Onycholysis is a common nail problem when the nail separates from the nail bed. It is also referred to as nail lifting. It can be a sign of a skin disease, an infection or the result of injury. The majority of the cases, however, are women with long fingernails or “trouble” toenails and patients with fungal nail infections.
You can injure your finger or toe nails by accident, such as with a splinter or other physical trauma to the nail bed, but an injury to the nail may also develop from excessive filing, chemical overexposure in manicures and pedicures, nail tip application, allergic reaction to a nail hardener or adhesives used to attach fake nail, or from other consistent mechanical or chemical stress to the nail. Certain medications (Oxsoralen, Tetracycline, Minocycline, Naproxen) may cause abnormal sensitivity to light. These patient get sunburns under the nails, which may cause onycholysis.
In rare cases all nails are affected and begin separating from nail beds. Typically this is a sign of severe iron deficiency in the patient or thyroid hyperactivity.
Untreated or poorly treated fungal infections and nail psoriasis can cause onycholysis. Fungus starts to occur in the space under the nail and slowly appears as off-white, yellowish or brown tinge. Nails may start separating at an advanced stage of toenail fungus (onychomycosis). Patients may feel discomfort when walking and a foul odor is common. If this condition is not medically treated the nails will not re-attach. The deformity may be permanent.
For treatment all of the unattached nail must be clipped off. The hand should be kept out of water as much as possible. Use gloves when cleaning and washing. It is very important to avoid mechanical cleaning under nails. One should not bandage or cover the cut nails. A drying agent such 3% Thymol in alcohol (by prescription) should be used after washing hands or getting hands wet for two or three months. Trim the nails back daily with a clipper until reattachment is seen. Additional medications by mouth may be needed in some cases.