Onycholysis is the detachment of the nail from the nail bed – a painful and somewhat unsightly problem which can be the result of psoriasis, eczema, infection, impaired circulation, allergy or trauma.
Generally treatment should first of all address the cause and this means it will vary from case to case. By eliminating the predisposing cause of the problem it is possible to allow the nail to grow back naturally.
In the case of eczema or psoriasis, the best treatment will often be a mild topical corticosteroid which can prevent inflammation. In one reported case meanwhile pulsed dye laser treatment has been reported as successful for psoriasis and ultraviolet treatment might also be useful.
In the case of a tissue infection caused by bacteria such as the staphylococcus virus, it may be suitable to use antibiotics to help remove the infection. In more severe cases an ‘intralesional injection’ may be used which involves the frequent injection of a saline solution into the nail fold around every four weeks for 4-6 sessions. For fungal infections a topical antifungal imidazole or ally amine can be useful.
For an allergy it will be important to identify the cause of the allergy and to help avoid coming into contact with the irritant. If necessary immunotherapy may be recommended to help reduce or eliminate the reaction.
Of course it will be highly necessary for the patient to avoid further trauma and to protect their finger. To this end they should cut the remaining nail to avoid it catching on clothes and should avoid activities that might put the finger in harm’s way more than necessary (piano playing and rock climbing are off limits).
You may wish to wrap the finger up in a plaster, but make sure that the padded part comes into contact with your nail rather than the adhesive – otherwise you might pull and damage the remaining nail and harm the nail bed when removing it.
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