Fingernails are made of protein layers called keratin and provide protection for the fingertips. According to the Mayo Clinic, nails that have become split, brittle or discolored can be a sign of health problems, so a visit to your doctor is recommended. In difficult cases, health care providers will refer patients to dermatologists who have specific training in diagnosing and treating nail disorders.
Infection
Nail infections can cause the nail to discolor, split and crumble. The organisms responsible for these infections include parasitic fungi, yeasts and molds. Diagnosis is important for proper treatment and confirmed by studying nail clippings and scrapings. The New Zealand Dermatological Society reports that treatment options are more successful for fingernail than toenail infections, although treatment is often expensive and time consuming.
Psoriasis
Psoriasis is a disease that is most recognized by itchy and scaly white patches on the skin. However, 50 percent of patients also experience nail psoriasis. The longitudinal splitting of the nails can cause pain and distress in these patients. A 2009 article in "Journal of Cutaneous Medicine and Surgery" reports that the biologic drug infliximab may provide a significant treatment option.
Lichen Planus
Nail lichen planus usually affects middle-aged adults, although it may occur in children as well. Nails become brittle and split, especially near the fingertips. In rare cases, permanent damage can occur, destroying the nail. The American Academy of Dermatology states that the condition is likely an abnormal immune reaction perhaps caused by a virus (such as hepatitis C) or by an allergic drug reaction. There is no cure, but in a study of five patients reported in a 2010 letter to the editor of "Drug Development and Adverse Reactions," topical tacrolimus was found to be an effective treatment.
External Causes
The American College of Osteopathic Dermatology (ACOD) notes that regular exposure to water and chemicals can damage the nails. People in any profession that requires repeated hand washing, such as medical personnel, hair dressers, chefs or professional cleaners, are at risk for developing split and brittle fingernails. Wearing cotton-lined rubber gloves and applying nail prep spray once a week will strengthen the nails. The ACOD notes that biotin vitamin supplements taken for six months may help, although pregnant women should avoid this option.
References
- Mayo Clinic: Fingernails---7 Signs of Possible Health Problems
- Dermnet NZ: Fungal Nail Infections
- "Journal of Cutaneous Medicine and Surgery"; Nail Psoriasis and Biologics; Noiles K; 2009
- American Academy of Dermatology: Lichen Planus
- American Osteopathic College of Dermatology: Brittle Splitting Nails
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