Isla Bennett
If your fingernails are lifting off, you may be experiencing onycholysis, a condition in which the nail separates from the skin beneath it. Onycholysis can be caused by several factors, including nail trauma, injury, or an allergic reaction. It is also associated with certain medical conditions such as eczema, psoriasis, thyroid disease, and iron deficiency. The treatment for onycholysis depends on the underlying cause, and it typically takes four to six months for fingernails to fully regrow. During this time, it is important to keep the nails short and avoid potential irritants to prevent further complications.
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Onycholysis: the medical term for nail separation
Onycholysis is the medical term for nail separation, a common nail disorder in which the nail plate separates from the nail bed. It is easy to spot—you will notice your nail lifting or peeling away from the nail bed. Onycholysis can affect a single nail or multiple fingernails and/or toenails. The distal part of the nail is most commonly affected, lifting the free edge; sometimes, the nail may detach laterally or proximally.
The condition is typically painless and does not go away on its own. The detached portion of the nail will not reattach, so the goal is to allow new, healthy nail growth, which may take several months. In the meantime, it is important to minimise activities that traumatise the nail and nail bed and to keep the nail bed dry. You should also avoid potential irritants such as nail enamel, enamel remover, solvents, and detergents.
Onycholysis has several possible causes, including nail trauma, injury, or an allergic reaction. It can also be caused by a fungus, yeast infection, or psoriasis. Nails can also be a barometer of your overall health, and onycholysis can sometimes indicate a more serious underlying condition such as thyroid disease.
Treatment for onycholysis depends on the underlying cause. This may involve ceasing or changing a medication, treating a nail infection, or addressing an associated systemic condition or dermatosis. For example, doctors may prescribe topical vitamin D or corticosteroids to treat psoriasis-related onycholysis.
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Causes: injury, fungus, psoriasis, eczema, thyroid disease
Onycholysis, or nail lifting, is the separation of the fingernail or toenail from the nail bed. It is somewhat common and has several possible causes.
Injury
Injury to the nail is the most common cause of nail lifting. The condition can be the result of acute trauma or a number of more chronic issues. The portion of the nail that has separated from the nail bed cannot reattach itself, so treatment involves allowing new nail growth, which may take several months.
Fungus
Fungal nail infections can cause yellow and thick nails, often with white spots or streaks. If you have a fungal infection, proper nail care can stop it from spreading. Avoid biting your nails, and if the onycholysis is occurring in your toenails, make sure to wear clean socks and expose your feet to dry air as much as possible.
Psoriasis
Nail psoriasis causes nail changes such as pitting, nail bed separation, and discolouration. Treatment can prevent nail psoriasis from worsening. Injections of corticosteroids or other psoriasis medications can be effective.
Eczema
Atopic dermatitis (AD) is a common skin disease characterised by chronic, relapsing forms of skin inflammation. It is one of the main predisposing factors for chronic hand and foot eczema. Approximately 58.9% of active AD patients have hand eczema, and 16% of them experience nail changes.
Thyroid Disease
Onycholysis has been observed in patients with thyroid issues, including hyperthyroidism and hypothyroidism.
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Symptoms: white, yellow, or green discolouration
Fingernails that are partially or completely white in colour are described as having leukonychia. This condition can be caused by arsenic poisoning, heart disease, renal failure, pneumonia, hypoalbuminemia, trauma, liver disease, diabetes, an overactive thyroid, heart failure, chemotherapy, or a lack of nutrients in the diet. White nails with darker rims can indicate liver problems such as hepatitis. If your nails are mostly white with a narrow pink band at the tip, you may have a condition called Terry's nails, which can be caused by ageing, diabetes, kidney disease, liver disease, or heart disease. Arsenic poisoning may also cause white lines and horizontal ridges.
Yellow nails can be caused by a fungal infection, which is more commonly seen in toenails than fingernails. The most common fungal infection is from the Trichophyton family. Yellow nails can also be a symptom of thyroid disease, lung disease, diabetes, or psoriasis. Nails that are thick, slow-growing, and yellow can point to lung diseases like emphysema or chronic bronchitis. Fluid in the lungs and hands can also lead to yellow nail syndrome. So can Raynaud's phenomenon, which is caused by poor circulation to the fingers, toes, and nose. Yellow nail syndrome is characterised by yellow nails that lack a cuticle, grow slowly, and are loose or detached (onycholysis).
Green discolouration of the nails was not a common symptom found in the sources. However, yellow nails may progress to yellow-green discolouration in the case of yellow nail syndrome.
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Treatment: trim nails, wear gloves, avoid irritants
Onycholysis, or nail lifting, is the separation of the nail from the nail bed. It is usually caused by some sort of injury to the nail, fungus, or psoriasis. The condition does not go away on its own, and the affected portion of the nail should be clipped off. To prevent onycholysis, it is important to keep your nails trimmed, wear gloves, and avoid irritants.
Trimming your nails is an important step in treating and preventing onycholysis. Keep your nails short and trim them frequently, being careful not to cut them too short. This will help minimise trauma to the nail and nail bed, which can lead to onycholysis.
Wearing gloves is crucial, especially if you work with chemicals, detergents, or have your hands in water for extended periods. Choose waterproof gloves that do not irritate your skin, such as rubber or vinyl gloves. For wet work, consider wearing light cotton gloves under vinyl gloves for added protection. Glove liners can also be worn under regular gloves to absorb moisture and keep your nails dry.
Avoiding potential irritants is essential to prevent onycholysis. Stay away from nail enamel, enamel remover, solvents, and detergents, as these can all contribute to nail lifting. Opt for gentle soaps and lotions that are not irritating to the skin and be cautious when using chemicals or detergents. Additionally, avoid artificial nails and harsh products on your fingernails, as these can also cause nail lifting.
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Prevention: cut nails short, avoid harsh chemicals
Onycholysis, or nail lifting, is the separation of the fingernail or toenail from the nail bed. It is usually caused by an injury to the nail, but it can also be caused by fungal infections, certain medications, or underlying medical conditions. To prevent nail lifting, it is recommended to keep your nails trimmed short to prevent them from catching on objects and pulling off further from the nail bed.
When cutting your nails, it is important to avoid cutting them too short, as this can lead to painful ingrown nails. Make sure to only trim off the excess length and leave a small amount of white at the tip of the nail. Keep your nails and cuticles well-moisturized with nourishing cuticle oil or cream to prevent them from becoming dry and brittle, which can lead to breakage and damage. Filing your nails is crucial to creating even, smooth edges, but always file in a single direction to maintain the strength of your nails.
To avoid exposure to harsh chemicals, it is recommended to wear gloves when doing activities that may damage your nails, such as washing dishes or cleaning. When choosing nail products, opt for those that are labeled as "five-free," which means they do not contain formaldehyde, toluene, dibutyl phthalate, formaldehyde resin, or camphor. These chemicals can cause skin irritation, headaches, and even harm to unborn children during pregnancy. If you notice any signs of irritation, discontinue use of the product immediately.
Additionally, be cautious when using products that involve a harsh removal process, such as gel manicures or artificial nails, as these can damage the nail plate and cuticle. Soaking nails in acetone, aggressive buffing, and scraping can injure the nail plate. It is recommended to take intermittent breaks from nail polish and keep your nails natural and moisturized to maintain their health.
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Frequently asked questions
Your fingernails may be lifting off due to a condition called onycholysis, which is when the nail separates from the skin beneath it. This condition can be caused by a number of factors, including nail trauma, injury, or an allergic reaction.
The symptoms of onycholysis include an irregular border between the pink portion of the nail and the white outside edge of the nail. The nail may also appear white, yellow, or green, and the surface may be pitted, indented, or crumbly.
Treatment for onycholysis focuses on new nail growth and keeping the nail attached to the underlying nail bed. General measures that can be performed at home include clipping the affected portion of the nail, keeping the nail short, and avoiding activities that can result in nail injury or exposure to irritants.
It is recommended to visit a dermatologist if onycholysis affects more than one finger or toe. A doctor will be able to examine your nails and determine the underlying cause of the condition.
