Onycholysis

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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.

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