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This article was co-written by Luba Lee, FNP-BC, MS. Luba Lee is a licensed family physician practicing in Tennessee. She received her MSN from the University of Tennessee in 2006.
There are 8 references cited in this article that you can see at the bottom of the page.
This article has been viewed 3,214 times.
Onychpysis is a condition in which the fingernails or toenails gradually separate from the nail bed. The most common cause is trauma, but there are other factors that lead to nail separation. You should see your doctor to determine the cause. If there’s an underlying medical condition causing the problem, your doctor will help you treat it so your nail can heal. If it is caused by trauma or prolonged exposure to moisture or chemicals, nail separation usually resolves with appropriate treatment and preventive measures.
Steps
Define the reason
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See your doctor if you have symptoms of nail separation. Your doctor can determine the cause of the nail separation by examining the nail. They may also take a sample of tissue underneath the nail to test for fungus or other infections. See your doctor if you have the following symptoms: [1] X Trusted Source Harvard Medical Schop Go to source
- One or more nails are lifted from the nail bed below
- The edge between the nail bed and the outer white nail has an irregular shape
- The wide part of the nail is opaque or discolored
- The nail plate is deformed because of dents or curved edges
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Tell your doctor about all the medicines you are taking. Some medications can cause the nail to react to sun exposure, causing the nail to separate from the nail bed. The drugs of the psoralen, tetracycline or fluoroquinpone class are most notable. Tell your doctor about any prescription or over-the-counter medications you are taking so he or she can rule out this cause. [2] X Harvard Medical Schop Trusted Source Go to Source
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Tell your doctor if you have a history of psoriasis or other skin conditions. Let your doctor know if you’ve been previously diagnosed with psoriasis, as it can lead to nail detachment. If you haven’t been diagnosed, tell your doctor about any skin problems you’ve had recently. Psoriasis symptoms can include: [3] X Trusted Source Mayo Clinic Go to source
- Dry, cracked or bleeding skin
- There are red patches on the skin
- There are silvery flakey patches on the skin
- Itchy, burning or painful skin
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Tell your doctor about recent injuries to your hands and feet. Injury to the nail bed can lead to gradual and painless separation of the nail. Tell your doctor if you have had any trauma that affects the nail, including trauma or stabbing injuries that cause the nail to break or tear. [4] X Trusted Source Science Direct Go to Source
- Injuries can range from minor incidents like tripping a toe to more serious accidents, such as getting a finger stuck in a car door.
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Consider any external environmental causes. Exposure to environmental agents can damage the nail, gradually leading to nail separation. Review your routines like cleaning, manicure, and other activities to determine which habits may be to blame. Environmental and occupational factors that damage nails can include: [5] X Trusted Source Science Direct Go to source
- Soaking in water for long periods of time (such as frequently swimming or washing dishes)
- Regularly apply nail polish, fake nails or use nail polish remover
- Frequent exposure to chemicals, such as cleaning products
- Wearing closed-toe shoes when the foot is subjected to uneven pressure due to flatfoot [6] X Trusted Source PubMed Central Go to source
Cure nail disease
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Cut nails short to prevent further damage. Nails that are separated from the nail bed are very vulnerable. Ask your doctor if they can help you remove the split nail in the clinic. If you do this yourself at home, there is a risk that the nail will become sore, infected, or damaged. [7] X Research Sources
- If you have an infection under your nail, removing the nail will help you apply the medication directly to the infected area.
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Use antifungal medication if the nail fungus is caused by a fungal infection. Nails can only grow back when the fungus and bacteria underneath the nail have been destroyed. After diagnosing a fungal nail infection, your doctor will prescribe an oral or topical antifungal medication to help treat the infection. You need to take or apply medication exactly as prescribed by your doctor until a new healthy nail begins to grow. [8] X Research Sources
- Oral medication should be used for 6-24 weeks, depending on the severity and nature of the disease.
- Topical creams or ointments need to be applied daily around the nail bed and usually have slower results.
- Oral medications are generally more effective than topical medications, but carry some risks, such as liver damage.
- Follow-up visit after 6-12 weeks of treatment.
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Ask your doctor about treatment options for psoriasis-induced nail detachment. Psoriasis is a common cause of nail separation. Talk to your doctor about psoriasis treatment options to choose the most effective method. These options include: [9] X Trusted Source Mayo Clinic Go to source
- Oral medications such as methotrexate, cyclosporine, and retinoids
- Topical medications such as corticosteroids, synthetic vitamin D, anthralin, calcineurin inhibitors, salicylic acid, and topical retinoids.
- Light therapies such as UVB irradiation, narrow band UVB rays, excimer lasers
- There are also natural remedies like aloe vera, fish oil and topical creams made with Oregon grape extract
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Ask your doctor about supplements if you have vitamin and mineral deficiencies. Vitamin and mineral deficiencies can make nails weak and brittle, making it difficult for them to regrow. Ask your doctor if you should take supplements to help strengthen your nails. Iron in particular can help strengthen nails. [10] X Research Source
- Biotin, a B vitamin, may also improve nail health.
- Taking a multivitamin every day will help you get all the vitamins your body needs for overall health.
- Your doctor may also recommend changes to your diet to increase the amount of vitamins and minerals your body needs.
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Apply a nail drying solution prescribed by your doctor. To protect your nails from getting wet while they heal, you can apply a drying solution after your hands or feet get wet. Ask your doctor if they can prescribe a drying solution like Thymp 3% in alcohol. This solution can be applied directly to the nail using a dropper or a small brush. [11] X Research Source
- Apply a drying solution for about 2-3 months while the nail heals.
Prevent nail disease
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Keep nails clean and dry. Prevent bacteria and fungus from growing under your nails by washing your hands often throughout the day. Rub mild hand soap into lather and rinse thoroughly. Remember to dry your nails thoroughly after getting wet. [12] X Research Source
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Choose the right shoe size. Small shoes will compress the toes and cause injury. Long-term pressure on the nail will lead to nail separation.
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Avoid wearing wet shoes for long periods of time. Wet feet can cause onychomycosis and lead to nail detachment. Wear waterproof shoes or boots if you must walk or exercise in wet conditions. Remove sweaty shoes and socks immediately after exercising to prevent bacteria from multiplying. [13] X Research Source
- Let the shoes dry completely when the shoes get wet.
- If you exercise regularly, consider buying multiple pairs of sneakers to avoid having to wear wet shoes.
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Wear gloves when cleaning. Prolonged exposure to chemicals and frequent immersion in water can lead to lichen planus. You should protect your hands by wearing rubber gloves when cleaning the house, washing dishes or doing similar things. Gloves also help protect long nails from injury when doing housework. [14] X Research Source
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Cut and keep nails clean. Moisture and bacteria easily accumulate under the nails to lengthen and increase the risk of nail splitting. To avoid this situation, you should regularly cut your nails short and neat. Use a clean nail clipper when trimming your nails and be sure to file the edges. [15] X Harvard Medical Schop Trusted Source Go to Source
- Short nails are also less prone to injury.
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This article was co-written by Luba Lee, FNP-BC, MS. Luba Lee is a licensed family physician practicing in Tennessee. She received her MSN from the University of Tennessee in 2006.
There are 8 references cited in this article that you can see at the bottom of the page.
This article has been viewed 3,214 times.
Onychpysis is a condition in which the fingernails or toenails gradually separate from the nail bed. The most common cause is trauma, but there are other factors that lead to nail separation. You should see your doctor to determine the cause. If there’s an underlying medical condition causing the problem, your doctor will help you treat it so your nail can heal. If it is caused by trauma or prolonged exposure to moisture or chemicals, nail separation usually resolves with appropriate treatment and preventive measures.
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