Onycholysis


Onycholysis

Description, Causes and Risk Factors:

ICD-10: L60.1

Onycholysis is the separation of a fingernail or toenail from its pink nail bed. The separation occurs gradually and is painless.

The most common cause of onycholysis is trauma. Even slight trauma can cause onycholysis when it happens repetitively - for example, the daily tapping of long fingernails on a keyboard or counter. Onycholysis also can be caused by manicure tools that are pushed beneath the nail to clear dirt or smooth the nail. Too much moisture also can cause the problem.

Onycholysis disease is not restricted to any one sex but generally women are more prone to it specially those who keep long fingernails. Actually long fingernails result in its tip being hit against hard objects repeatedly. It is also seen that the affected nails do not show any skin inflammation and the finger nail remains firm and smooth. It is simply because onycholysis is not a disease of the nails tissue matrix.

Some medical conditions can cause onycholysis, generally by changing the nail's shape or the contour of the soft tissue bed beneath it. In these situations, the nail cannot attach smoothly to the nail bed.

    Fungal infections of the nails thicken the tissue immediately underneath the nail plate and cause the edge of the nail to lift.

  • The skin condition psoriasis is a common cause of onycholysis.

  • Exposure to some medicines the nail can react to sun exposure by lifting away from its bed and sometimes cause onycholysis.

  • An overactive thyroid gland can cause onycholysis.

Symptoms:

A nail that has lifted from its bed at its end can have an irregular border between the pink portion of the nail and the white outside edge of the nail. A greater portion of the nail is opaque, either whitened or discolored to yellow or green. Depending on the cause of onycholysis, the nail may have collected thickened skin underneath the edge of its nail plate, and the nail plate may have a deformed shape with pits or indentations in the nail surface, a bent nail edge or coarse thickening of the nail.

In addition, most of the nail turns opaque and loses its natural coloration. There might also be discoloration of the nails to yellow or green. That actually signifies secondary infection making the situation more serious. Secondary infections might also result in the deformation of the shape of the nail plate and appearance of pits and indentations in the nail surface.

Diagnosis:

Your doctor will be able to confirm that you have onycholysis by examining your fingernails or toenails. If the cause of onycholysis is not obvious, your doctor will note additional characteristics of your nails, such as their shape and color, the presence of indentations in the nail surface, and the appearance of the skin under and around the nail. He or she also will examine you to check for evidence of skin rashes or thyroid problems. If your doctor suspects that a fungal infection is the cause of nail changes, he or she might scrape a sample of tissue from beneath the nail plate. This sample can be tested in a laboratory to check for fungus.

Treatment:

Treatment would certainly be slow as the nail grows very slowly. The nail which has detached itself can't be reattached. The only way to go is to let fresh nails grow and replace it. You should also keep in mind one thing. It is very difficult to cure and most often it leaves permanent marks on the nail. It might permanently change its appearance.

Treatment for onycholysis depends on the cause of the problem:

    Treatment for hyperthyroidism can permit the nails to re-grow normally.

  • Some treatments for psoriasis that are given by mouth may improve nail health.

  • Fungal nail infections sometimes can be treated with prescription medicines. However, the medicines required to treat the nail condition are expensive and can have side effects. You should discuss the pros and cons of treatment with your doctor.

Preventive Measures May Include:

    Cut nails to a comfortable length so that they will be less likely to endure repeated trauma from tapping in everyday use.

  • Wear rubber gloves to avoid repetitive immersion in water. Nails expand after they are exposed to moisture and then shrink while drying, a cycle that over time can make them brittle. Keeping your nails dry also will help prevent fungal infections.

  • Avoid frequent exposure to harsh chemicals, such as nail polish remover.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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