I have a client whose nails are lifting from the nail bed, but only about a quarter of the way. They grow just fine, but then they start to lift again. She had an acrylic overlay on for about two weeks and when that acrylic came off, the nails were perfect. Soon after, they started lifting again. She is using a nail strengthener and is on several medications and vitamins.
Lifting of the nail plate from the nail bed is called onycholysis. There are many causes of onycholysis, including trauma to the nail, allergic reaction to products, excessive water/detergent exposure, psoriasis, thyroid abnormalities, and anemia.
Certain medications that are photosensitizing can result in photo-onycholysis when the client is exposed to sun. (Ask your client’s doctor if this is the case with any of her medications.) Sometimes onycholysis is further complicated by the presence of yeast under the involved nails. It is difficult to know why your client has onycholysis. Encourage her to use gloves when doing wet work chores and gardening and keep her nails short so they don’t project past the tip of the finger. This is so that the nails will not be subjected to multiple microtraumas during the day, which will delay the reattachment as the nails grow out. Long nails also act as a lever and put stress on the portion of the nail that is still attached. Also be cautious about cleaning under the nails too vigorously so as not to disrupt the delicate nail bed cells as the nail is trying to attach as it grows in. — Dr. Rich
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