When is nail surgery recommended for nail separation?

Nail separation, also called onycholysis, is lifting of the nail plate from the skin underneath. It may follow injury, repeated moisture or chemical exposure, skin disease, medicine effects, or infection. Treatment usually begins by identifying and addressing the cause while protecting the lifted edge from further trauma. Surgery is not needed for every separated nail. It may be considered if a damaged portion is catching and painful, if debris or infection cannot be managed, or if an unusual change needs sampling from the nail bed or matrix.

Keep the nail short only by trimming the unattached edge carefully, and protect it from knocks and prolonged soaking. Avoid pulling off attached nail, placing objects underneath it, or covering it with artificial nails until it has been assessed. Bring information about recent injury, work exposures, skin rashes, medicines, and other affected nails. A clinician can decide whether observation, treatment of infection or inflammation, or surgery is appropriate.

Arrange prompt assessment for pain, swelling, redness, green or yellow drainage, bad odour, bleeding, or separation that is spreading or not improving. Seek earlier advice if you have diabetes, poor circulation, reduced sensation, or a weakened immune system. After a procedure, contact the clinic for persistent bleeding, increasing pain, pus, fever, or redness extending beyond the treated area.

Ask what caused the separation, whether the nail needs sampling or removal, how much nail will be treated, how to protect the nail bed, and what regrowth changes are expected.