Summary about Disease
Onycholysis is the separation of the nail from the nail bed. This separation usually starts at the tip or sides of the nail and progresses towards the cuticle. The affected portion of the nail appears white or opaque due to the air space beneath it. It is usually painless, although the underlying cause might cause discomfort.
Symptoms
Separation of the nail plate from the nail bed.
White, yellow, or green discoloration of the separated nail.
The separation usually starts at the tip or sides of the nail.
A visible gap under the nail.
Possible thickening of the nail plate.
Causes
Trauma: Injury to the nail, such as repetitive bumping or stubbing.
Infections: Fungal infections (onychomycosis), bacterial infections, or yeast infections.
Skin conditions: Psoriasis, eczema, lichen planus.
Systemic diseases: Thyroid disorders, anemia, iron deficiency.
Medications: Certain antibiotics (tetracyclines), psoralens.
Allergic reactions: To nail polish, nail hardeners, or acrylic nails.
Irritants: Prolonged exposure to water, detergents, or chemicals.
Nail products: Acrylic nails and gels.
Idiopathic: Sometimes no cause can be identified.
Medicine Used
The medicine used depends on the underlying cause. Some examples include:
Antifungals: For fungal infections (oral or topical).
Topical corticosteroids: For skin conditions like psoriasis or eczema.
Antibiotics: For bacterial infections.
Addressing underlying medical conditions (e.g., thyroid medication for thyroid disorders, iron supplements for iron deficiency).
If caused by medication, your doctor might change your medication. Important: Always consult a doctor or dermatologist before using any medication.
Is Communicable
Onycholysis itself is not communicable. However, if the onycholysis is caused by a contagious infection like a fungal infection, that underlying infection is communicable and can spread to other nails or people.
Precautions
Keep nails short and dry.
Avoid trauma to the nails.
Wear gloves when washing dishes or using harsh chemicals.
Avoid excessive exposure to water.
Avoid biting or picking at nails.
Treat any underlying medical conditions.
Choose nail products carefully and avoid those that cause irritation.
If wearing artificial nails, ensure proper application and removal techniques.
How long does an outbreak last?
The duration of onycholysis depends on the underlying cause and how quickly it is addressed. It can take several weeks to months for the affected nail to grow out completely and be replaced by healthy nail. Fingernails take approximately 6 months to fully regrow, while toenails can take 12-18 months.
How is it diagnosed?
Physical examination: A doctor or dermatologist will examine the affected nail.
Medical history: Gathering information about potential causes like trauma, medications, or underlying conditions.
Nail clippings or scrapings: To test for fungal infections (KOH exam or fungal culture).
Nail biopsy: Rarely needed, but may be performed if the diagnosis is unclear or to rule out other conditions.
Timeline of Symptoms
Initial Stage: The nail starts to separate, usually from the tip or sides.
Progression: The separation gradually extends towards the cuticle. The color of the separated nail changes to white, yellow, or opaque.
Advanced Stage: A significant portion of the nail is separated. The risk of secondary infections increases. The whole course can take weeks to months, depending on the speed of nail growth and the severity of the initial separation.
Important Considerations
It's important to identify and treat the underlying cause of the onycholysis.
Onycholysis can be a sign of a more serious medical condition.
Do not self-treat without consulting a doctor.
Be patient, as nail regrowth takes time.
Preventing further trauma to the nails is crucial for healing.
Maintain good nail hygiene.