What to Know About Onycholysis (Nail Separation)

Onycholysis can have different causes. These include:

• injury to the nail
• wearing tight shoes
• allergy to products used on the nail, like chemical nail polish remover or artificial nail tips
• nail fungus
• psoriasis
• reaction to a medication

Nails also tend to be a barometer of your overall health. If your nails look unhealthy or have problems like onycholysis, this could be the first visible sign that something deeper is going on in your body.

Sometimes, onycholysis can indicate a serious yeast infection or thyroid disease. It can also mean that you aren’t getting enough of essential vitamins or minerals, such as iron.

In addition, another cause can be graft-versus-host disease (GVHD), which is a condition that can develop after a stem cell transplant.

With onycholysis, your nail will start to detach from the nail bed and peel upward. This is typically not painful, but depending on the cause, the affected nail may change color to yellow, greenish, purple, white, or gray.

This condition lasts several months because a fingernail or toenail won’t reattach to its nail bed. Once a new nail grows to replace the old one, symptoms should resolve.

Fingernails take 4 to 6 months to fully regrow, and toenails can take 8 to 12 months.

The most important step is to determine the cause of your onycholysis. Once the cause is found, treating the underlying issue will help resolve it.

While it’s important to keep your nails short, aggressive clipping is not recommended. As the affected portion of the nail grows out, you’ll be able to clip off the lifted nail as the new nail comes in.

Overall, the goal of treatment is to help a new nail grow. To support this, it’s best to keep all of your nails short and trimmed and avoid activities that might harm them.

What to consider

Be cautious with things like nail polish and chemicals, and consider wearing gloves when working with substances that could hurt your nails. You can also use diluted vinegar to prevent infections.

That said, in some cases, depending on the cause, topical medication may be needed to reduce the symptoms and prevent the development of any secondary infection.

Any additional treatment needed will depend on the underlying cause. For example, onycholysis occasionally occurs as a symptom of psoriasis. At least 50% of people with psoriasis experience problems with their nails. Doctors may prescribe topical vitamin D or corticosteroids to treat it.

A blood test may also reveal that you have a thyroid condition or vitamin deficiency, causing you to have onycholysis. In this case, your doctor may prescribe medication or an oral supplement to treat the underlying cause

What happens if onycholysis is left untreated?

Without treatment, onycholysis can result in a disappearing nail bed (DNB), which can cause the nail plate to become shorter or narrower.

In the meantime, you might want to try to treat your onycholysis at home. Don’t try to clean underneath the nail, as you could sweep bacteria deeper underneath the nail or make the problem worse.

If there’s no obvious underlying cause, you can try avoiding things like bandages, gloves, or creams on the affected area, as these can create a moist environment that bacteria love to grow in. You can also try to use a hairdryer on low heat once or twice a day to help keep bacteria from growing.

If your toenails are peeling due to an uneven gait, using custom-made insoles can help correct your walking and distribute weight evenly. Other helpful tips include:

• taking probiotics
• keeping your nails short
• avoiding harsh chemicals
• drying your hands thoroughly after washing with gentle soap and water

There’s also some evidence that tea tree oil might help treat fungus. If this is the cause, try applying a mixture of tea tree oil diluted with a carrier oil, such as jojoba or coconut oil, to help get rid of the fungus. It’s important to keep the nail dry while it heals.

That said, always speak with your doctor before using tea tree or another essential oil. Don’t put essential oils directly on your skin — dilute them with a carrier oil first.

Onycholysis can result from skin sensitivity to products such as glue, acrylics, or acetone during manicures and pedicures. If you have skin allergies to these products, avoid the nail salon. Choose allergen-free products and paint your nails at home.

Artificial tips applied to the nail can also cause trauma to the nail bed, with onycholysis as the result.

If you have a fungus or yeast growth causing your onycholysis, you can stop it from spreading by taking proper care of your nails. Don’t bite your nails, as this will spread the problem and possibly affect your mouth.

If your onycholysis is happening in your toenails, make sure you’re wearing clean socks and exposing your feet to dry air as much as possible.

Onycholysis is easy to spot. If you notice that your nail is beginning to lift or peel away from the nail bed underneath, you have onycholysis.

Finding out the underlying cause might be trickier. You may need to visit a dermatologist, especially if it affects more than one digit of your fingers or toes. The Healthline FindCare tool can provide options in your area if you don’t already have a doctor.

What autoimmune diseases cause onycholysis?

Autoimmune causes of onycholysis include:

• psoriasis
• hyperthyroidism
• type 1 diabetes

How do I know if my onycholysis is fungal?

Fungal nail infections can cause yellow and thick nails, often with white spots or streaks. The infection may affect part of the nail, whole nails, or multiple nails.

Common signs include a deformed nail that detaches from the bed, an unpleasant odor, and a fragile or bulky appearance.

What vitamin deficiency causes onycholysis?

Iron deficiency can cause onycholysis. Pellagra can also cause it, which is a condition associated with low levels of niacin (vitamin B3).

How serious is onycholysis?

Onycholysis usually isn’t painful. How serious it is, however, depends on the underlying cause. It’s always a good idea to see a doctor to determine what’s triggering it.

Onycholysis is not a reason for an emergency medical appointment, but you need to find out what’s causing it. With effective treatment, your nail will reattach to the nail bed as new growth occurs.