Nail separation from the skin is a common condition that affects people of all ages, and is medically known as onycholysis. This separation occurs when the nail separates from its bed as a result of an injury to the finger, or as a result of some autoimmune diseases, or for other reasons. In the following article, Dalili Medical, we will review the causes of nail separation from the skin.

**Natural nail growth** The average natural nail growth is very important for maintaining the health and beauty of the nails. This average is affected by several internal and external factors that must be taken into account. Here are some factors that play a role in the natural growth of nails:

- **Genetic factors**: Genetics play a role in the speed of nail growth, as you may have a genetic predisposition to grow them faster or slower.

- **Nutritional factors**: Proper nutrition is essential for the growth of strong and healthy nails. It is recommended to eat foods rich in proteins and vitamins such as vitamins A, B, C, and E.

- **Environmental factors**: Environmental conditions, such as excessive exposure to moisture or dryness, can affect nail growth.

- **Health factors**: Some health conditions, such as thyroid disorders and diabetes, may negatively affect nail growth.

- **Psychological factors**: Stress and anxiety can affect nail growth, leading to cracks and breakage.

How can I relieve nail pain?

 

It is normal for the patient to feel some pain after surgery, so the doctor will prescribe painkillers and anti-inflammatory drugs, such as ibuprofen, paracetamol, and diclofenac sodium or potassium.

The doctor will recommend placing the hand or foot on a pillow while sitting or sleeping to reduce swelling and pain.

It is important to follow the doctor's instructions carefully, take care to take the prescribed medications and care for the wound, which will help speed up the healing process and relieve pain.

What is Onycholysis?

 

Nail loss or nail separation or nail separation is medically called (Onycholysis) and occurs in the toenails or hands where the nail separates from the skin underneath it or what is called the nail bed partially or completely. It is often painless but occurs as a result of several reasons, the most important of which are fungal or bacterial infections, accidents, or some diseases and medications. It acquires a pale white, yellow and sometimes green color and gradually separates from and in such a case, a doctor specialized in treating nail dissolution or nail loss must be consulted immediately so that further complications do not occur. Nail loss may be a non-serious condition but it indicates other diseases such as congenital keratosis or infection with some infections or other problems that must be treated immediately.

**Causes of nail loss**

 

There are many reasons that may lead to nail loss or dissolution, and it is necessary to determine the main reason behind this in order to treat it appropriately. Possible causes of nail loss include:

**Pathological causes**

Some diseases contribute to nail loss, the most prominent of which are:

- **Congenital dyskeratosis**: This is a rare genetic disease that can cause serious complications affecting the skin and nails, and may also lead to bone marrow failure. Its symptoms include weak nails, stunted growth, and falling out. Treating nail loss in this case is difficult, but some steroid medications or stem cell transplantation can be used.

- **Fungal nail infections**: Fungal infections are one of the most common causes of nail loss, whether in children or adults, and often occur as a result of pollution. One of the most important symptoms of fungal infection is a change in the color of the nail to yellow, and it may crack or become thick, and in some cases it may fall out. A dermatologist usually treats this condition using ointments and topical antifungals, and it must be treated immediately, especially in cases of diabetes, to avoid worsening the condition.

**Nail psoriasis**: It is considered an autoimmune disease that affects the nails and skin in general. The most prominent symptoms of nail psoriasis are increased thickness of the nail and discoloration.

**Thyroid disorders**: Thyroid disorders lead to nail separation and loss, as increased gland secretion can cause nail problems.

**Some skin diseases**: Some skin diseases such as dermatitis, porphyria cutanea tarda, and pemphigus vulgaris can lead to nail loss. Herpes simplex virus infection, hyperhidrosis, leprosy, scleroderma, lichen planus, syphilis, and lupus erythematosus can also affect nail health.

**Vitamin deficiency and malnutrition**: Eating an unhealthy diet and malnutrition lead to a deficiency of vitamins necessary for healthy nail growth.

**Some other health conditions**: Some diseases affect the condition of the nails and cause them to fall out, such as anemia, bronchiectasis, diabetes, ischemia, psoriatic arthritis, neuritis, and Reiter's syndrome.

**Unhealthy causes**

Unhealthy causes include accidents such as heavy objects falling on the nails or hitting them with solid objects, in addition to car accidents and others.

Genetic factors.

Excessive use of chemicals or household cleaning tools.

Excessive use of nail care products, such as nail polish or nail polish.

Medications: Some medications may cause reactions that negatively affect the nails, causing them to weaken or dissolve. These medications include cancer medications, oral contraceptives, as well as medications such as chlorpromazine and fluoroquinolones.

What are the signs of nail separation from the skin?

 

Onycholysis is characterized by several symptoms, the most prominent of which are:

- Change in nail color, which may vary depending on the cause of separation, as it can appear in colors such as white, yellow, gray, green, blue, or black.

- Feeling pain in the nail and surrounding areas

- Increased thickness and hardness of the nails.

- Ripples in the nails, where the white or colored spots are thicker than the rest of the nail.

- The appearance of pits or scratches on the surface of the nail.

- Bleeding under the nails.

- Weak and brittle nails.

What happens after nail extraction?

 

After the nail extraction procedure, the patient may notice some swelling or changes in the color of the surrounding area, but there is no need to worry, as these symptoms are normal and will disappear within about two to three days.

The extraction wound usually heals within a few weeks, and taking good care of the area will help speed up the healing process and reduce the chances of infection.

It takes about 6 months for a new nail to grow on the hands, while toenails need a period ranging from 12 to 18 months to grow again.

The patient should follow up with his condition periodically with a dermatologist after the extraction procedure to monitor healing and detect any infections or problems that may negatively affect the wound.

The doctor may prescribe oral and topical antibiotics to help speed up healing and recovery and prevent any new infection.

It is recommended to avoid swimming and soaking your fingers in water during the first two weeks after surgery to keep the wound from getting infected.

A plastic bag or glove can be used while showering to avoid water contact with the wound. If this happens, the wound should be gently dried immediately, then an antibiotic ointment should be applied and covered to protect it from moisture and infection.

It is also recommended to wear appropriate shoes.

**First consultation with a nail loss treatment doctor**

 

The first consultation is one of the most important steps in the nail loss treatment journey, as treatment requires time and patience. During this consultation, the cause of nail loss is determined and how to start treatment to achieve satisfactory results. The most important things that happen in this consultation are:

- The doctor will ask you about your medical and genetic history.

- You should inform the dermatologist of any skin diseases you suffer from, in addition to any medications or treatments you are taking.

- The doctor will examine the nail, noting its color, thickness, and accompanying symptoms, to determine the cause of nail separation and the appropriate method for treating it.

- The doctor may ask you to do some tests, such as thyroid tests, and may take a sample if he suspects the presence of fungi under the nail to test it in the laboratory to confirm the cause of separation.

- You can ask any questions that concern you without hesitation.

- After confirming the cause of nail loss, the doctor will tell you the treatment steps that you will follow, in addition to the appropriate expectations.

**Steps to treat nail loss**

The treatment process begins by choosing the appropriate method based on the results of the tests and examination of the nail. The dermatologist determines the cause of nail separation and then determines the appropriate treatment for each case. The most prominent methods of treating nail loss are:

**First: Treating thyroid disorders**If it turns out that the main reason behind the separation of the nail from the skin is increased thyroid secretions, the doctor begins to treat these disorders. The doctor will prescribe medications aimed at regulating thyroid hormones, which helps restore normal nail growth. However, treatment may require some patience until the hormones return to balance and the nail grows properly again.

Second: Treatment of nail psoriasis associated with nail separation If nail psoriasis is the cause of nail separation, its symptoms will appear in the form of red, scaly patches on the skin that affect the nails. The nails turn gray and gradually begin to separate from the flesh. The dermatologist will use topical treatments to combat nail loss, such as corticosteroid creams or injections. He may also prescribe calcipotriol to treat the affected area under the nail, in addition to tazarotene cream to treat discoloration and pitting. He may also resort to laser treatment and phototherapy, which we will talk about later. It is necessary to continue treatment until the problem disappears completely.

Third: Treatment of fungal infections that cause nail loss Nail fungus is one of the most common diseases and one of the main causes of nail loss. After conducting a sample analysis and confirming that fungal infections are the cause of nail loss, treatment will begin. The doctor will prescribe effective antifungal medications to treat the infection. In addition, he will prescribe creams and ointments to effectively treat nail fungus. In some advanced cases, the dermatologist may resort to using local injections of diluted Triamcinolone, where the injection is given every 4 weeks, and you may need a certain number of sessions ranging from 4 to 6 sessions to achieve the desired results.

**Fourth: Treating vitamin and mineral deficiencies** Nail and hair growth is greatly affected by minerals, vitamins and a healthy diet. Therefore, malnutrition can lead to hair loss, weak nails and improper growth. Therefore, it is necessary to treat weak nails by taking nutritional supplements that contain the essential vitamins and minerals necessary to promote nail health. In addition, a balanced diet rich in essential nutrients, such as nourishing olive oil, should be consumed.

Fifth: Treating nail loss resulting from accidents The cause of nail dissolution, separation or fall can be due to an accident, so it is necessary to go to the doctor immediately to avoid infection and increased damage. The dermatologist will sterilize and clean the wound well, then carefully remove the remaining nail. A topical antibiotic will also be used on the broken nail area to help prevent infection. Finally, the wound will be covered with a bandage until it heals. In addition, the plastic surgeon will prescribe a healthy diet that supports the restoration of nail growth and strength through the necessary vitamins and minerals.

**Sixth: Treatment of nail loss with laser** Laser treatment is considered one of the best available methods for treating nail loss, as it is characterized by speed and effectiveness in achieving guaranteed results. The laser technique has provenIts effectiveness in treating many skin diseases without causing any damage to the surface layers of the skin. Doctors resort to using lasers to treat nail loss when other treatments such as topical creams, ointments, antibiotics, and steroid medications are unsuccessful. It is necessary to choose a highly experienced and qualified dermatologist, in addition to the availability of the latest laser devices used in treating nail loss on the hands or feet. Among the most prominent types of lasers used in this field are the YAG laser and the carbon dioxide (CO2) laser.

**Laser nail loss treatment steps**

1. The doctor begins by sterilizing the nail area and the entire nail bed to ensure that the infection does not spread.

2. The dermatologist uses local anesthesia to relieve the patient's feeling of heat resulting from the laser rays.

3. The doctor removes the dead skin surrounding the affected area.

4. The nail treatment doctor uses laser beams, whether from the YAG device or the carbon dioxide (CO2) laser device. Where laser beams penetrate the skin surface and work to destroy the fungi and tissues affected by nail psoriasis, if the main cause is fungi or psoriasis.

5. The session takes only about 30 minutes, depending on the patient's condition and the number of affected nails, whether on the hands or feet.

**Tips to prevent nail separation from the flesh and its complications**

 

Although it may always be difficult to prevent nail separation from the flesh, there are a set of steps and tips that can help reduce the severity of the problem and the possibility of its occurrence. Here are some of these tips:

1. Avoid wearing wet or warm shoes that cause sweating for long periods.

2. Use appropriate gloves or shoes while exercising or doing manual work.

3. Try to control psoriasis using available treatments to reduce the risk of nail separation from the flesh.

4. Take the necessary nutritional supplements in case of deficiency, such as vitamin D and iron when needed.

5. Treat thyroid problems and try to control them using available treatments to prevent nail separation from the flesh.

6. Trim your nails appropriately to reduce the chances of bumping into things during daily activities.

7. Keep your nails dry to avoid fungal infections and to prevent them from becoming brittle, as moisture causes nails to expand and then contract when dry, making them more brittle.

8. Avoid constant exposure to harsh chemicals such as nail polish remover.

9. Be careful not to wear wet or warm shoes for long periods.

**Treatment of a dislocated nail with herbs**

Some herbs are effective in reducing inflammation, reducing pain, and promoting the growth of new nails. However, it should be noted that the effectiveness of these herbs may vary from person to person, and may not be considered a substitute for medical treatment in severe cases. The most prominent herbs used to treat a dislocated nail are:

- **Tea tree oil**: It has antibacterial and antifungal properties, which helps fight infection and speed up the healing process.

- **Oregano oil**: It contains powerful antifungal and antibacterial compounds, and can be useful in treating fungal infections that affect the nails.

- **Garlic**: Known for its antimicrobial properties, it can be used topically to treat infections.

- **Turmeric**: Contains curcumin, which has anti-inflammatory properties, helping to relieve pain and swelling.

- **Lavender Oil**: It has antiseptic and anti-inflammatory properties, and can help soothe the affected area.

**How ​​to Use Herbs to Treat a Dislocated Nail**

 

Before starting any of the treatments, it is essential to clean the affected area well with soap and water.

Oils and herbs diluted with a carrier oil such as olive oil or coconut oil can be applied to the affected area several times a day.

Warm compresses can also be used to enhance blood flow to the affected area and speed up the healing process.

**Treatment of Dislocated Nails in Children**

Dislocated nails are a common injury among children, and often occur as a result of minor accidents. Although this condition may be worrying for children and parents, it usually heals completely with time and proper care. Treatment involves:

1. Clean the affected area well with warm soap and water to prevent infection.

2. Apply a clean bandage to the affected area and secure it with tape. An ice pack wrapped in a towel can be used to reduce swelling and pain.

3. Encourage the child to rest and avoid moving the affected finger as much as possible.

4. If part of the nail is hanging down, it can be carefully trimmed using clean nail clippers.

5. Monitor the affected area daily to ensure that there are no signs of infection such as redness, increased swelling, or pus.

6. Use antibacterial creams as needed.