Sophia Delgado
Long nails can be a style statement for many, but they can also be a cause for concern. Nails that extend past the fingertips can separate from the nail bed, a condition known as onycholysis. This condition can be unsightly and persistent, requiring new nail growth to resolve. Onycholysis can be caused by various factors, including nail injuries, fungal infections, and even manicures. It is characterised by nails lifting or peeling away from the skin underneath, and while it is usually painless, it can be contagious if caused by a fungus. Treatment options include cutting away the affected nail, oral or topical antifungal medications, and proper nail care to prevent the spread of infection.
| Characteristics | Values |
|---|---|
| Medical term | Onycholysis |
| Cause | Nail injury, fungus, psoriasis, yeast growth, chemicals in nail products, or fungal infection |
| Symptoms | Nails lift or peel away from the nail bed, nail thickening, nail turning yellow, white spots or streaks on nails |
| Treatment | Cut away separated nail, antifungal medication, stop using certain nail products, tea tree oil diluted with a carrier oil |
| Regrowth time | 4–6 months for fingernails, 8–12 months for toenails |
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What You'll Learn
Onycholysis: the medical term for nail separation
Onycholysis is the medical term for nail separation, derived from the Ancient Greek words "ónuks", meaning nail, and "lúsis", meaning lysis or disintegration. It is a common condition characterized by the detachment of the nail from the nail bed, usually starting at the tip and/or sides. While it typically affects a single nail, it can occur on any of the fingernails or toenails, particularly the ring finger.
The condition has several possible causes, including injuries or trauma to the nail or the nail matrix (the area where nails start to grow). Such injuries can result from various activities, including bumping or hitting nails, wearing tight shoes, prolonged exposure to water, frequent manicures, or even tapping nails on a hard surface over an extended period. Onycholysis can also be caused by a reaction to chemicals in nail products, fungal infections, or certain underlying health conditions.
In terms of treatment, it is crucial to identify the underlying cause of onycholysis. Once the cause is determined, addressing it will help resolve the nail separation. For instance, if the issue is caused by a fungal infection, oral or topical antifungal medications may be prescribed. Additionally, keeping the nail dry and trimmed is essential to promote reattachment and prevent further separation. However, aggressive clipping is not recommended, and cleaning under the nail should be avoided as it can worsen the condition.
In some cases, onycholysis may indicate a more serious underlying condition, such as a yeast infection, thyroid disease, vitamin or mineral deficiencies, or graft-versus-host disease (GVHD) following a stem cell transplant. Therefore, if nail separation occurs without an apparent cause, it is advisable to consult a healthcare provider to rule out any potential underlying health issues.
While onycholysis is not typically painful, it can be contagious if caused by a fungal infection. It is often accompanied by other symptoms, including fatigue, dizziness, headaches, and a sore tongue. Effective treatment can lead to nail reattachment as new nail growth occurs, although this process can take several months for fingernails and up to 18 months for toenails.
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Causes: injury, fungus, chemicals, psoriasis, yeast infection
Onycholysis, or nail separation, can occur due to various factors, including injuries, fungal infections, chemical reactions, nail psoriasis, and yeast infections.
Injury to the nail or the nail matrix (the area where nails start to grow) can cause onycholysis. Such injuries can occur from bumping or hitting nails, wearing tight shoes, prolonged exposure to water, or even aggressive manicures. Regularly tapping your nails on a hard surface can also lead to nail separation over time.
Fungal infections are another common cause of onycholysis. Fungi enter the nail bed through cracks or cuts in the fingers or toes, causing the nails to thicken and turn yellow, with white spots and streaks. This type of onycholysis is contagious and can spread through skin-to-skin contact or by touching infected surfaces.
Chemical reactions to nail products like nail polish, nail gloss, nail hardeners, and fake nails can also lead to nail separation. Avoiding irritant chemicals and wearing gloves during activities that may damage nails can help prevent this issue.
Nail psoriasis, an autoimmune condition, can also cause onycholysis. It leads to discoloration, pitting, and changes in nail structure, such as horizontal grooves (Beau's lines). While nail psoriasis is not contagious, it is a chronic condition that can cause flare-ups throughout life.
Lastly, yeast infections, often caused by Candida, can result in onycholysis. Yeast onychomycosis is more likely to affect fingernails than toenails and may indicate a weakened immune system.
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Symptoms: nail lifts, thickens, discolours, shows streaks
Fingernail and toenail abnormalities can indicate an infection, injury, or an underlying condition. If your nails show any of the following symptoms—lifting, thickening, discolouration, or streaking—it is important to determine the cause and seek appropriate treatment.
Nail lifts:
Nail lifting, or onycholysis, occurs when a nail separates from its nail bed. It is often caused by injury or trauma to the nail or nail matrix, such as bumping or hitting the nail, wearing ill-fitting shoes, or prolonged exposure to water. Regular manicures, forceful trimming, buffing, and polishing can also lead to onycholysis. Additionally, chemical exposure and reactions to nail products like nail polish, gloss, hardeners, or fake nails can be contributing factors. Onycholysis can also be caused by fungal infections, which may require antifungal medication. In some cases, it may be a sign of hyperthyroidism.
Nail thickens:
Thickened nails are commonly caused by fungal nail infections, which can also lead to discolouration and crumbling of the nail. Other possible causes include psoriasis, reactive arthritis, and long-term pressure from ill-fitting shoes. In older individuals, severely thickened and overgrown nails, known as onychogryphosis or "ram's horn nails," may develop and require professional intervention for removal.
Nail discolours:
Fungal infections can cause nails to become thick and yellow, with the appearance of white spots and streaks. This discolouration can also be a sign of a bacterial infection, such as acute paronychia, which may require antibiotic treatment. In some cases, discolouration can indicate a more serious underlying condition. For example, brown discolouration of the nail plate has been associated with hyperthyroidism.
Nail shows streaks:
White streaks or spots on nails are usually harmless and nothing to worry about. However, parallel white lines extending across the nails, known as Muehrcke's lines, can indicate low protein levels in the blood and may be linked to liver disease or malnutrition. Splinter haemorrhages, which appear as small, thin, red or brown lines, can be a sign of endocarditis, especially when accompanied by other symptoms such as fever or skin lesions.
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Treatment: antifungal medication, avoid chemicals, keep nails dry
Fingernails and toenails can become separated from the nail bed due to several reasons, including injury, fungal infections, and reactions to chemicals in nail products. Onycholysis, or nail separation, can cause the nail to thicken and become yellow, with white spots and streaks. While it typically affects only one nail, it can sometimes occur in multiple nails due to iron deficiency.
Treatment: Antifungal Medication
If onycholysis is caused by a fungal infection, your healthcare provider may prescribe oral or topical antifungal medication. Oral antifungal medication comes in the form of liquid medicines, pills, or tablets, such as terbinafine (Lamisil®), itraconazole (Sporanox®), and fluconazole (Diflucan®). Topical antifungal treatments include creams, ointments, or gels that are rubbed directly onto the nails. It is important to complete the full course of antifungal medication to prevent a recurrence of the fungal infection.
Avoid Chemicals
Another way to treat and prevent onycholysis is to avoid certain chemicals and products that can irritate the nails or the skin surrounding them. These include nail polish, nail gloss, nail hardeners, nail polish removers, and fake nails. It is recommended to wear gloves when engaging in activities that may damage your nails, such as washing dishes, playing sports, or working outdoors.
Keep Nails Dry
Fungal infections thrive in damp environments. Therefore, it is essential to keep your nails and feet clean and dry to prevent the growth of fungi. Allow damp shoes to dry completely before wearing them, and practice good nail hygiene by keeping your nails trimmed and sanitizing your nail clippers or scissors.
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Prevention: keep nails short, avoid trauma, moisturise cuticles
Onycholysis, or nail separation, is a common condition in which the nail separates from the nail bed, or the skin beneath it. It is often caused by trauma or injury to the nail or nail matrix, which can occur through various everyday activities such as bumping or hitting nails, wearing tight shoes, or even prolonged exposure to water. Even regular manicures or the simple act of tapping nails on a hard surface over time can cause onycholysis.
To prevent onycholysis, it is important to keep nails short and trimmed. This helps to avoid accidental trauma to the nail and the nail matrix, as shorter nails are less likely to come into contact with surfaces or be exposed to water for extended periods. Keeping nails short also reduces the risk of yeast or fungal growth, as these organisms have less surface area to grow on.
Avoiding trauma to the nails and nail matrix is crucial. This includes being mindful of the force applied during manicures and pedicures, choosing well-fitting footwear, and refraining from habits such as nail-biting or picking at cuticles. Activities that put repeated pressure on the nails, such as tapping on a hard surface, should be avoided as well.
Moisturising cuticles can also help prevent onycholysis. Cuticles are the thin layers of skin at the base of the nail, and keeping them moisturised helps to maintain their integrity and create a protective barrier. This can be done by regularly applying a cuticle oil or cream, ensuring that the product is gently massaged into the cuticle area.
Additionally, it is important to be cautious when using nail care products. Some chemicals in nail polish, nail gloss, nail hardeners, and artificial nails can contribute to onycholysis. It is recommended to always read the labels and instructions on these products and to avoid using them if onycholysis is present.
By following these preventive measures, you can help keep your nails healthy and reduce the risk of experiencing onycholysis, allowing your nails to grow past your fingertips without separation.
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Frequently asked questions
Nails growing past fingertips is a condition called onycholysis, where the nail separates from the skin beneath it, or the nail bed. This condition may be caused by a nail injury, fungus, or psoriasis.
Treatment for onycholysis involves cutting away the separated nail as it grows out. If the cause of onycholysis is fungal, your healthcare provider may prescribe oral or topical antifungal medication.
Fingernails typically take 4 to 6 months to fully regrow, while toenails can take 8 to 18 months.
Onycholysis is easy to spot. If you notice that your nail is beginning to lift or peel away from the nail bed, you have onycholysis. It usually isn't painful, but it can be contagious if caused by a fungus.
