Brittle Nails: Causes, Symptoms, and Treatment

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)

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)

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:

Standard 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.

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

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

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.

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