What is ONYCHOLYSIS?

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Often in our field, we encounter various problems, including ONYCHOLYSIS, which you have probably already heard of. Today, we will delve into the topic.

Onycholysis is the partial or complete detachment of the nail from the nail bed, both on the hands and feet. It is a gradual process that often starts at the lateral margins or the free edge and then progressively extends over the entire nail. In the early stages, it is not painful and only results in a change in the color of the nail plate (the common "black nail"). With increased detachment, however, the nail can deform and eventually completely detach and fall off, a process that is often painful.

Some signs of detachment can be identified, such as:

  • The border between the pink and white parts of the nail becomes irregular.
  • The surface of the nail becomes opaque.
  • Accumulation of skin is observed under the edge of the nail.

What are the causes?


There are many factors that can cause onycholysis, with the most frequent being trauma -> damage that occurs unpredictably and suddenly to the body by various agents. Regarding nails, the most common traumas are due to excessive pressure (e.g., pressure from the top of the shoe while walking) or impact (e.g., an object falling on the nail).

Based on the nature of the cause of onycholysis, two main forms can be distinguished:

  • Non-infectious -> derived from traumas, heart conditions, or other medical conditions.
  • Infectious -> derived from infections such as Candida or fungi (in this case, it can also develop as onychomycosis).

Why is it important to know the causes?


  • To best protect the client -> taking action on a nail damaged by trauma can further promote detachment.
  • For one's own protection and that of other clients -> infectious forms are transmissible. In any case, it is advisable to always handle the situation with great care and protect oneself with appropriate gloves and use disposable items and towels.

Diagnosis and Treatment


In most cases, to determine if onycholysis is present or not, it is sufficient to observe the affected area. If there is no obvious trauma, it would be advisable to refer to a doctor for a more in-depth examination to rule out infectious causes or associated diseases.

Whatever the cause, the most recommended treatment for direct action on the nail is to keep it as dry as possible and free from band-aids or dressings, to allow it to slowly reestablish contact with the nail bed.

Onycholysis and Nail Techniques, How to Proceed?


Incorrect nail techniques can also cause onycholysis:

Overly aggressive filing leads to excessive thinning of the nail plate, promoting the development of onycholysis.
In reconstruction, attention must be paid to the degree of pinching, as failure to respect the structure of the nail can cause damage, both in terms of the chosen length, as excessive length can harm the underlying nail bed.
To prevent this from happening, it is necessary to:

Use brushes with soft bristles for cleaning, avoiding overly abrasive tools that can injure the nail or promote detachment.
Reduce the filing of the original nail to the bare minimum and, if necessary, perform a gentle pinching.
Choose a reconstruction proportionate to the nail bed, discouraging clients from extreme lengths.
And when onycholysis is already present?

  • Mild Onycholysis
  • When there are no infections present, it is possible to perform reconstruction with some simple precautions, such as avoiding pinching, limiting the length, and avoiding extreme shapes even if they are short.
  • Moderate and Severe Onycholysis

In this case, it is only possible to apply a semi-permanent cover, even with a slight curvature. Reconstruction should be avoided at all costs.

In any case, the goal is to eliminate any sign of onycholysis and promote the nail's adhesion to the nail bed. This can be achieved by following these steps:

  • Using nail clippers, remove the lifted part.
  • To eliminate any excess from the remaining nail edge and thoroughly clean the area, use a cuticle grinder with gentle abrasion.
  • Degrease the entire affected area with a cleaner.
  • Finally, apply a transparent base layer to seal the nail and prevent the opening from scarring, thus promoting adhesion to the nail bed.

I hope this article is helpful to everyone, and thanks to Master Majida for contributing to the detailed description.

See you next time!
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