What Is It?
Onycholysis is the technical term for a nail lifting away from the nail plate. This can occur with fingernails and toenails. This condition is surprisingly common and may be due to a number of causes.
We tend to think of our toe and fingernails as being tough and hardy but the cells that make up our nails are very similar to our skin cells.
This means they are subject to damage from injury, fungal infections, and even skin cancers. So what happens when the nail separates from the nail bed (the skin underneath)? What are the most common causes and how do you treat it?
Trauma to the nail such as kicking your toe or a heavy object falling on your toe may lead to Onycholysis or nail lifting. Repeatedly smashing your finger with a hammer or catching it in a door, for example, or even simply drumming your fingers may result in onycholysis.
Repeated wearing of poorly fitting footwear may also cause nail damage and trigger onycholysis.
Some medications and nail care products such as chemical nail cosmetics and polish removers may cause allergic reactions that lead to nail lifting. Skin conditions such as nail psoriasis or a fungal infection are also very common causes of nail lifting.
The term Onychomadesis denotes the complete separation of the nail from the nail bed. Onychomadesis is not, strictly speaking, a nail disease but a secondary result of an underlying condition. This could be a range of issues such as Raynaud’s Disease, thyroid disease, a tumour, or other diseases.
Secondary infections may cause discolouration in the nail bed underneath the nail.
The nail simply begins to lift away from the nail bed. This is usually a painless and gradual process. However, the lifting nail may catch on socks and foot wear causing some discomfort. If there is an infection, you may see discolouration (yellow, green, purple or grey).
If a fungal disease is the trigger for your nail lifting you may see the nail become brittle and chalky white. A distinctive lined bruise-like pattern in your toenail may indicate a subungual melanoma. This can be a dangerous type of skin cancer and we will recommend further testing including a nail biopsy.
Once the nail starts lifting, the damaged nail will not reattach itself to the bed. Once the detached nail has fallen off nail growth will begin again.
In the case of nail trauma of injury the nail will usually regrow in a healthy normal fashion. With fingernails, this may take up to 6 months and for toenails up to 12 months.
Your nails, like your skin, reflect your state of health, and it is important to treat any underlying conditions otherwise the onycholysis will reoccur.
You can help make the nail lifting process painless by trimming the raised section of nail back to where it’s connected to the nail plate. If onycholysis is the result of trauma injury then this may be all you need to do.
In other cases, treatment of onycholysis usually requires treatment of the underlying problem otherwise, the condition will reoccur. We will undertake a thorough investigation to determine the cause of your onycholysis condition.
If your onycholysis is the result of an allergy, you will need to identify the cause. It may be that you will need to stop using particular nail polish or chemical polish removers or whatever the trigger might be.
Research shows that around 50% of psoriasis sufferers experience nail problems. Your doctor might prescribe vitamin D or corticosteroids to treat the problem.
Fungal infections can be notoriously difficult to treat and it is important to see your podiatrist to get an accurate diagnosis and the correct care. We often use highly effective laser treatment for treating fungal conditions underneath the nail.
Further Treatment Options
Tea tree oil and other essential oils are useful home remedies that can be used to fight fungal infection if that is the underlying cause. It’s important to wear slip-on footwear when using communal showers such as at the gym or swimming pool to prevent infection.
It might be that something as simple as ill-fitting footwear is damaging your nail and nail bed. The team at Erica Dash Podiatry are trained footwear fitters and are able to measure your foot with a Brannock Device to ensure you have the correct length and width shoe. Erica Dash Podiatry have a variety of shoes to fit the most difficult of feet.
Foam rubber cushioning can transform the way your feet work and feel. Custom orthotics may be necessary in severe cases where your gait is applying damaging pressure on the nails.
Erica Dash Podiatry: we have the expertise and the treatment tools to solve your nail problems.
Shockwave is a great alternative to treatments such as dry needling if you’re needle phobic and not keen on dry needling. We also have effective treatment offers for kids.