From the Research
Onychomadesis typically resolves within 1-4 months after hand, foot, and mouth disease (HFMD), with the most recent and highest quality study suggesting a resolution time of approximately 35 days 1. The affected nails will usually grow out and be replaced by new, healthy nails during this time. There is no specific treatment to speed up this process. The best approach is to:
- Keep nails clean and dry
- Avoid picking or manipulating the affected nails
- Trim nails regularly as they grow out
- Use gentle nail care products if desired Onychomadesis occurs because HFMD temporarily disrupts nail matrix function, causing a pause in nail growth, as supported by studies 2, 3, 4, 5. As the infection resolves, normal nail growth resumes, but there's a visible gap where growth was interrupted. This gap slowly moves outward as the nail grows, eventually reaching the free edge and falling off, replaced by new nail. Patients should be reassured that this is a benign, self-limiting condition. If there's no improvement after 4 months, or if there are signs of secondary infection, they should consult a healthcare provider for further evaluation. It is essential to note that the exact mechanism behind onychomadesis is still not fully understood, but it is hypothesized that the virus elicits an inflammatory process, inhibiting nail-matrix proliferation 1.