“Surprise” Onycholysis

An unbelievable amount of posts and questions with pictures of clients who are exhibiting “surprise” onycholysis are popping up!

Many explain it by saying that the client is ‘heavy-handed’, so let’s deal with this one first.

Fingernails are there to protect the last bone of the fingers from any damage. They are also there to give fingers some rigidity to enable dexterity. If they are healthy, they will be securely attached to the nail bed. It will take a huge trauma to detach this connection! It will probably even involve bleeding where the nail plate has been ripped off the nail bed.

Onycholysis will not happen under normal circumstances! This is not a physical trauma that wrenches the nail plate away. This is a situation where the nail bed is rejecting the nail plate for several reasons. Very often it is the nail bed epithelium doing its best to protect the matrix from injury or invasion of pathogens. It can be from illness or a skin condition such as psoriasis.

It can, of course, be a result of trauma, but usually after an accident causing pain and bleeding. This is, probably, most common when a nail is too long for the wearer, whether it is a natural nail or an enhancement.

People have been wearing enhancements for 40+ years. We have seen horrific accidental damage. An enhanced nail too long or too strong can be ripped off the nail bed! 

However, it is very unusual for a nail to exhibit onycholysis without that very obvious trauma. So it comes as a surprise when a coating or enhancement is removed. 

As nail professionals, we cannot diagnose an allergy. But when this happens, as described, it is likely to be the nail bed and/or matrix rejecting the product on the nail. 

Clients who have had COVID can, unusually, react. There is no evidence that the vaccinations cause any such issues. However, COVID does alter the body’s immune system, and can make it more susceptible to irritation and allergy. Whatever the cause, this is an unexpected and unwanted reaction, and we cannot ignore it.  

Do not ignore the presence of “surprise” onycholysis, and put it down to ‘heavy-handedness. This is the most unlikely cause. It is a situation that, in the numbers we are seeing it, is a relatively new phenomenon. It is most likely a reaction to the nail coating.