What causes an empty fingernail?

Generally, nail separation occurs in the middle of the nail. Nail separation may be caused by trauma, excessive manicures, onychomycosis, paronychia, lichen planus, and other factors. It is recommended to seek timely medical treatment under a doctor's guidance. Specific explanations are as follows:

1. Trauma

In daily life, when fingers or toes suffer from compression, collision, or other injuries, the connecting structures between the nail bed and the nail plate may be damaged. For example, injuries from being pinched in a door or struck by heavy objects may cause the nail plate to separate from the nail bed, resulting in onycholysis. It is recommended to wear appropriate protective gloves during potentially hazardous activities, such as lifting heavy objects or using tools, to reduce direct injury to the nails.

2. Excessive manicures

Frequent manicures, such as filing the nails or using low-quality nail polish or removers, may damage the cuticle layer on the nail surface, making the nails fragile. Meanwhile, some chemicals used during manicures may irritate the nail bed, affecting normal nail growth and causing separation of the nail plate from the nail bed. Reduce the frequency of manicures in daily life, choose reputable manicure products, avoid excessive filing, and allow sufficient rest time for the nails.

3. Onychomycosis

Onychomycosis is usually caused by dermatophyte infections, such as Trichophyton rubrum or Trichophyton mentagrophytes. These fungi invade the nail plate and nail bed, where they grow and reproduce, decomposing keratin and damaging the normal structure of the nails, leading to separation of the nail plate from the nail bed. Symptoms such as nail discoloration, thickening, and brittleness may also occur. Patients may use medications such as itraconazole capsules, terbinafine hydrochloride tablets, amorolfine topical solution, and others under a doctor's advice.

4. Paronychia

Paronychia is often caused by minor puncture wounds, bruises, reverse peeling, or cutting nails too short, allowing bacteria such as Staphylococcus aureus to enter the nail fold and cause inflammation. If the inflammation persists for a long time, it may gradually spread to the nail bed, damaging the connection between the nail bed and the nail plate, causing nail separation. Symptoms such as redness, swelling, pain, and pus in the nail fold may also occur. Patients can use medications such as mupirocin ointment, fusidic acid cream, cefixime dispersible tablets, and others under medical guidance.

5. Lichen planus

Lichen planus may be associated with multiple factors, including heredity, immunity, infection, and others. When lichen planus affects the nails, it damages the normal structure and function of the nail matrix and nail bed, impacting nail growth and causing separation of the nail plate from the nail bed. Symptoms such as purplish-red polygonal flat papules on the skin and white reticular streaks on oral mucosa may also accompany. Patients should follow medical advice to use medications such as tretinoin cream, tacrolimus ointment, hydroxychloroquine sulfate tablets, and others for treatment.

In daily life, maintain clean and dry nails, avoid prolonged immersion in water; eat a balanced diet with adequate nutrition; and avoid bad habits such as nail-biting or picking at hangnails.