What should you know about proximal onycholysis?

The detached portion may look white because air lies beneath the nail. When separation begins near the nail fold rather than the free edge, clinicians consider causes such as infection, inflammation, injury, medication effects, or a problem affecting nail growth. Nail fungus and nail psoriasis can both be associated with nail lifting, but the appearance does not identify the cause by itself.

The separated nail cannot be reattached. Improvement is seen as new nail grows forward and replaces the affected portion, which takes time and varies by finger or toe.

Keep nails short by trimming only loose free edges, without pulling attached nail. Keep hands and feet dry, wear protective gloves for wet work, and avoid biting, scraping, aggressive manicures, and artificial nails until the cause is clearer. Do not place antiseptics or antifungal products under the nail unless a clinician recommends them.

A clinician may examine the nail, surrounding skin, and other nails, and may take a sample when infection is suspected. Treatment follows the cause; Nail Surgery is reserved for selected problems rather than routine nail lifting.

Arrange a dermatology review when lifting starts near the cuticle, spreads, affects several nails, or does not settle after protecting the nail. Seek prompt care for severe pain, pus, increasing warmth or swelling, a dark streak, or a rapidly changing nail or nail fold.

Ask whether the pattern suggests Nail Fungus, Nail Psoriasis, trauma, or another cause; whether testing is needed; how to protect the nail while it grows; and which treatment would be appropriate if infection or inflammation is confirmed.