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Proximal Nail Fold

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The proximal nail fold is the layer of epidermis and dermis covering the nail matrix, from the proximal edge of the nail plate to the first joint of the finger. Where the proximal nail fold meets the nail plate, it folds back on itself to create a colourless, keratinised frame of epidermis which along with the cuticle beneath it and the nail plate below that, create an important nail seal at the proximal end of the nail plate.

 

The nail bed is completely sealed all the way around by these seals, the proximal nail fold, the lateral nail fold and the hyponychium and this prevents infection from getting under the nail plate, into the nail matrix and even down to the bone or distal phalanx of the finger.

On the ventral side of the proximal nail fold is the eponychium, which creates the cuticle. 

Ask the Experts

What is the proximal nail fold?

The proximal nail fold is the entire area of skin from the distal finger or toe joint to the nail plate where it folds under. On the underside (or ventral side) it has a specialized area called the eponychium. This is where the dead skin cells of the proximal nail fold are shed and form the cuticle. The proximal nail fold is all living skin. The frame where it folds under is often mistaken for the cuticle. The cuticle is dead skin cells. This frame is the living skin of the epidermis

What does the proximal nail fold do?

Along with the hyponychium and the lateral nail folds, the proximal nail fold is an important seal of the nail, protecting the matrix, preventing infection, allergens and pathogens gaining access to the rest of the nail unit and the sensitive areas of the nail bed and nail matrix. The eponychium, on the ventral side of the proximal nail fold creates the cuticle which acts as a strong seal between proximal nail fold epidermis and the nail plate.

Can you cut into the proximal nail fold?

No, that is not recommended. The proximal nail fold is an important nail seal and by cutting it away and exposing the dermis behind the frame of keratinised skin, you risk allowing infection into the nail unit plus the skins defenses will encourage it to grow back thicker. The proximal nail fold with its frame of colourless keratinised skin needs to be left. Any cuticle that remains on the nail plate where it has moved beyond this frame, can safely be removed.

Do proximal nail folds grow back?

Skin has amazing restorative powers, so if the frame or the proximal nail fold are cut, then it will recover. However, skin if continually cut, will grow thicker, to protect itself, and grow calluses and scar tissue. So by cutting continually into the frame or proximal nail fold, these areas will thicken and harden as they try to protect themselves from attack.

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