What is Onycholysis and what causes it?
Onycholysis, the separation of the nail plate from the nail bed, can be a painful condition. It is caused by the nail bed responding to an irritation an allergen or mechanical damage by creating keratinous structures and cornifying nail bed epithelium. This separates the nail from the nail bed, forming a cavity where infectious micro-organisms can quickly grow, preventing this new cornified layer from healing, and causing the Onycholysis to persist.
What causes it?
This condition can be caused by a number of different issues including:
– mechanical factors. This can happen if the strong seal, the hyponychium, is broken by something being pushed undertone free edge. This can be by accident of it could be an aggressive cleaning implement under the free edge.
– infections. If the hyponychium seal is broken it is possible that pathogens can enter and infect the nail bed. It is also possible for a pathogens to enter the nail bed from the proximal end of the nail plate under the proximal nail fold. It can be fungal or bacterial.
– allergies. If anywhere on or in the nail unit there is the presence of a substance that is causing an allergic reaction, the nail bed epithelium can keratinise to help protect the nail bed and the nail matrix. This can often be one of the early signs that an allergic reaction is present.
– excessive temperatures such as ‘heat spike‘. A ‘heat spike’ (or exothermic reaction’ can be so severe that it burns the nail bed. If this happens the burned area will keratinise and cause the nail plate to separate. Although onycholysis is usually seen under the free edge, it can also be evident in the centre of the nail bed.
– improper structure of artificial enhancements. By this, it means that the structure on the nail is causing too much pressure and lifting the nail plate from the nail bed. A common cause of this is ‘pinching’. This is safe to do on the free edge of the structure if gentle, but when this pressure is exerted over the nail bed with too much force, the nail plate is lifted away from the centre of the nail bed. Another possible cause is a nail tip that has a deeper ‘c’ curve than the natural nail. Even if flattened out during application, the tip will revert to its natural shape and exert an upward pressure on the sides of the nail and have a similar effect to pinching.
Who does it affect?
How can nail technicians help?
Severe cases must be referred to a doctor, especially if signs of onychomycosis or inflammation are visible.
– mechanical factors: be gentle when cleaning under the free edge and advise clients to do the same.
– infections: Avoid damaging the hyponychium seal and keep all tools clean and disinfected/sterilised. If an infection is suspected refer the client to a medical practitioner. A fungal infection can only be determined by medical testing. There are other conditions that can be mistaken for a fungal infection.
– allergies: If there is any sign of an allergic reaction at all, remove all products and do not reapply until the allergen has been identified and the nail is healthy.
– heat spike: This is avoidable if matching UV gel systems are used and by avoiding apply thick layers of UV gel. If it does occur, the fingers should be removed from the lamp immediately. Sensitive clients can put their nails in the glow of the UV for a few seconds before putting them into the lamp. This will slow down the reaction that is causing the excessive heat.
– improper structure of artificial enhancements: Avoid any procedure or structure that puts pressure over the nail bed.
Nails should be kept short, clean and dry and no product should be applied. If a fungal infection is suspected it can only be confirmed by a dermatologist after testing. If an allergy is suspected, all products must be removed from all nails and the client should be allergy tested to discover exactly which ingredient is the cause.
Do not suggest tea tree oil! This ca be an irritant and could make the problem worse.