Onycholysis is when the nail of a finger or toe separates from the underlying nail bed. Below is my experience with this condition, documented over many months.

It contains pictures of my toe with the condition. If the sight of an infected and exposed nail bed makes you feel queasy or disgusted, stop reading now.

Otherwise, go ahead.

It all started last year, when I noticed the toenail on my left foot’s great toe was slightly discoloured. Thinking nothing of it, I ignored the problem, till earlier this year I noticed that the discolouration had spread considerably.

I assumed it was nothing serious, but still got an appointment with a Dermatologist.

I was in for a rude shock when the doctor said that my nail was mostly dead & diseased and needed to be removed.

The nail removal was not as painful as I had expected, but it was extremely uncomfortable watching her cut away the nail. The result was horrifying to look at.

They also sent my nail for culture, which would take 1 month. I had to apply 20% Urea cream to the nail bed every morning and Daivobet Ointment (Calcipotriol/Betamethasone) every night.

Week 1 of recovery

The exposed nail bed was sensitive and the first few days, I couldn’t stand anything touching it. Sleeping was near-impossible, because every time the sheets or my other foot would touch the exposed nail bed, I would wake up.

The discomfort was more psychological than physiological. I tried my best to get over it and after the first few nights, I was at least able to sleep.

I was also quite conscious about how I stood, deliberately keeping my left leg away from people ad standing at an angle to them.

By Day 4, luckily, I was well enough to resume running, with a toe condom on.

By the end of the week, I had more or less gotten over the discomfort and gone back to a normal life.

Further Recovery

Within 2 weeks, it was no longer uncomfortable when my toe touched things. While sleeping when the toe would rub against the sheets, I wouldn’t wake up anymore. The nail grew out very-very slowly.

After a month’s time, I went to the doctor for a follow up, during which she informed me that I also had Onychomycosis, which is a fungal infection of the nail and nail bed. She postulated that this happened because the gap between the nail and the nail bed allowed moisture to fester.

She started me on a course of Itraconazole, 1 week on, 3 weeks off.

Over the next few months, the toenail grew out, but I noticed there was quite a bit of bad nail still left. The doctor clipped off more nail around the 4, 6 & 8 month marks and I continued with the anti-fungals till the 6th month.

Eventually, I realised that the leading of the toenail would not adhere to the nail bed, no matter what I did. So I resigned myself to having a shorter nail on that toe.

Also, now the affected toenail is permanently a darker shade than all other toenails.

Advice for Runners

1. Always wear correctly sized shoes. When in doubt, go for a higher/wider size. The toe should not touch the front of the shoe or rub against the sides.
2. Use heel-lock lacing.
3. Regularly trim toe-nails and keep them shorter than you normally would, especially around the outer edges.
4. Always wear flip-flops in the shower and dry your feet thoroughly before putting on socks. Avoid getting your feet wet during the day.
5. Wear running socks which absorb sweat.