Onycholysis is when a nail separates from the skin underneath. Treatment options can vary, but may include trimming and protecting the nail, and treating the underlying cause of the detached nail.

Onycholysis is the medical term for when a nail separates from the nail bed underneath it. A detached nail can occur for many different reasons, such as injury, infection, or certain skin conditions. With effective treatment, the nail can reattach to the nail bed as new growth occurs.

Recovery time varies for onycholysis as it is largely dependent on nail growth, which is typically quite slow. It is not uncommon for fingernails to take about 4 to 6 months to grow to a full size. Toenails may take twice as long.

A person trimming their nails-1.Share on Pinterest
Laura Herrera/Stocksy

With onycholysis, the detached portion of the nail will not reattach. Instead, treatment will focus on new nail growth and keeping the nail attached to the underlying nail bed. The first step in treating onycholysis is to determine what is causing the nail to lift from the nail and treating the underlying cause.

Home remedies

General measures a person can perform at home to support nail health can include:

  • clipping the affected portion of the nail and keeping the nail short with regular trimming
  • avoiding or minimizing activities that can result in nail injury
  • avoiding possible irritants, such as nail products
  • wearing protective gloves
  • taping the nail to the underlying digit
  • using antimicrobial soaks to reduce the risk of infection

Medical treatments

Specific measures will depend on identifying and treating the underlying cause of onycholysis. For example, this may include:

Evidence notes that a combination of general measures and medical treatments and usually effective in managing and treating onycholysis. Similarly, a 2023 study notes that using several methods of treatment with different effects on the nail is often most effective.

Health experts define onycholysis as the detachment of the nail plate from the underlying nail bed. Clinical features of onycholysis can include:

  • an irregular border between the pink portion of the nail and the white outside edge of the nail
  • discoloration of the nail, which may include white, yellow, or green
  • the nail surface may be pitted, indented, or cumbly
  • thickened skin under the nail

Onycholysis itself is usually not painful. However, the underlying cause of onycholysis may cause pain.

The potential causes of a person’s onycholysis can vary widely. Health experts may use the terms primary or secondary onycholysis when diagnosing the cause. Primary describes when they cannot identify an exact cause, and secondary is when onycholysis occurs due to another condition.

Irritation to the nail area is a common cause of onycholysis. This can include:

  • excessive filing
  • exposure to chemicals, such as during a manicure
  • allergic contact dermatitis, which can occur as a reaction to certain nail products
  • prolonged immersion in water

It is also not uncommon for an injury, such as stubbing a toe, or repetitive trauma, from repeatedly tapping nails for a long time, to cause the nail to separate from the skin.

Some other typical causes include:

  • fungal infections, common in the feet
  • skin conditions, such as psoriasis
  • reaction to medications, such as drug-induced photosensitivity
  • systemic conditions, such as thyroid problems or diabetes

It is not always possible to prevent onycholysis. However, a person can try:

  • cutting nails and maintaining good nail hygiene
  • wearing protective gloves, to avoid repetitive immersion in water
  • avoiding exposure to irritant chemicals

Additionally, if a person is living with a condition that can result in onycholysis, managing the condition should help to reduce the risk of nail detachment.

Typically, onycholysis is not an urgent problem. As such, a person may wish to discuss it with their doctor during a routine visit.

However, onycholysis can be a potential visible sign of a more serious condition. Therefore, if a person notices other symptoms, or if aware they have a related condition, it may be advisable to contact a doctor.

Some FAQs about onycholysis may include:

How do you get rid of onycholysis?

Treatment of onycholysis will vary depending on the underlying cause. Possible options can include trimming the nail, wearing gloves, avoiding nail irritants or nail products, changing medications, using supplements, or taking medications to treat a nail infection.

What is causing my onycholysis?

There are many possible causes of onycholysis. These can include fungal infections, certain skin conditions such as psoriasis, certain medications, an overactive thyroid, iron deficiency, and working with the fingers or toes in a wet environment.

What happens if onycholysis is left untreated?

Without treatment, onycholysis can cause the nail bed to disappear. This can lead to the nail plate becoming shorter or narrower. In more severe cases, onycholysis can also result in scarring of the nail bed.

What autoimmune disease causes onycholysis?

Autoimmune conditions that may relate to onycholysis can include psoriasis, hyperthyroidism, and type 1 diabetes.

Onycholysis describes when the nail detaches from the nail bed underneath. It can occur for multiple reasons, such as injury, or due to an underlying condition.

Treatment will vary depending on the underlying cause. Generally, managing the cause will help to relieve symptoms. A person can also take general measures, which includes trimming the nail, using antibacterial soaks, and avoiding activities or chemicals that may irritate the nail.