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Onychorrhexis - Brittle Nails


Overview, Causes, & Risk Factors

Brittle nails are fingernails and toenails that peel and break easily.

What is going on in the body?

Fingernails and toenails are made up of protein layers. The thickness and strength of the nails is inherited. Separation or breaking of the protein layers can occur in a person with brittle nails.

What are the causes and risks of the symptom?

The main cause of brittle nails is extreme dryness of the nail. Some individuals have a genetic predisposition to brittle nails. As people age, their nails become drier and more brittle. Dry air, common with winter's low humidity and use of indoor heat, can cause nails to dry out. Long, hot baths and showers can also make nails dry.

Diseases and conditions that can cause brittle nails include:

  • hypothyroidism, a condition caused by low levels of thyroid hormone
  • Raynaud's phenomenon, a disorder that affects the arteries of the arms and legs
  • skin diseases, such as psoriasis
  • endocrine disorders, such as Sjogren-Larsson syndrome, which also causes dry skin
  • malnutrition
  • Factors that increase a person's risk of brittle nails include:

  • frequent handwashing, which may be associated with the person's job
  • prolonged exposure to cold, dry weather
  • sunburn or windburn
  • excess exposure to chemicals, such as nail polish remover
  • Repeated injury to the nail tip can also lead to brittle nails.


    Symptoms & Signs

    What other signs and symptoms are associated with this symptom?

    The signs and symptoms of brittle nails include:

  • peeling at the nail tips
  • easy breaking
  • inability to grow the nails out

  • Diagnosis & Tests

    How is the symptom diagnosed?

    The diagnosis of brittle nails is made when splitting of the nails is seen. Diagnostic tests may be ordered if an underlying condition, such as hypothyroidism, is suspected.


    Prevention & Expectations

    What can be done to prevent the symptom?

    People subject to brittle nails should limit the amount of soap they use and the length of time their hands are exposed to water. Some people may be able to use mild, moisturizing soap on their hands. A few need to limit soap use to the underarms and genitalia.

    After patting the hands dry with a towel, the individual should apply a moisturizer to the skin and nails. The two types of moisturizers available over the counter include:

  • cosmetic moisturizers, which provide immediate relief of dryness but last only while they are applied. For people with mild or intermittent brittle nails, a cosmetic moisturizer may be enough to keep the skin from feeling dry.
  • therapeutic moisturizers, which have been shown to act as a barrier that keeps water from evaporating from the nails. Many therapeutic moisturizers contain mineral oil or petroleum.
  • Other measures to avoid brittle nails include the following:

  • wearing protective gloves whenever possible
  • avoiding prolonged exposure to water, such as swimming
  • avoiding exposure to chemicals that irritate the skin and nails. Some forms of nail polish remover are gentler than others.
  • Several vitamins and minerals have been proposed for the prevention of brittle nails, but none have been proven effective in human studies.

    What are the long-term effects of the symptom?

    Brittle nails are often unsightly but have no significant long-term effects.

    What are the risks to others?

    Brittle nails are not contagious and pose no risk to others.


    Treatment & Monitoring

    What are the treatments for the symptom?

    Brittle nails are treated the same way they are prevented, following the guidelines for bathing and using moisturizers. Several vitamins and minerals have been proposed for the treatment of brittle nails, but none have been proven effective in human studies.

    What are the side effects of the treatments?

    There are no side effects to treatment, unless an individual is allergic to moisturizers. Those individuals should choose unscented or hypoallergenic moisturizers.

    What happens after treatment for the symptom?

    Moisturizer should be applied to the skin and nails on a regular basis as needed. This will help prevent symptoms from returning.

    How is the symptom monitored?

    Any new or worsening symptoms should be reported to the healthcare provider.


    Attribution

    Author:Lynn West, MD
    Date Written:
    Editor:Ballenberg, Sally, BS
    Edit Date:02/28/01
    Reviewer:Barbara Mallari, RN, BSN, PHN
    Date Reviewed:07/27/01


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