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Home > Skin & Beauty > Nail Care > Brittle Nails: Causes, Symptoms, and Treatment

Brittle Nails: Causes, Symptoms, and Treatment

February 4, 2021 - Updated on September 29, 2021
5 min read
By Akanksha Shah Sanghvi, MD, Clinical Dermatology

In this article:

  • How Common Is It?
  • Types of Brittle Nails
  • Causes of Brittle Nails
  • Symptoms Associated With Brittle Nails
  • Standard Treatment for Brittle Nails
  • Diagnosing Brittle Nails
  • When to See a Doctor
  • Final Word

Brittle nails, medically known as onychoschizia, refers to a condition wherein the nails turn soft, thin, and brittle, often accompanied by splitting of the nails. (1)(2)

brittle nails

In general, nails are tough structures made up of a protein called keratin. They help protect the toes and fingers from injury and damage. However, different environmental and chemical factors can make them brittle.

These factors include frequent hand washing, swimming, and other forms of frequent wetting and drying of nails. In some cases, brittle nails may be a symptom of nutritional deficiencies and medical problems.

How Common Is It?

Brittle nails are a common occurrence in dermatological settings. Around 20% of the population has a problem of brittle nails. (3) The problem is found to be more common in women than in men. (3)(4)

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Types of Brittle Nails

types of brittle nails

Brittle nails are classified into:

  • Dry and brittle nails – Dry nails, hands, and cuticles are a common problem caused by a lack of moisture, generally due to excessive washing of hands or using air dryers.
  • Soft and brittle nails – Excessive moisture can also cause brittle nails. This can result from exposure to detergents, nail polish remover, and household cleansers.

Causes of Brittle Nails

Brittleness of the nails can result from various reasons, including:

  • Aging (People above 50 years of age are highly prone to brittle nails.) (3)
  • Exposure to chemicals and toxins
  • Repetitive or overuse of nail polish and polish removers
  • Low humidity (5)
  • Nutritional deficiency, including that of vitamins or proteins
  • Fungal infection
  • Use of artificial nails, nail glue, and gel polish
  • Prolonged contact with water
  • Nail damage due to improper nail clipping, long nails, or telephone dialing, among others (6)
  • Cancer treatment including targeted therapies and chemotherapy
  • Raynaud’s syndrome, which affects blood circulation to the extremities, causing a lack of oxygen supply to the nails (7)
  • Hypothyroidism
  • Iron-deficiency anemia, which causes a lack of oxygen due to low hemoglobin levels (A lack of iron in the body causes the nails to become brittle and moon-shaped, known as koilonychia) (8)(9)
  • Nail psoriasis, characterized by the excessive growth of skin cells on the surface, resulting in roughness, crumbling, and blood under the nails

Symptoms Associated With Brittle Nails

Brittle nails can manifest along with the following signs and symptoms:

  • Roughness
  • Dryness
  • Nail pitting
  • Nail chipping
  • Cracking, breaking, or splitting of nails
  • Peeling
  • Delamination of the nail from the nail bed
  • Slow nail growth
  • Thin nails

Standard Treatment for Brittle Nails

medical treatment for brittle nails

Brittle nails are a common problem, and most people affected with the condition often hide their nails in social situations. However, brittle nails can be treated easily with self-care, such as avoiding excessive water or chemical exposure.

If simple self-care measures or direct nail treatments do not work or the symptoms worsen, consult your dermatologist. The doctor may recommend the following treatments depending on the cause of your brittle nails: 

1. Supplements

You may be required to take iron supplements if your nail brittleness is caused by iron deficiency anemia.

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Also, biotin supplements can help prevent nail dryness or brittleness and can improve nail texture. (10) A 2.5 mg dose of biotin or 10 mg of silicon every day can significantly improve nail health. (11)

2. Nail strengtheners

You can consult your doctor for nail-strengthening creams and gels, such as Nuvail and Genadur. (12) Hyaluronic acid is another nail-strengthening agent that can treat brittle nails. (13)

3. Hydrating nail service

You can go for extra hydrating nail services performed using nail-strengthening creams and natural oils at a salon upon your dermatologist’s recommendation.

Diagnosing Brittle Nails

It can be a task to diagnose brittle nails due to the number of possible causes and a wide variety of symptoms. The doctor may start with an evaluation of your medical history and overall health to look for possible causes.

Further diagnosis may be based on the following tests:

  • Physical exam. This includes noting the condition of your nails and checking for other associated symptoms on the body.
  • Nail culture. The doctor may send samples of your nails to the lab for culture to check for bacterial, viral, or fungal growth.
  • Blood test. This helps determine nutritional deficiencies, including iron and zinc deficiencies.
  • Biopsy. In some cases, the doctor may take a sample of your cuticle tissue and send it for microscopic observation.

When to See a Doctor

when to consult a doctor regarding brittle nails?

It is best to seek medical opinion for brittle nails if they appear suddenly or are accompanied by:

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  • Hair loss
  • Falling off of nails
  • Vomiting or diarrhea
  • Thinning or thickening of the nails
  • Nails separating from the surrounding skin
  • Pain or swelling around the nails
  • Nongrowth of nails
  • Mood swings and confusion
What you may ask your doctor
  • What measures can I take to help improve my nail health?
  • Do I need to take medications?
  • Do I need to make dietary changes?
  • What can be the cause of the nail brittleness?
What your doctor may ask you
  • Do you have other symptoms such as lethargy, fatigue, or fever?
  • Are you diabetic?
  • When did you first notice brittleness in your nails?
  • Do you smoke?

Final Word

Brittle nails are often a mild problem characterized by dryness, ridges, and lines and can break off easily. While they generally result from environmental factors, they can also be caused by medical conditions such as thyroid problems in a few cases.

Brittle nails commonly cause social anxiety. Thus, it is best to seek medical attention for a proper diagnosis and appropriate treatment.

Continue Reading Continue ReadingHome Remedies to Strengthen Brittle Nails
References
  1. D; DRR. Management of simple brittle nails. Dermatologic therapy. https://pubmed.ncbi.nlm.nih.gov/23210755/.
  2. Sparavigna A, Tenconi B, La Penna L. Efficacy and tolerability of a biomineral formulation for treatment of onychoschizia: a randomized trial. Clinical, cosmetic and investigational dermatology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525000/. Published May 13, 2019.
  3. Chessa MA, Iorizzo M, Richert B, et al. Pathogenesis, Clinical Signs and Treatment Recommendations in Brittle Nails: A Review. Dermatology and therapy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994568/. Published February 2020.
  4. Rao S, Banerjee S, Ghosh SK, Gangopadhyay DN, Jana S, Mridha K. Study of nail changes and nail disorders in the elderly. Indian journal of dermatology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221241/. Published 2011.
  5. SJ; FLEARE. The effect of humidity on the fracture properties of human fingernails. The Journal of experimental biology. https://pubmed.ncbi.nlm.nih.gov/19011206/.
  6. Iorizzo M; Pazzaglia M; M Piraccini B; Tullo S; Tosti A; Brittle nails. Journal of cosmetic dermatology. https://pubmed.ncbi.nlm.nih.gov/17134428/.
  7. Temprano KK. A Review of Raynaud’s Disease. Missouri medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139949/. Published 2016.
  8. Kumar V, Aggarwal S, Sharma A, Sharma V. Nailing the diagnosis: koilonychia. The Permanente journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442766/. Published 2012.
  9. N; WJBRVNJ. Koilonychia: an update on pathophysiology, differential diagnosis and clinical relevance. Journal of the European Academy of Dermatology and Venereology: JEADV. https://pubmed.ncbi.nlm.nih.gov/27531645/.
  10. PMC E. Europe PMC. https://europepmc.org/article/med/8477615.
  11. R; SNDMJS. Vitamins and minerals: their role in nail health and disease. Journal of drugs in dermatology: JDD. https://pubmed.ncbi.nlm.nih.gov/17763607/.
  12. An evaluation of the safety and efficacy of a hydro soluble nail lacquer (Genadur®) for the treatment of simple brittle nails. Joint Clinical Trials Office. https://jcto.weill.cornell.edu/open_clinical_trials/an-evaluation-of-the-safety-and-efficacy-of-a-hydro-soluble-nail-lacquer-genadur-for-the-treatment-of-simple-brittle-nails.
  13. Piraccini BM, Granger C, Alessandrini A, et al. Clinical and Instrumental Objective Evidence of the Efficacy of a New Water-Based Nail-Strengthening Solution Containing Pistacia lentiscus and Hyaluronic Acid Applied for Up to 6 Months to Improve the Appearance of Weak, Brittle Nails. Dermatology and therapy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994637/. Published February 2020.
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