Onycholysis is the separation of the nail plate from the underlying skin, known as the nail bed. This detachment breaks the natural seal, creating a space beneath the nail. The safety of applying artificial nails, including gels, acrylics, or press-ons, over this condition is a frequent concern. This article addresses the risks of using artificial enhancements on an onycholytic nail and provides practical steps for promoting healing.
What Exactly Is Onycholysis?
Onycholysis is the lifting of the nail plate from the underlying nail bed, usually starting at the free edge and progressing inward. The separated area often appears opaque white, yellow, or green, contrasting with the healthy pink attached nail. Since the separated portion will not spontaneously reattach, the condition must grow out completely, which takes several months for fingernails.
The separation is frequently caused by external trauma, such as aggressive cleaning, direct impact, or repetitive microtrauma from long nails. Chemical irritants and prolonged water exposure, which weakens the nail structure, are also common culprits. Underlying medical issues can trigger onycholysis, including inflammatory skin conditions like psoriasis, fungal infections, or systemic disorders such as thyroid disease. Identifying the initial cause is important for proper management.
Applying Artificial Nails: The Significant Risks
The direct answer to whether artificial nails should be worn over onycholysis is a definitive no. This practice introduces serious dangers that prolong healing and increase the risk of severe infection. Artificial enhancements like acrylics or gels create a rigid structure that can dramatically worsen the initial separation.
The strong adhesion of the fake nail to the detached natural nail plate is often greater than the bond between the nail plate and the delicate nail bed underneath. This difference in strength causes the artificial nail to pull the natural nail further away with every minor bump or stress, leading to deeper damage.
The removal process is equally problematic. The strong solvents required or the mechanical prying action can cause traumatic damage to the already vulnerable, exposed nail bed. This trauma can injure the nail matrix, potentially leading to permanent structural changes in the new nail growth.
The sealed environment created by an artificial nail is an ideal breeding ground for microbial growth, representing the most significant risk. The space beneath the separated nail plate becomes a warm, dark, and moist pocket that traps water and debris. Applying an artificial nail effectively seals this area, creating an anaerobic chamber.
Bacteria, especially Pseudomonas aeruginosa, thrive in this sealed, damp setting. A Pseudomonas infection is known as Green Nail Syndrome because the bacteria produce pigments that stain the nail plate a distinct blue-green color. Fungal infections (onychomycosis) are also highly probable. These secondary infections are difficult to treat and can cause further detachment and chronic pain.
Healing Protocols and Management Strategies
The primary goal for managing onycholysis is to prevent further separation and protect the exposed nail bed while waiting for healthy nail growth. The most important step is to keep the detached portion of the nail trimmed very short, clipping it back to the point where it is still attached. This eliminates the leverage that worsens separation and reduces the space where moisture and debris collect.
It is imperative to maintain absolute dryness of the affected nail, as moisture encourages infection and prevents reattachment. Wear waterproof gloves when performing wet tasks like washing dishes or using cleaning agents. Also, avoid all potential irritants, including nail polish, polish remover, and harsh solvents, as they can cause inflammation that impedes healing.
Do not attempt to clean aggressively underneath the separated nail with any tool, as this action can worsen the detachment and introduce bacteria. Healing requires patience, as new, healthy fingernail tissue takes approximately four to six months to grow from the matrix to the tip. If the cause of the separation is unknown, or if there are signs of infection—such as pain, swelling, discharge, or deep green discoloration—a dermatologist or healthcare provider must be consulted for accurate diagnosis and treatment.