Nail separation can sometimes be associated with other abnormalities of the nails, including nail pitting, flaking or crumbling, or other damage to or changes in the nail.
One of the most common conditions that affects the nail is onycholysis, which is the separation of the nail plate from the nail bed. Onycholysis occurs as a result of or along with a great variety of nail traumas and disorders.
Some medical conditions can cause onycholysis, generally by changing the nail's shape or the contour of the soft tissue bed beneath it. In these situations, the nail cannot attach smoothly to the nail bed.
- Fungal infections of the nails thicken the tissue immediately underneath the nail plate and cause edge of the nail to lift.
- The skin condition psoriasis is a common cause of onycholysis.
- After exposure to some medicines (notably medicines from the psoralen, tetracycline or fluoroquinolone groups) the nail can react to sun exposure by lifting away from its bed.
- An overactive thyroid gland can cause onycholysis.
Some ingredients used in nail products, such as formaldehyde, may also cause onycholysis if the products are misused. Formaldehyde, found in trace amounts in some nail polishes and hardeners, can cause onycholysis in two ways: as a solvent dissolving the connection between the nail plate and the nail bed or as an allergen causing an allergic reaction. While only a trace amount of formaldehyde can cause onycholysis if a person is allergic to it, the situation is very uncommon.
Signs and Symptoms of Onycholysis?
- Irregular border between the pink portion of the nail and the white outside edge of the nail when the nail has lifted from the nail bed.
- Larger portion of the nail is opaque, can be whitened or discoloured to yellow or green.
- Discoloration underneath the nail may occur as a result of secondary infection.
- Depending on the cause, the nail may collect thickened skin underneath the edge of its nail plate and the nail surface may become deformed with pits or indentations.
- It is usually painless as the separation occurs gradually. Pain may occur if nail is further detached from the nail bed as result of trauma or if active infection sets in.
Prevention of Onycholysis
The following preventive measures can make oncholysis less likely to occur:
Cut nails to a comfortable length so that they will be less likely to endure repeated trauma from tapping in everyday use.
Wear rubber gloves to avoid repetitive immersion in water. Nails expand after they are exposed to moisture and then shrink while drying, a cycle that over time can make them brittle. Keeping your nails dry also will help prevent fungal infections.
Avoid frequent exposure to harsh chemicals, such as nail polish remover.
Treatment for Onycholysis
Treatment of onycholysis depends on the cause of the problem. Eliminating or correcting the predisposing cause is the best treatment. For example, treatment of hyperthyroidism will allow the nails to regrow normally and nail infections can be treated with antimicrobials.
The portion of nail that has separated will not reattach to the nail bed and you will have to wait until the nail is fully regrown for the condition to be completely gone. Fingernails take 4-6 months to fully regrow whilst toenails may take twice as long.
If the condition does not clear up within a few weeks, you should refer your client to a dermatologist. Once the cause of the onycholysis has been determined and treated, in most cases it should disappear.
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