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Article: How to treat onycholysis?

Qu'est-ce que l'onycholyse et comment la soigner efficacement ?

How to treat onycholysis?

Onycholysis, or “nail peeling” is a frequent reason for consultation. Often painless, it can be caused by carelessness with your nails, a skin disease or taking certain medications.

To prevent onycholysis and maintain healthy nails, it is very important to take care of them. Indeed, nails perform different functions in daily life and constitute a reflection of the overall state of health.

What is a nail made of?

Nails are essentially made up ofkeratin , and are divided into three distinct parts:

  • The nail plate : this is a horny plate made up of three layers of keratin which overlap. The lower layer is softer and is linked to the nail bed.
  • The nail bed : it is a surface of the skin with a pink color, on which the nail plate is placed. Only the end of the tablet, also called the “free edge”, is detached. The nail bed is pink in color due to its high vascularity. Its coloring shows through the nail plate, which appears translucent. The nail bed can change color and become white or slightly bluish depending on various environmental and physical factors (shock, traction, pressure, compression). It is surrounded on each side by the epidermis of the nail folds as well as the lateral folds.
  • The matrix : this part is located under the skin at the base of the nail. It produces the keratin necessary for the formation of the nail, and ensures the growth of the nail plate. We can also see the lunula, a white area placed at the birth of the nail plate, which represents the extension of the matrix.

The nail matrix is ​​vascularized and innervated and is constantly connected to the rest of the body. The quality of keratin reflects the overall state of health and the structures that maintain the nail system.

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What is onycholysis?

Onycholysis is a condition which gradually causes partial or total detachment of the nail.

The nail detaches from the nail bed, a surface of skin located on the last phalanges of the fingers and toes, on which it rests and grows.

The detachment begins at the end of the nail (white part of the nail that is cut regularly), and can reach the matrix, which leads to complete detachment of the nail.

In some cases, onycholysis can cause the nail to fall out.


What are the symptoms of onycholysis?

When one suffers from onycholysis, the nails flake and lift from the top. They gradually detach from the nail bed. 

It is also possible that the nail changes color and becomes pinkish, whitish or yellow. Depending on the cause of onycholysis, the nail may also be brown or greenish.

Be careful, however, onycholosis should not be confused with onychomycosis (or nail fungus). The symptoms of this infection are:

  • A thickening of the nail;
  • Discoloration of the nail (yellowish or whitish discoloration);
  • A weakening of the nail which becomes more fragile and brittle;
  • Possible separation of the nail;
  • Pain or discomfort;
  • A splitting or splitting of the nail.


What causes onycholysis?

Various mechanical, inflammatory or infectious causes can cause onycholysis:

  • Repeated trauma or shock (wearing shoes that are too tight, finger stuck in a door, manual activity, etc.);
  • Aggressive or excessive cleaning of the nails;
  • Vitamin deficiency;
  • Exposure to chemicals found in cleaning agents, manicure/pedicure products, or citrus fruits;
  • A dermatological disease such as eczema or psoriasis (chronic inflammation of the skin);
  • Taking antibiotic medications (particularly tetracyclines) and molecules intended to reduce or suppress immune capacity;
  • Exposure to the sun after taking certain medications (including doxycycline, vandetanib, psoralens and fluoroquinolones). This manifestation is called “photo-onycholysis”.
  • Onychomycosis, a fungal infection of the nails.
  • Thyrotoxicosis, a condition of the thyroid.

How to treat onycholysis?

To cure onycholysis and regain healthy nails , a new nail must replace the old one. Regrowth can take between four to six months for fingernails, and between eight to twelve months for toenails.

In case of suggestive symptoms, it is recommended to consult a dermatologist who will determine the cause of onycholysis by examining the nails. He or she may also take a tissue sample from under the nail to look for fungus, yeast, or other infections. He may also order a blood test to check for dietary deficiencies.

When diagnosing nails, it is also necessary to inform the doctor if there is a history of psoriasis or other skin problems. Indeed, psoriasis can cause onycholysis. Its main symptoms are red or silver spots on the skin, itching, burning, skin pain or even dry and cracked skin.

1- Treat with corticosteroids

First of all, onycholysis can be treated with local corticosteroid therapy. It is a treatment based on corticosteroids which must be applied to the nail pulp of the infected nail.

During treatment, loose nails should be cut frequently to prevent traction and macerations underneath the nail. Nails separated from their nail bed are more vulnerable to injury.

In addition, you should not pick your nails, otherwise you risk causing them to come off.

If the onycholysis is repetitive, a molded orthoplasty (device which corrects a deficient function or a deformation of one or more toes) can be considered.


2- Do an antifungal treatment

If the cause of onycholysis is of mycotic origin, antifungal treatment is necessary. This treatment is administered orally for a period of 6 to 24 weeks, until a healthy nail grows back.

A cream can also be applied to the affected nail. An antifungal for local use is often not sufficient. Nail fungus takes a long time to treat and local treatments are not always sufficient if the damage is deep.


3- Take food supplements

In the event of nutritional deficiencies, the doctor recommends a course of food supplements to strengthen the nails and promote their healthy regrowth.

B group vitamins (notably biotin) and zinc are highly recommended to regain long and strengthened nails.

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Indeed, nails, hair and skin have one thing in common, they are made up of keratin. It is an essential protein that ensures the growth and strength of nails and hair, and keeps the skin hydrated by preventing water from escaping.

A sufficient intake of vitamins and trace elements promotes the production and synthesis of keratin. Food supplements rich in nutrients are therefore valuable allies in finding stronger and more resistant nails.

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How to prevent onycholysis?

To prevent onycholysis and maintain healthy nails , especially during treatment, a few simple and effective actions should be applied on a daily basis:

  • Avoid contact with water, by wearing gloves when carrying out manual activities or work in contact with water;
  • Wear properly sized, waterproof shoes during heavy rain. Shoes that are too small cause nail deformities. In addition, wet feet can cause toe fungus, which can cause onycholysis;
  • Keep the nail dry to avoid the development of fungus;
  • Apply anti-fungal lotions to the nail to prevent infections;
  • Cut loose nails to avoid traction and prevent the nail from drying out;
  • Avoid contact with cosmetic or chemical products likely to weaken the nails;
  • Monitor the appearance of your nails (their strength, their coloring, etc.) and consult a doctor quickly if they are damaged ;
  • Have a healthy and balanced diet and a good lifestyle;
  • Take care of your nails, using natural treatments based on vegetable oils , which are just as effective for your hair.
  • Trim your nails regularly to keep them short and neat. Short nails are less prone to trauma and injury. To do this, you must choose a clean nail clipper and ideally an emery board to smooth their edges.

Moisture and bacteria accumulate more easily under long nails, creating a greater risk of onycholysis.

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