Onycholysis: What Causes It and How Can It Be Treated?

I often see women with onycholysis, or peeling of the nails. I feel like they don’t buy into my standard explanation, which is that the most common cause is mild chronic trauma to the nails. Most seem to want a miracle lotion, or a prescription for anti-fungal medication, but this isn’t always the correct form of treatment.

Onycholysis occurs in the fingernails and toenails, when the nail plate begins to peel away from the nail bed. It’s characterized by a white sheen over the nail, which is the nail plate separating from the nail bed. In the fingernails, the cause is most often trauma from manicuring, picking, and occupational injuries. In the toenails, the most frequent source is pressure and friction from walking in close-toed shoes.

Most onycholysis patients are women, and the most common cause is irritation. As mentioned before, excessive nail filing and overexposure to chemicals in manicuring products can irritate the area and cause breakage. Sometimes, a patient can even have an allergic contact dermatitis reaction to the adhesives in acrylic nails. In rare cases, onycholysis indicates iron deficiency anemia or an overactive thyroid.

To treat onycholysis, clip off the unattached parts of the nail. Keep your fingers away from water unless absolutely necessary. Use gloves when cleaning dirty surfaces, so that bacteria can’t get underneath your nails. Gloves also prevent mechanical injuries. Some even suggest using a hair dryer to blow your fingers dry, or just letting your hands air dry. Make sure you don’t cover or bandage the nails, as fungus and bacteria thrive in closed, moist areas. In more severe cases, you may need to get a prescription from a doctor.

In conclusion, if you have onycholysis, the key is to keep everything clean and dry. Thus, bacteria and infection have a minimal chance of finding a place to grow.  


Onycholysis – American Osteopathic College of Dermatology (AOCD). Onycholysis – American Osteopathic College of Dermatology (AOCD). http://www.aocd.org/?page=onycholysis. Accessed August 16, 2016.

Result Filters. National Center for Biotechnology Information. http://www.ncbi.nlm.nih.gov/pubmed/25512134. Accessed August 16, 2016.