What should you know about permanent onycholysis?

The detached portion may appear white, yellow or opaque because air sits beneath the nail. It may begin at the tip or sides and can trap moisture and debris. Causes include repeated trauma, manicures, irritants, medicines and inflammatory nail conditions; nail fungus and nail psoriasis are two possibilities, but separation alone cannot identify the cause.

A nail that stays lifted can become thicker, discoloured or uncomfortable. The detached part usually does not reattach; improvement comes as healthy nail grows forward, which is gradual and differs between fingernails and toenails.

Keep the nail short and dry, trim only loose edges safely, and avoid digging beneath it. Wear protective gloves around water or cleaning products and choose roomy footwear if a toenail is affected. Pause artificial nails, aggressive filing and picking until the cause is known.

A clinician may examine nail clippings or surrounding skin when infection is suspected. Treatment could target fungus, psoriasis or another trigger. Nail surgery is sometimes considered when a damaged or abnormal nail needs removal or a problem requires direct treatment; it is not a substitute for finding the cause.

Arrange medical review for spreading separation, pain, swelling, pus, bleeding, a dark streak, a new lump or a nail that changes rapidly. Seek earlier advice if you have diabetes, poor circulation or reduced sensation, because small nail injuries can be harder to notice and heal.

Ask whether the pattern suggests nail fungus, nail psoriasis or trauma, whether a sample is needed, how to protect the nail while it grows, what treatment could restore healthy growth, and whether nail surgery has a role.