How does a nail affected with onycholysis become reattached?
Q: How does a nail affected with onycholysis become reattached? One of my clients wants to know if her separated nail will reattach itself or if she will need surgery. How long does it typically take to reattach, or are there some nails that never do?
A: Onycholysis (separation of the nail plate from the nail bed) is a disorder with many different causes. The more common causes that I see in my practice include fungal infection (particularly the yeast fungus candida), psoriasis, or perhaps a sensitivity to certain nail products. Usually, nails will not reattach on their own unless the causative factor is eliminated, and surgery is not a recommended treatment for lifting nails. Sometimes cutting back the nails and removing the lifted portion and then treating the nail bed or skin underneath can be helpful, but it is difficult to know which treatment is correct unless the patient is evaluated medically with proper tests that point to a specific diagnosis.
Once the diagnosis is made and the client is treated for the disorder, it usually takes anywhere between three to six months for the nails to reattach, depending upon the extent of the lifting. Sometimes the nails never reattach. If the cause of the lifting is allowed to continue affecting the nail, it can eventually create a scar in the nail bed, and the nails won’t be able to reattach. Scar tissue typically accumulates over a very long period of time.