Isla Bennett
If you've ever noticed your fingernail separating from the nail bed, you may have experienced onycholysis, the medical term for nail separation. This condition can affect both finger and toenails and is usually caused by trauma or injury to the nail. It can also be caused by fungal infections, certain skin conditions, and even underlying medical issues. While onycholysis is typically painless, it can lead to nail bed issues and permanent nail changes if left untreated. Effective treatment focuses on new nail growth and preventing further separation, which can take several months for fingernails and up to a year for toenails.
| Characteristics | Values |
|---|---|
| Medical Term | Onycholysis |
| Cause | Nail trauma, allergic reaction, fungal infection, injury, certain skin conditions, chemotherapy, medication causing light sensitivity, nail psoriasis, iron deficiency, hyperthyroidism |
| Symptoms | Fatigue, feeling cold, dizziness, weakness, headaches, sore tongue, fast heartbeat, nail discoloration, nail thickening, white spots or streaks, nail deformity, nail odour, nail fragility, nail separation |
| Treatment | Trimming the nail, wearing gloves, avoiding nail irritants, changing medications, using supplements, treating nail infection, antibacterial soaks, avoiding harsh chemicals, keeping nails dry |
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What You'll Learn
Onycholysis: the medical term for nail separation
Onycholysis is the medical term for nail separation, specifically when the nail pulls up and peels away from the nail bed. It is a common nail disorder that can affect people of any gender, age, or race, though it is most frequently observed in adult women. Onycholysis can occur in a single nail or multiple fingernails and/or toenails.
The condition is typically not painful, but it can be if the cause is acute or inflammatory. The affected nail may change colour to yellow, greenish, purple, white, or grey. The nail surface may appear normal or pitted, indented, or crumbly. In some cases, there may be dents or pits (cupuliform depressions) in the nails, and the white areas may vary in thickness.
Onycholysis can be primary (idiopathic, of unknown cause) or secondary to various factors. It can be caused by nail trauma or injury, skin disease, nail infections (especially fungal and yeast infections), tumours, or systemic events. Certain medications, such as chemotherapy drugs, tetracycline, non-steroidal anti-inflammatory drugs (NSAIDs), psoralens, and oral retinoids (vitamin A derivatives), can also lead to onycholysis. Additionally, it can be associated with underlying conditions like psoriasis, thyroid disease, vitamin deficiencies, or anaemia caused by iron deficiency.
The treatment of onycholysis focuses on addressing the underlying cause. It is important to keep nails short and trimmed, and avoid aggressive clipping. Specific treatments may include ceasing or changing medications, treating nail infections, or managing associated conditions. In the case of fungal or yeast infections, proper nail care is crucial to prevent the spread of the infection.
The duration of onycholysis varies, typically lasting several months or over a year. The detached portion of the nail will not reattach, and the goal of treatment is to promote new nail growth that remains attached to the nail bed. The time for nail regrowth is approximately 4-6 months for fingernails and 8-12 months for toenails, with some sources citing longer durations of up to 12-18 months for toenails.
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Nail trauma: an injury or repetitive action can cause separation
Onycholysis is the medical term for nail separation, when the nail peels away from the nail bed. This condition can be caused by nail trauma, which can be the result of an injury or a repetitive action.
Nail biting and cuticle biting are habits that can cause trauma to the nails. Nail biting is a common cause of acute paronychia, a bacterial infection that causes swelling and irritation. Repetitive picking at the nail and cuticle can also produce horizontal hatch marks in the nail and, in extreme cases, the nail can split. A subungual hematoma, which appears dark red under the nail, is another possible consequence of nail trauma. This can be treated by draining the blood trapped under the nail, either at home or by a physician.
Wearing shoes that are too small can also lead to toenail trauma. Toenails can take 12 to 18 months to grow out completely, so it is important to take care when trimming them.
Minor injuries such as stubbing your toe or catching your finger in a door can cause noticeable alterations to the nail. Severe trauma, such as crushing injuries or deep cuts, may result in long-term or permanent changes to the nail if the nail matrix is significantly damaged.
If you have experienced nail trauma, it is important to keep the area clean to promote recovery. In some cases, you may need to seek treatment from a dermatologist to restore nail health and appearance.
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Infection: a nail fungal infection may be the cause
Onycholysis, or nail separation, can be caused by a fungal nail infection. Fungi that multiply and lead to infections prefer warm, dark, and moist places like the feet. Toenails are more frequently affected by fungal infections than fingernails. However, fungal nail infections can occur on the fingernails as well, especially if your hands are constantly warm and damp.
Fungal nail infections can be spread in places such as communal showers, locker rooms, and gyms. The fungi enter through cracks or cuts in your fingers or toes, getting between your nail and nail bed. The infection causes the nail to thicken and become distorted, brittle, and crumbly. Nails may also show white spots and streaks, and the nail may become discoloured, turning yellow.
If you have a fungal nail infection, you may experience pain or discomfort, especially when using or placing pressure on the affected toe or finger. The nail may also give off an unpleasant odour.
To treat a fungal nail infection, antifungal medication may be recommended. Antifungal medication comes in tablets or a special paint that you apply directly to the nail. Laser treatment is another option for stubborn infections. The laser emits high doses of light energy to destroy the fungus.
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Allergic reaction: a reaction to a product can cause separation
Onycholysis is the medical term for nail separation, when the nail peels away and separates from the nail bed. This condition can be caused by an allergic reaction to a product.
Nail cosmetics include nail enamels (varnish/polish), nail enamel removers, cuticle removers, and artificial nails. Some people may have a sensitivity to one or more of the different chemical components that make up these products. The chemical most responsible for allergic reactions to nail enamel is tosylamide formaldehyde resin, which was found to be the seventh most common ingredient causing allergic contact dermatitis in patients with a cosmetic allergy. However, it appears that most who react to this resin do not also have a formaldehyde allergy. Other common allergens found in nail products include liquid methacrylate acid esters such as ethyl methacrylate, powdered polymethyl methacrylate polymer, benzoyl peroxide, and hydroquinone.
Gel nail polish is made up of various chemical components that work together to create a durable and glossy finish. The main ingredients typically include oligomers, monomers, photoinitiators, pigments and dyes, additives and dyes, additives, and solvents. People can develop allergies to certain chemicals found in gel nail polish, particularly methacrylates, which are the main compound in gel nail polish. Monomers and photoinitiators are also known to be skin sensitizers, which means that if they are accidentally absorbed into the skin, they may cause an allergy.
Allergic reactions to nail cosmetics around the fingers usually appear as redness and swelling of the fingertips. Other affected areas show a typical allergic contact dermatitis reaction. There may be intense swelling and redness of the area within a few hours or a rash may appear after a day or two after contact. The affected skin may be red, swollen, and blistered or dry and bumpy. Nail plate discolouration occurs with long-term use of coloured nail enamels, particularly if deep red nail polishes that contain D&C Reds No. 6, 7, and 34 are used.
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Treatment: keep the nail short and avoid irritants
Onycholysis, or nail separation, is a common nail disorder where the nail plate separates from the nail bed. It is usually painless but can be irritating and contagious if caused by a fungal infection. The condition can last for several months or over a year and may affect one or multiple nails.
To treat nail separation, it is recommended to keep your nails short and trimmed. This prevents them from catching on objects and pulling further off the nail bed. However, aggressive or forceful clipping is not advised. As the affected nail grows out, you can cut away the separated portion while allowing the new nail to grow in. Overall, the goal is to support the growth of a new nail.
To avoid further irritation, it is crucial to minimise activities that can traumatise the nail and nail bed. This includes avoiding nail biting and being cautious when cleaning underneath your nails. Certain tools, such as cuticle sticks and nail brushes, can break the skin and lead to infection. Additionally, it is advisable to refrain from using products that can irritate the nails or the surrounding skin, such as nail polish, nail gloss, nail hardener, nail polish remover, fake nails, and detergents.
Wearing gloves can provide protection for your nails and prevent further trauma. When performing tasks that may damage your nails, such as washing dishes, playing sports, or gardening, consider wearing gloves to shield your nails from potential irritants. For wet work, you can wear light cotton gloves under vinyl gloves for added protection.
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Frequently asked questions
There could be several reasons for this. The most common cause is trauma or injury to the nail. Even slight trauma, such as daily tapping on a keyboard, can cause nail separation. Other causes include fungal infections, yeast infections, certain skin conditions, and underlying medical conditions such as thyroid disease or eczema.
Treatment depends on the underlying cause. In general, it's important to keep your nails short and trimmed to prevent further separation and irritation. You should also avoid activities that may damage your nails, such as biting your nails or cleaning underneath them with sharp tools. If a fungal infection is the cause, you may need to take antifungal medications.
Fingernails typically take 4 to 6 months to fully regrow, but it can take up to 9 months. During this time, it's important to take preventive measures to avoid further separation and promote healthy nail growth.
