If you are experiencing overgrown hyponychium, it is best to avoid picking at the skin and see a dermatologist, especially if it is bleeding, discoloured, or swollen. They can determine the best treatment, which may include topical treatments, antifungal medication, or corticosteroids.
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Peeling skin on fingertips can be caused by dry skin, harsh weather, or excessive handwashing
Peeling skin on fingertips is a common issue that can be caused by various factors, including dry skin, harsh weather, and excessive handwashing.
Dry skin is a prevalent cause of peeling fingertips. This can be due to a variety of reasons, such as vitamin B3 (niacin) deficiency, sunburn, or exposure to harsh chemicals in soaps and other toiletries. Individuals with dry skin on their fingertips are advised to use a moisturizer to hydrate the affected area and drink plenty of water to keep the skin supple and moist.
Harsh weather conditions, including cold, dry winters and hot, humid summers, can also lead to peeling fingertips. During winter, the lack of humidity in the air and indoor heating can zap moisture from the skin, causing it to dry out and peel. Similarly, in the summer, excessive sweating and sun exposure can irritate the skin and lead to peeling.
Excessive handwashing, especially with hot water and harsh soaps, can strip the skin of its natural oils, leading to dryness and skin peeling. This is particularly common in cold weather when frequent handwashing is important to prevent the spread of germs. To mitigate this issue, it is recommended to wash hands only when necessary, use gentle soaps, and moisturize afterward.
In addition to these primary causes, peeling skin on fingertips can also be attributed to various skin conditions such as eczema, psoriasis, or contact dermatitis. In some rare cases, it may be due to underlying health conditions or vitamin deficiencies, which should be addressed by a medical professional. Overall, while peeling fingertips are usually harmless, it is important to identify and address the underlying cause to promote skin health and comfort.
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Onycholysis is when a nail separates from the skin on which it rests, and can be caused by injury or fungus
Onycholysis is a common nail disorder characterised by the separation of the nail plate from the nail bed. It typically results in a distinct area of white opaque nail. Onycholysis can affect anyone, regardless of age, gender, or race, although it is most frequently observed in adult women. It can occur in a single nail or multiple fingernails and/or toenails, with the distal part of the nail being the most commonly affected area.
The condition can be idiopathic, with no apparent cause, or secondary to various factors. One of the primary causes of onycholysis is trauma or injury to the nail. Even minor trauma, when repeated over time, can lead to onycholysis. This can include daily activities such as tapping long fingernails on a keyboard or counter or using manicure tools to clean beneath the nails. Moisture can also be a contributing factor, as well as certain medical conditions that alter the nail's shape or the contour of the soft tissue bed beneath it, preventing the nail from attaching smoothly to the nail bed.
Fungal infections are another significant cause of onycholysis. These infections thicken the tissue immediately beneath the nail plate, causing the edge of the nail to lift. In addition, certain skin conditions, such as allergic reactions and psoriasis, are also associated with onycholysis. Other medical conditions linked to onycholysis include hyperthyroidism and iron deficiency.
The treatment for onycholysis depends on the underlying cause. For example, addressing hyperthyroidism and iron deficiency can promote normal nail regrowth. Treatments for psoriasis may also improve nail health. In the case of fungal infections, oral prescription medications are available, although they may have potential side effects and can be costly. Preventative measures, such as keeping nails trimmed and wearing rubber gloves when working in wet environments, can help reduce the likelihood of onycholysis occurring or recurring.
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Pterygium inversum unguis (PIU) is an uncommon condition that causes skin overgrowth under the fingernail
Pterygium inversum unguis (PIU) is an uncommon condition where the skin under the fingernail, known as the hyponychium, attaches to the underside of the nail as it grows, resulting in skin overgrowth. This condition was first described in 1973 and is considered rare, with its exact origin unknown. PIU can be congenital, present from birth, or acquired later in life. The acquired form is often associated with autoimmune conditions like lupus but can also be triggered by external factors such as gel manicures, acrylic nails, nail biting, or nail psoriasis.
The hyponychium is the thick skin under the nail tip, which serves to protect the nail from harmful substances. However, when it overgrows, it can cause discomfort and pain, especially when trimming nails. It may also increase the risk of infection. People with PIU may experience these symptoms and find it challenging to cut their nails without causing pain or bleeding.
While the management of PIU is not well-defined, various treatments have been explored, including keratolytics, topical steroids, and surgical excision with electrocautery, but these have been reported as ineffective. The most effective approach is addressing the underlying cause of PIU. Patients with this condition should be evaluated for associated rheumatologic diseases, and long-term follow-up examinations are necessary to monitor for the development of connective tissue diseases.
If you notice skin overgrowth under your fingernails or experience any related symptoms, it is recommended to consult a dermatologist for evaluation and appropriate treatment. They are medical specialists who can accurately determine the cause and provide suitable treatment options, which may include medications or changes in nail care habits.
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Frequently asked questions
The skin attached to your nail above your fingertip is called the hyponychium.
The hyponychium is generally good as it protects your nail from harmful substances. However, it can become a problem if it overgrows, which can be painful and may increase the chance of infection.
Pterygium inversum unguis (PIU) occurs when the hyponychium attaches to the underside of the nail as it grows. It is an uncommon condition but a common cause of skin overgrowth under the fingernail. Nail biting, gel manicures, acrylic nails, and fungal infections can also cause skin overgrowth.
If you are unsure what is causing the skin growth, it is best to visit a dermatologist. They can determine the best treatment by examining your nails and other symptoms. If you have overgrown hyponychium, you can "train" it back by cutting your nails short, right above the edge of the sensitive skin underneath.











































