Onycholysis, the separation of the nail plate from the nail bed, stands as one of the most common nail conditions. It often arises due to various nail traumas and disorders.
Medical conditions can induce onycholysis by altering the nail’s shape or the soft tissue bed beneath it, preventing smooth attachment to the nail bed. Causes include:
- Fungal infections thickening tissue beneath the nail plate, leading to its lifting.
- Psoriasis, a skin condition, commonly triggers onycholysis.
- Certain medications, notably from the psoralen, tetracycline, or fluoroquinolone groups, can prompt nail reaction to sun exposure, causing separation from the bed.
- Overactive thyroid gland may also contribute to onycholysis.
Ingredients in nail products, like formaldehyde, may induce onycholysis if misused. Formaldehyde, found in some polishes and hardeners, dissolves the nail plate-bed connection or acts as an allergen, triggering reactions.
Symptoms of onycholysis include:
- Pink-to-white border irregularity where the nail lifts from the bed.
- Opaque nail portion, possibly whitened or discolored.
- Discoloration beneath the nail due to secondary infection.
- Thickened skin collection beneath the nail plate edge, with possible nail surface deformities.
Preventive measures include maintaining comfortable nail lengths, wearing rubber gloves to limit water exposure, and avoiding harsh chemicals like nail polish remover.
Treatment varies based on the cause. Addressing underlying conditions is paramount. The separated nail portion won’t reattach, necessitating wait for full regrowth (4-6 months for fingernails, longer for toenails). Persistent cases should prompt referral to a dermatologist for further evaluation and treatment.