Onycholysis (Nail Separation): Symptoms, Causes & Treatment

Symptoms and Causes

What are the symptoms of onycholysis?

Symptoms of onycholysis include:

  • Nails that peel away from their nail beds.
  • Tough, thick nail beds.
  • An abnormal border between the pink area of your nail and the white edge of your nail. The border may look wavy, and the white areas may be thicker in some areas and thinner in others.
  • Discoloration in your nails and nail beds. They may look gray, green, purple, white or yellow.
  • Dents or pits (cupuliform depressions) in your nails.
  • Crumbling nails.
  • Hemorrhages underneath your nails.

Onycholysis usually isn’t painful, but what causes your onycholysis may be painful or irritating. If you have onycholysis due to injuries or fungal infections, you may experience pain and irritation.

What are the common causes of onycholysis?

The following are common causes of onycholysis:

  • Injuries (trauma): Injuries to a nail or the area where your nails start to grow (nail matrix) can cause onycholysis. You can injure these areas by bumping or hitting your nails, wearing shoes that are too small or even keeping your nails in water for too long. Regularly going to a nail salon to get manicures can also cause onycholysis. Manicurists use a lot of force to trim, buff and polish your nails. Even tapping your nails on a hard surface over a long period can cause onycholysis.
  • Reaction to chemicals: Chemicals in nail polish, nail gloss, nail hardener, nail polish remover and fake nails can cause onycholysis.
  • Fungal infections: Fungal infections occur when fungus gets between your nail and nail bed, usually through cracks or cuts in your finger or toe. Fungal infections cause your nails to become thick and yellow, and they may show white spots and streaks.
  • Medications: Chemotherapy and some medications that cause light sensitivity can cause onycholysis. These medications include tetracycline, nonsteroidal anti-inflammatory drugs (NSAIDs), psoralens and oral retinoids (vitamin A derivatives).
  • Nail psoriasis: Nail psoriasis causes changes to the structure of your nails, which may include onycholysis.

Onycholysis rarely affects all of your nails. The following may cause onycholysis in all of your nails:

  • Iron deficiency: An iron deficiency is when you don’t have enough iron in your diet. An iron deficiency can also cause anemia.
  • Hyperthyroidism: Hyperthyroidism causes your thyroid gland in your neck to create and release more hormones than your body needs. Hyperthyroidism can also cause a rapid heartbeat, unexplained weight loss, increased appetite and anxiety disorders.

Is onycholysis a fungal infection?

No, onycholysis isn’t a fungal infection. However, fungal infections can sometimes cause onycholysis.

Is onycholysis contagious?

Depending on what causes your onycholysis, it may be contagious. Onycholysis caused by an injury, nail psoriasis or reaction to a medication or chemical isn’t contagious. However, onycholysis caused by a fungus may be contagious.

A person with an infection can spread the fungus to someone else through skin-to-skin contact. You can also get nail fungus by touching an infected surface (indirect contact), like walking barefoot around public pools or showers or by sharing items like towels, nail clippers and nail scissors.

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