Onycholysis is a medical condition that causes the fingernails or toenails to separate from their pads gradually and painlessly. One of the most likely causes is trauma, but you also shouldn't rule out other factors and should see a doctor for an accurate diagnosis. If the cause is another medical disorder, the doctor can help treat it so that nail health returns. If the cause is exposure to excess moisture or chemicals, your nails should recover with proper prevention and treatment.
Step
Method 1 of 3: Finding the Cause
Step 1. See a doctor if you experience symptoms of onycholysis
Supposedly, your doctor can diagnose the cause of onycholysis just by examining the condition of your nails. In addition, the doctor may also take a tissue sample from behind one of the nails to identify the presence or absence of a fungal or other infection. See a doctor if:
- One or more of the nails come off the pads
- The boundary between the nail bed and the white outside of one or more nails is unequal
- Most of the nails look blurry
- One or more of the nail plates look crooked or sunken
Step 2. Tell your doctor what medicines you are taking
Some medications can increase the sensitivity of the nail to sun exposure and cause it to fall off the pads. Drugs in the psoralen, tetracycline, or fluoroquinolone categories have been shown to be most susceptible to this reaction. Therefore, inform all types of over-the-counter and prescription drugs to eliminate this possibility.
Step 3. Tell your doctor if you have a history of psoriasis or other skin problems
If you've previously been diagnosed with psoriasis, tell your doctor because psoriasis is one of the causes of onycholysis. If not, share any skin problems you've been experiencing recently. Some of the symptoms of psoriasis are:
- Skin feels dry, looks cracked, or bleeds
- Red rash appears on the skin
- Skin looks thickened with a silvery tint
- Itchy, painful, or burning skin
Step 4. Consider any recent hand and foot injuries
Trauma to the nail bed can lead to gradual and painless onycholysis. Therefore, tell your doctor if you have recently suffered an injury that might affect the health of your nails, including when your fingernail was broken or pulled out as a result of a collision with a hard object.
Injuries can be minor, such as when your big toe is injured lightly, or major, such as when your finger is caught in a car door
Step 5. Consider possible environmental factors
In fact, exposure to stressors can damage nails and, over time, put them at risk for onycholysis. Therefore, try to think about your nail cleaning and grooming routine, as well as any other activities you do that might be causing it. Some of the stressors you can consider are:
- Prolonged exposure to water (such as from swimming too much or washing dishes)
- Excessive use of nail polish, artificial nails, or nail polish remover
- Too often exposure to chemicals, such as cleaning products
- Have flat feet and often walk in closed shoes with uneven pressure
Method 2 of 3: Treating Onycholysis
Step 1. Trim the nails to minimize the risk of further trauma
Nails that are separated from their bearings are actually very susceptible to injury. Therefore, consult the doctor's possibility of removing the separated nail using a medical procedure. Don't try to do it yourself so your nails won't hurt more, get infected, or sustain further injury!
If there is an infection behind the nail, taking a separate nail will make it easier for you to apply the medicine directly to the problem area
Step 2. Use an antifungal medication if the onycholysis is caused by a yeast infection
Before the nail grows back, the bacteria and fungus behind it must first be killed. After diagnosing the infection, the doctor will prescribe oral and topical antifungal medications to treat it. Make sure you take or apply the medicine as directed by the doctor until new and healthy nails grow back.
- Oral medications should be taken for 6-24 weeks, depending on the severity and nature of the infection.
- Topical ointment or cream should be applied daily around the nail bed. Usually, its effectiveness will not be seen in the near future.
- In general, oral medications are more effective than topical medications, but carry additional side effects such as the risk of liver damage.
- Recheck your condition after doing treatment for 6-12 weeks.
Step 3. Talk to your doctor about treatment options for treating onycholysis caused by psoriasis
Discuss the options with your doctor to find the most effective method for your case. Some of them are:
- Taking oral medications such as methotrexate, cyclosporine, and retinoids
- Using topical medications such as corticosteroids, synthetic vitamin D, anthralin, calcineurin inhibitors, salicylic acid, and topical retinoids
- Perform light therapy, such as UVB phototherapy, narrow band UVB phototherapy, and excimer laser therapy
- In addition, you can also do natural therapies such as using aloe vera, fish oil, and using Oregon grapes topically
Step 4. Consult the possibility of taking supplements with your doctor, if you have vitamin and mineral deficiencies
Lack of vitamins and minerals can make nails brittle and break easily. As a result, the nails will be difficult to grow back after experiencing onycholysis. To fix this, try asking your doctor for recommendations for supplements that can maintain nail strength. In particular, iron supplements are great for strengthening the condition of your nails.
- In addition, you can also take biotin and B vitamins to improve nail health.
- Taking a daily multivitamin is the perfect step to ensure that your body receives the various types of vitamins it needs.
- Chances are, your doctor will also ask you to increase your intake of vitamins and minerals in your daily diet.
Step 5. Apply a special drying agent prescribed by your doctor if your nails start to get wet
To keep your fingernails or toenails from getting too wet during the recovery process, try applying a special drying agent like 3% Thymol in an alcohol solution, which you can ask your doctor for a prescription for. This kind of drying agent should be applied directly to the nails with the help of a dropper or small brush.
Use the drying agent for 2-3 months while the nail recovery process takes place
Method 3 of 3: Preventing Onycholysis
Step 1. Make sure your nails are clean and dry
Prevent bacterial or fungal growth behind your nails by cleaning them frequently with soapy water, then rinsing and drying them thoroughly.
Step 2. Wear the right size shoes
Shoes that are too small can put pressure on your toenails and make them more susceptible to trauma. Remember, prolonged trauma may increase the risk of onycholysis.
Step 3. Don't wear wet or damp shoes for too long
Wet feet can trigger fungal growth and increase the risk of onycholysis! Therefore, always wear waterproof shoes or boots if you have to work or exercise in wet areas. Also remove sweat-soaked socks after exercise to prevent bacterial growth.
- Dry shoes naturally if they are wet.
- If you exercise a lot, try buying some sneakers so that wet or damp footwear doesn't have to be worn over and over again.
Step 4. Wear gloves when washing clothes, washing dishes, and cleaning the house
All three are prone to making nails constantly submerged in water and exposed to chemicals. As a result, the risk of onycholysis will increase. Therefore, always protect your hands with rubber gloves when cleaning the house, washing dishes, washing clothes, and doing similar work. Gloves are also able to protect long nails from injury while working.
Step 5. Keep nails short and clean
In fact, it is easier for bacteria and excess moisture to accumulate behind long nails. As a result, owners of long nails are at higher risk for onycholysis. To prevent this, trim your nails regularly with special nail clippers to keep them short and neat. Make sure you also file your nails to smooth out the edges.
