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Something to Talk About: Onycholysis

by Michelle Pratt | November 29, 2017

Under our nail plate, at what might be described as a “border” between the free edge and our fingertip, is the hyponychium. It works as a protective seal between the nail bed and the nail plate. If that seal is broken, the nail separates from the bed, causing onycholysis. The detached nail often has a whitish hue rather than a soft, healthy pink.

Many factors can cause onycholysis. Some are as commonplace as repeated typing, tapping, biting, or picking. Repeated pressure against the nail tip breaks the seal and causes the plate to pull away. Techs may even contribute to the problem with aggressive filing or buffing, or by breaking the hyponychium’s seal when they clean under the nail. Another culprit could be prolonged and repeated exposure to allergens in nail products. This happens when the product isn’t cured correctly or is applied too wet and runs onto the skin. 

Separation of the nail plate can occur as a secondary condition to another nail disease, or be the result of age, psoriasis, or a systemic, internal health issue. This compromise in the bond between the nail plate and the nail bed can lead to a bacterial infection or yeast infection. As nail techs, it’s our job to notice any nail abnormalities and let clients know when to seek a doctor’s assessment. That conversation could go something like this:

You: This nail is separated from the nail bed at the free edge. Did you notice this?

Client: Oh yes! I think I did that. I was trying to clean under my nails, and I think I went too deep. It really hurt!

You: I’m going to shorten this nail close to the free edge so it doesn’t catch on anything. It’s clean and dry, so you should be fine. As your nail grows, this unattached area will become of part of the free edge.

Client: What do you mean, “I should be fine”? Could it be a problem?

You: Actually, the condition is known as onycholysis. Onycholysis can be a problem if a significant amount of your nail detaches or if it appears on multiple nails. The separation puts you at risk of water and debris getting trapped under the nail. If I saw any black, green, or yellow, or if the skin on the nail bed was thick, flaky, or even wet and “soggy,” I’d recommend you go see a doctor. You would want to confirm you didn’t have a larger health issue.

Client: Yes. I’ve seen nails like that! Is this how it starts?

You: When the seal under the nail or at the cuticle is compromised, a problem can definitely develop, but when we see advanced cases of onycholysis and discolored nails, it’s usually not the result of something as harmless as someone poking themselves too hard. Those situations indicate a larger problem and require the attention of a doctor. The good thing is, as a licensed nail tech, I can alert people if I ever see the early stages of these problems on a client’s fingernails or toenails.

Client: Do you see this on toenails too?

You: Our toenails are often moist from our feet sweating, plus they get crushed in shoes and banged around when we run and exercise. That type of trauma can also cause onycholysis. Clients often don’t notice because they don’t check — or can’t see — their toes that closely. That’s one reason regular pedicures are so important. I can assess your toenails every month and notice small changes before they develop into larger issues.

 

 

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