Onycholysis

What Is Onycholysis?

Onycholysis is a condition where the nail plate separates from the nail bed, often leading to a noticeable gap. This separation can affect fingernails or toenails and may cause the nail to become discolored and brittle.

Symptoms

• Nail Separation: The nail plate detaches from the nail bed, often starting at the tip and moving toward the base.
• Change in Nail Color: The detached part of the nail may appear white, yellow, or green.
• Nail Texture: The affected area may become brittle or fragile.
• Discomfort or Pain: In some cases, there may be pain or discomfort at the nail bed, especially if there’s an infection.

Causes

Onycholysis can result from various factors, including:

• Trauma or Injury: Repeated trauma or pressure on the nail can lead to separation.
• Fungal Infections: Fungal infections are a common cause, leading to discoloration and separation.
• Psoriasis: This skin condition can affect the nails, causing them to lift from the nail bed.
• Thyroid Disorders: Hyperthyroidism or hypothyroidism can lead to onycholysis.
• Chemical Exposure: Harsh chemicals or nail products can weaken the nails.
• Medication Side Effects: Certain medications, including chemotherapy drugs and some antibiotics, can cause nail changes.
• Systemic Conditions: Conditions like diabetes or peripheral artery disease can contribute to onycholysis.

Diagnosis

Diagnosing onycholysis typically involves:

• Physical Examination: A healthcare provider will inspect the nails for signs of separation and discoloration.
• Medical History: Discussing any recent injuries, medical conditions, medications, or exposure to chemicals.
• Laboratory Tests: Blood tests may be performed to check for underlying conditions such as thyroid disorders or diabetes.
• Nail Clipping Analysis: A sample of the affected nail may be examined under a microscope to identify fungal infections.

Treatment

Treatment for onycholysis focuses on addressing the underlying cause and managing symptoms:

1. Avoid Trauma: Protect nails from further injury by trimming them carefully and avoiding activities that could cause trauma.
2. Treat Infections:
   • Topical Antifungals: If a fungal infection is present, antifungal creams or lacquers may be prescribed.
   • Oral Antifungals: For severe infections, oral antifungal medications might be necessary.
3. Manage Underlying Conditions: Treat any underlying health issues, such as thyroid disorders or psoriasis, with appropriate medications and therapies.
4. Proper Nail Care:
   • Keep nails trimmed and clean.
   • Avoid harsh chemicals and nail products.
   • Use moisturizing lotions to keep the nails and surrounding skin hydrated.
5. Regular Monitoring: Regular follow-up with a healthcare provider to monitor the condition and adjust treatment as needed.

By addressing the root cause and following appropriate care guidelines, onycholysis can often be managed effectively.