The separation of the nail from the nail bed is known as onycholysis. When your nail lifts off the nail bed, it can be hard to look at and sometimes painful. Many causes and conditions can lead to your nail starting to lift away.
The most common reasons for nail separation are linked to trauma (injury). But, it can be caused by an underlying health condition or skin problem. If there is trauma to the nail, separation can happen rather suddenly.
More often, though, it happens gradually. If you have a skin problem or health condition, you may not feel any pain as the nail separates. Trauma can make it a painful experience initially.
The highest risk is infection. If the skin underneath or around your nail becomes infected, it could lead to more significant problems and spread to other areas. When you’re more aware of what might be causing your nail to lift away, you can take precautions.
Table of Contents:
- 1 Reasons for Nail Bed Separation
- 1.1 Nails Lifting from the Nail Bed After Using Acrylics
- 1.2 Nail Detached from Nail Bed Due to Injury
- 1.3 Fungal Nail Infection Symptoms
- 1.4 Can Psoriasis Cause the Nail to Become Detached?
- 1.5 Other Causes for a Torn or Detached Nail
- 2 Can Onycholysis be Cured?
- 3 How to Prevent Infection from a Detached Nail
- 4 How to Get the Nail to Reattach to the Nail Bed
- 5 Can Onycholysis be Prevented?
Reasons for Nail Bed Separation
This guide will cover the common causes of onycholysis. A torn or detached nail can grow back with the right care.
Some of the primary symptoms of nail detachment include:
- Pitting marks on the nails
- Flaky or crumbly nails
- Thin, brittle nails
If the cause is an underlying health problem, treating that condition first will reduce the severity of the symptoms. Your nails are an indicator of your health in general. If you’re experiencing onycholysis, you need to find out the reason why this has happened.
Let’s look at the reasons and how you can lower your risk.
Nails Lifting from the Nail Bed After Using Acrylics
People who love having fake nails might be harming their nail beds in the process. If your nail is lifting from the nail bed after acrylics, you can probably blame the add-ons for the separation.
There are risks when using acrylic nails. They use glues and chemicals to adhere to the nail. If you don’t go to the right nail tech and they are misapplied, it could create a lot of damage to your toenails. So, the best thing to do for starters is to make sure you trust the nail tech.
If you notice your nail separating from the cuticle from your acrylics, don’t panic. The symptom you’ll probably see is that the area where the nail is supposed to be pink has turned white.
This can be due to using too much of the glue to attach the nail. You may also have an allergy to some of the ingredients used. These allergies can develop over time, so even if you’ve gotten acrylics before, it doesn’t mean you’re immune.
Or, you could have a yeast or fungal infection of the toenail. When you use acrylics, you’re not giving your real nails a chance to breathe. It’s easy for moisture to get trapped underneath the nail bed.
If you aren’t aware of what’s going on with your real nails because they are covered, an infection could be multiplying. Don’t use acrylic nails to cover up the fungus.
If you frequently get acrylic nails, make sure you’re practicing good foot hygiene at home. Check your feet regularly for changes. You should also get your acrylics replaced every six to twelve months. They should be maintained every two or three weeks to make sure your nails are still healthy, and the acrylics aren’t causing any damage.
You may also want to consider giving yourself a ‘break’ from acrylics for a while if you’ve noticed problems with your nails. You need to give yourself time for a new nail to grow in. This will give your other toenails an opportunity to breathe and get stronger again, too.
Nail Detached from Nail Bed Due to Injury
One of the most common reasons for toenail discoloration and separation is an injury. Trauma to the toenail can create a lot of unsightly and painful problems. The nail lifting from the nail bed can be one of them. Though it’s not always painful, it can cause further issues if left untreated.
Two different types of injuries can cause your toenail to fall off. One is considered acute trauma, and the other is blunt trauma.
- Acute trauma happens when the nail is injured over time, again and again. This most commonly occurs for people like runners or athletes. A runner who has ill-fitting shoes, for example, might be banging their toenail against the toe box of the shoe with every step they take. Over time, that can cause harm to the nail. This can be painful and may make it difficult to run for a while.
- Blunt trauma occurs when you drop something heavy on your toe or bang it against something with force. Severe stubbing of the toe can either cause the nail to tear or come away from the nail bed completely.
Many times when the toenail is injured, you might experience something called a subungual hematoma. This is a blood blister that forms underneath the nail and causes it to turn a dark color. Trauma can lead to a ‘dead toenail,’ which is why it eventually falls off.
Toenail separation from running can be a relatively easy fix. Usually, wearing shoes that fit correctly will make a huge difference. It will limit the amount of acute trauma that builds up when you go on longer runs. The most important thing for someone who uses their feet a lot is to make sure they have enough room in the toe box to avoid damage.
To protect your nails from blunt damage, wear protective shoes, or steel-toed boots. If you work in a place where you’re at risk for dropping something heavy, it’s essential to make sure that your feet are protected with sturdy shoes.
Fungal Nail Infection Symptoms
Toenail fungus can be another reason why your toenail is detaching from the nail bed. Toenail fungus is quite common and highly contagious.
It comes with a variety of different symptoms, including:
- Bad smell from the nails
- Brittle nails
- Thickened nails
If a fungal toenail infection is left untreated, it can build up underneath the toenail. This type of debris can eventually cause the nail to lift from the nail bed. If the infection gets too bad, the nail may fall off on its own, or it may have to be removed by a doctor.
An infection that lingers after a toenail has been removed can be dangerous and will still need to be treated to prevent spreading to other areas of the body.
Toenail fungus can’t be prevented entirely, but you can do things to lower your risk of getting it or spreading it. These include keeping your feet dry, wearing flip flops in public pools or showers, and sprinkling your shoes with antifungal powder. Make sure always to wear clean socks as well. Creating a difficult environment for fungus to grow will help to keep it from spreading so quickly.
Can Psoriasis Cause the Nail to Become Detached?
Psoriasis is a common skin condition, but many people don’t think about it. It’s an autoimmune disorder. It causes skin cells to build up. When they build up underneath the toenail, it can cause the nail to lift from the nail bed, and it may eventually fall off.
Other symptoms of psoriasis to look for include:
- Thickening of the nail
- An unusual shape or growing pattern
- Nail turning a brown or yellowish color
It’s tempting to remove any buildup you might find. Unfortunately, that can do more harm than good. It can push your nail to fall off faster. Instead of digging or picking away at a buildup underneath your nail from psoriasis, it’s best to treat the condition itself.
Psoriasis is something that never goes away. If you have it, you’ll have it for life. No treatment gets rid of it altogether, but there are ways to manage it.
Most people who have it live perfectly healthy lives. You need to understand what might cause your flare-ups of the condition, and what works best for you to keep it under control.
Keeping your toenails and feet moisturized is an excellent management option if you have psoriasis. If you have a worse case, your doctor may prescribe a topical steroid that you can put on the toenails.
How Can I Tell the Difference Between Psoriasis and Toenail Fungus?
Psoriasis and toenail fungus are easily confused for one another. That can be an issue, as they need different treatment/management solutions.
Neither of them should be ignored, or they could get worse. So, treating them the right way is important. Thankfully, there are subtle symptoms you can look for to tell the two conditions apart.
Toenail fungus will often cause a bad smell to come from the nail. Psoriasis doesn’t create a foul odor. Toenail fungus can also make your nails brittle, and they can start to crumble.
A buildup under the nail caused by psoriasis may be painful, where pain usually isn’t a side effect of toenail fungus unless it becomes severe.
Nail fungus can happen to almost anyone and can be caught easily. Psoriasis is a condition you’ll probably already notice signs of on other areas of the body, like your skin, scalp, etc.
Having toenail fungus and psoriasis at the same time is possible. In these cases, both conditions will have to be treated. An antifungal solution won’t clear up the symptoms of psoriasis. Soaking your feet in warm water or using a topical steroid won’t get rid of a fungal infection.
If you have symptoms of either of these conditions and you’re not sure which one you’re dealing with, a podiatrist can give you an official diagnosis.
Other Causes for a Torn or Detached Nail
While the most common causes for a detached toenail are listed above, there are other reasons people might find their nail is separating from the cuticle.
Some of the other causes include:
- Underlying health conditions or illness
- Medications and treatments, such as chemotherapy
- Certain soaps
- Nail polish removers
- Other chemicals used on the nails or skin
The best way to determine what has caused your toenail to start coming up from the nail bed is to look at other symptoms. It’s relatively easy to decide if your nail is separating due to injury or toenail fungus.
But, if you can’t figure out why it’s becoming detached, look at some of these possible causes for a better idea. Once you know the cause, you can take measures to treat the problem.
Can Onycholysis be Cured?
The treatment of onycholysis varies. It depends on what caused the nail to lift from the nail bed in the first place. The cause must be determined before the symptoms of the nail separation can stop.
In the case of an underlying condition like psoriasis, topical or even prescription medications can be used to help keep your nails healthy. Certain conditions like this, though, cannot be treated. They will never entirely go away, but the symptoms can be managed.
A vitamin deficiency or some other type of medical condition may be affecting your nails and making them separate from the nail bed. In this case, your doctor may prescribe a multivitamin or another supplement to keep your toenails healthy and strong.
If a fungal infection has caused your toenail to start lifting away, you can try an over-the-counter antifungal solution. There are gels, creams, and ointments designed to kill toenail fungus at the core. There are also many home remedies for toenail fungus, such as tea tree oil.
Using one of these solutions can help to ease the symptoms of a fungal infection. If your nail hasn’t separated yet, it can prevent it from happening. If the nail has already lifted off, using a treatment for toenail fungus can prevent the infection from spreading and getting worse while the nail heals.
Some people experience recurring onycholysis. The symptoms are usually easy to identify. If you notice your nail is starting to lift away or turning white where it should be pink, you’re experiencing onycholysis. If you still don’t know the cause, you can see a doctor for help.
It may be a medical condition causing the issue. If that’s the case, and it keeps happening, treating the medical condition first is the most important thing you can do. Once you do that, the symptoms of onycholysis should lessen or go away completely.
How to Prevent Infection from a Detached Nail
If you have onycholysis, you must treat it to prevent infection. No matter the cause, treating a nail that has fallen off is necessary to keep yourself safe from bacteria, fungus and more. You also want to create a sound environment for a new nail to grow. Keeping your nail bed and surrounding skin healthy is the best way to do this.
Follow these tips to help prevent infection and keep your nail bed as healthy as possible once a nail has fallen off:
- If the nail has torn but not completely detached, file away any edges that are sharp. Keep the toenail trimmed close, too. If the nail is already torn, it will be easy to tear even more. Keeping it trimmed and smooth will help to prevent that from happening. If it does catch on something, it can be painful, so this is a vital step for healing and not making things worse.
- If the nail has become partially detached, you can use nail scissors to trim away that part. Leave the attached part intact.
- Cover the attached part with a loose bandage. This will help to protect the exposed nail bed from bacteria. Be sure to occasionally remove the bandage and give the nail bed a chance to breathe.
- Keep the nail bed as clean and dry once a nail has detached.
- Keep the nail bed covered with petroleum jelly. This will serve as a barrier against dirt, debris, and bacteria.
- Soak your foot in a saltwater solution containing one tsp of salt for every 4 cups of water. You can also use a foot soak containing Epsom salt or tea tree oil. Be sure to dry your feet completely when you’re done.
- Regularly apply an antibacterial cream or ointment to the exposed skin of the nail bed.
- If you choose to bandage the exposed nail bed, you should change the bandage whenever it has become wet.
- Take over-the-counter pain medications like ibuprofen for discomfort.
Trimming your nail when part of it has detached can be scary for some people. But, if you’re careful, it’s safe. If you have diabetes or an immune disease of any kind, have a doctor trim the nail for you.
Conditions that reduce blood flow to the feet can be dangerous, and medical attention should always be considered when you experience any foot problems.
How to Get the Nail to Reattach to the Nail Bed
Unfortunately, once a nail has detached from the nail bed, it will not reattach. It doesn’t matter what caused it. If your nail has separated, even partially, you’ll have to play a waiting game for it to come back.
Toenails tend to detach from the nail bed more often than fingernails. The downside to that is that it can take twice as long for a toenail to grow back as it does for a fingernail.
If a nail falls off completely, it can take up to 18 months in some cases for it to fully grow back. There is nothing you can do to reattach a part of the nail, or the entire thing.
Of course, that’s probably a little disheartening to hear if your toenail has fallen off. An exposed nail bed can be dangerous and embarrassing to deal with.
You can cover the exposed nail bed with a bandage to prevent consistent bleeding and to hide away any unsightly symptoms that go along with nail regrowth. But, be sure to give the nail bedtime to ‘air out’ so a fungal infection doesn’t start to grow.
Can Onycholysis be Prevented?
Knowing the cause of what caused your nail to separate from the nail bed can give you a head start in making sure it doesn’t happen again. But, some things might be out of your control. Fungal infections aren’t always possible to prevent, and neither are underlying health conditions.
Since onycholysis can be the result of skin sensitivity to certain products, knowing what those products are can help you to avoid them in the future. For example, if the glue from acrylic nails has caused your toenail to detach, you can prevent it from happening again by avoiding those ingredients. Choose products that are labeled as allergen-free.
If trauma from running or wearing shoes that don’t fit has caused your toenail to detach, there are some tips you can keep in mind to help lower your risk of separation again. Let’s take a closer look at some of those suggestions so you can keep running without pain or embarrassment.
How Can Runners Avoid Losing a Toenail?
Most of the time with runners and athletes, the nail detaches from the big toe. This is because that’s the nail that most often gets banged against the toe box of the shoe. Not surprisingly, black toenails are commonplace.
If you’re an active runner, you might think losing a toenail is inevitable. But, it doesn’t have to be. Again, the best thing you can do to avoid repeated acute trauma to the nail is to wear shoes that fit correctly.
But, there are a few more tips and tricks runners can use to reduce their risk of losing a nail:
- Apply nail gel or nail varnish. This will give your toenails an extra layer of protection and can harden them more. It’s important to alternate wearing nail varnish and leaving your nails natural, so they have a chance to breathe. If you’re worried about toenail fungus, try using an antifungal polish. This little trick alone might not prevent your toenail from detaching, but it can help.
- Wear running socks with a little extra cushioning. This can be a balancing act since socks with extra padding may make your shoes feel tighter. To find the perfect fit, buy your running socks before investing in a pair of running shoes, so you can try on the shoes while wearing the socks. This is a great tip, especially for distance runners.
- If your nail does start to fall off or shows signs of detaching, don’t pull on it. For the most part, it’s not extremely painful to deal with a nail that is detaching. Most runners find that if it falls off naturally, it’s far less painful than pulling it off. Pulling off a toenail prematurely can be excruciating. It can also cause the nail bed to bleed, making it even easier to catch an infection.
The primary risk when losing your toenail is a possible infection. Keep your nail bed as protected as possible if your nail falls off. Unfortunately, a toenail can’t be reattached once it’s lifted from the nail bed. But, a new nail will eventually grow in its place.
It can take a long time for a healthy toenail to grow back. Caring for your nails and toes in the process will make it easier and can encourage growth and stronger nails.