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Brittle Fingernails

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Written by
Carina Ryder, MS, BSN.
Certified Nurse Midwife, Takoma Park Gynecology
Last updated September 22, 2020

Brittle fingernails quiz

Take a quiz to find out what's causing your brittle fingernails.

Understand brittle fingernails symptoms, including 7 causes & common questions.

Brittle fingernails quiz

Take a quiz to find out what's causing your brittle fingernails.

Take brittle fingernails quiz

Symptoms associated with brittle fingernails

Like most people, you probably take your nails for granted. Toe nails. Finger nails. You might be good at trimming, painting or otherwise decorating them. It seems to be the aesthetics that concern you from day-to-day. How often to you give your nails credit for protecting the tips of your fingers? Or helping you pick up small objects? Until your nails become brittle. You can't scratch your head without breaking them. Your dexterity is limited. You think they will heal, but in the meantime, you consider it to be a cosmetic concern. Or is it something more than that?

Common accompanying symptoms of brittle fingernails

In addition to being brittle, your nails might also be:

  • Rough
  • Pitted
  • Weak
  • Dry
  • Frayed and torn
  • Discolored
  • Slow growing

Nails, skin, hair, and sweat and oil glands are all part of your integumentary system. Your integumentary system holds you together. It prevents an excess loss of fluid from your body and helps your body regulate temperature. It protects all that is inside from all that is outside. But when your nails are brittle, it might not be just about your nails.

7 causes of brittle fingernails

Inflammatory conditions and autoimmune disorders

Brittle nails can be a symptom of an underlying inflammatory condition, such as lichen planus or psoriasis. Alopecia areata, an autoimmune disorder, can also cause nails to be brittle. Inflammatory and autoimmune conditions can also involve your hair, skin and mucous membranes (like the inside of your nose or your lips).

Environmental causes

Frequent, prolonged exposure to water can cause brittle fingernails. In fact, water exposure is the most common cause of brittle nails. Whereas skin is waterproof, nails are absorbent and become brittle with repeated wetting and drying. Swimmers are susceptible to brittle nails, as are dish washers.

Nail care products

Frequent use of nail care products (especially nail polish remover, acetone or otherwise) can be harmful to your nails. Many of these products are dehydrating, and can make your finernails brittle. Household or industrial cleaning products can be absorbed by your nails, causing injury including brittleness.

Nutritional causes

Improper nutrition can result in brittle fingernails.

  • Poor nutrition: Such as from disordered eating (such as anorexia or bulimia), malnutrition, or protein, iron or calcium deficiency takes its toll on your health, and shows on your skin, hair and nails.
  • Too much selenium: Interestingly enough, an excess of dietary selenium — found naturally in seafood, muscle meat, organ meat, grains and cereals — can lead to brittle nails. Taking too high a dose of selenium supplements can have the same effect.

Other causes

Brittle fingernails are not always caused by medical conditions, environmental exposures or nutritional deficiencies or excesses. Sometimes, it is just about your nails. Sometimes, it's genetic. Sometimes, it is simply due to the normal aging process. Brittle nails are common in children — especially boys. In childhood, nails can be brittle for no apparent reason. While unsightly, childhood brittle nails are usually not associated with any underlying condition, and resolves on its own after several years.

This list does not constitute medical advice and may not accurately represent what you have.

Brittle fingernails quiz

Take a quiz to find out what's causing your brittle fingernails.

Take brittle fingernails quiz

Psoriasis

Psoriasis causes an overgrowth of surface skin cells, creating a red, scaly, itchy, and painful rash.

It is believed to be an autoimmune disorder that causes the body to attack its own healthy skin cells. It may be genetic in origin but triggered by anything that further strains the immune system, such as infections, skin injury, alcohol consumption, obesity, smoking, and stress.

Symptoms may come and go in cycles lasting weeks or months. They include red patches of thickened skin, sometimes with gray-white scales; dry, cracked, bleeding skin; stiff and swollen joints; and thickened, misshapen nails.

It is important to see a medical provider for care, because psoriasis can interfere with quality of life. It is associated with higher risk of arthritis, heart disease, diabetes, and other conditions.

Treatment involves different combinations of topical medications, oral medications, and phototherapy with natural or artificial light. Lifestyle changes such as improved diet, quitting smoking, and managing stress are very helpful in many cases.

Rarity: Uncommon

Top Symptoms: itchy rash, red or pink, rough patch of skin, rash with well-defined border, painful rash, scaly rash

Symptoms that never occur with psoriasis: fever, black-colored skin changes, brown-colored skin changes, blue-colored skin changes

Urgency: Primary care doctor

Low calcium level

Hypocalcemia is a condition where there is not enough calcium in the blood. Calcium is a mineral contained in the blood and helps the heart and other muscles function properly. It is also needed to maintain healthy teeth and bones. Low calcium levels can cause bones to become brittle and more easily fractured. Parathyroid issues and vitamin D deficiency are common causes of this condition.

You should consider visiting a medical professional to discuss your symptoms. Low calcium levels can be evaluated with a review of your symptoms and a blood test. Once diagnosed, treatment depends on the cause of your low calcium levels.

Rarity: Rare

Top Symptoms: fatigue, shortness of breath, irritability, general numbness, tingling foot

Urgency: Primary care doctor

Iron deficiency anemia

Iron deficiency anemia means that the body does not have enough iron to form hemoglobin, the protein in red blood cells that carries oxygen throughout the body.

The condition is caused by:

  • Acute blood loss through injury, surgery, or childbirth.
  • Chronic blood loss through an ulcer, overuse of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs,) or heavy menstrual periods.
  • Inability to absorb dietary iron due to intestinal surgery or disease, or interference from certain medications.
  • A diet low in iron-supplying foods.

Symptoms include fatigue, shortness of breath, lack of endurance, and chest pain with rapid and irregular heartbeat.

If not treated, iron deficiency anemia can lead to heart disease because the heart has to pump extra blood to get enough oxygen to the tissues. Developmental problems in children can also occur.

Diagnosis is made through physical examination and blood tests.

Treatment includes a diet higher in iron-rich foods, such as red meat and dark green leafy vegetables, along with iron supplements. Severe cases may require hospitalization for blood transfusion and/or intravenous iron therapy.

Eczema (atopic dermatitis)

Atopic dermatitis, also called eczema, dermatitis, atopic eczema, or AD, is a chronic skin condition with an itchy rash.

AD is not contagious. It is caused by a genetic condition that affects the skin's ability to protect itself from bacteria and allergens.

AD is most often seen in infants and young children. Most susceptible are those with a family history of AD, asthma, or hay fever.

Infants will have a dry, scaly, itchy rash on the scalp, forehead, and cheeks. Older children will have the rash in the creases of elbows, knees, and buttocks.

Without treatment, a child may have trouble sleeping due to the intense itching. Constant scratching may cause skin infections and the skin may turn thickened and leathery.

Diagnosis is made through physical examination, patient history, and allergen skin tests.

AD cannot be cured, but can be controlled through prescribed medications, skin care, stress management, and treatment of food allergies. Those with AD often have allergies to milk, nuts, and shellfish. Keeping the skin clean and moisturized helps prevent flareups.

Bulimia

Bulimia nervosa is an eating disorder. It is characterized by periods of binge eating, along with compensatory behaviors to prevent weight gain such as fasting, forced vomiting, or excessive exercise.

Patients with bulimia nervosa should see a primary care physician, who may help coordinate care with a psychiatrist or therapist.

Anorexia

Anorexia nervosa is a condition characterized by preoccupation with weight loss and intense fear of gaining weight. This leads to caloric restriction and weight loss. In its most severe form, this can even be life-threatening.

Patients with anorexia nervosa should see a primary care physician who will coordinate care with a psychologist, counselor, or other mental health professional.

Brittle fingernails quiz

Take a quiz to find out what's causing your brittle fingernails.

Take brittle fingernails quiz

Allergic contact dermatitis of the hand

Allergic contact dermatitis means the skin has touched something that provoked an allergic reaction, causing inflammation and irritation.

"Contact" means the allergic reaction came from touching something, not from consuming something. The first exposure to the substance sensitizes the immune system, and then the second exposure actually causes the symptoms.

The most common causes of allergic contact dermatitis are:

  • Nickel, a metal often used in belt buckles, the buttons on pants, and jewelry, including piercing jewelry.
  • Poison ivy.
  • Various types of perfumes, including those founds in soaps, fabric softeners, and detergents.
  • Of course, there are many more.

Symptoms include red, itching, scaling, flaking skin that may be painful due to the irritation and inflammation.

Diagnosis is made through first avoiding contact with any suspected substance, to see if the dermatitis clears. Patch testing can be done if the results are not certain.

Treatment involves fully avoiding the allergy-provoking substance and using topical steroid cream as prescribed. Cool compresses and calamine lotion can help to ease the discomfort.

Rarity: Common

Top Symptoms: hand itch, hand redness, scabbed area of the hand

Symptoms that always occur with allergic contact dermatitis of the hand: hand redness

Urgency: Self-treatment

Brittle fingernails treatments and relief

When to see a doctor for brittle fingernails

Seek medical care if you have brittle fingernails and:

  • You are losing your hair
  • Your fingernails start to fall off
  • You are experiencing mood swings or confusion
  • You have nausea, vomiting or diarrhea
  • The brittleness came on suddenly

At-home treatments for brittle fingernails

Unless you have an underlying medical condition, keeping your fingernails healthy is mostly a matter of good nutrition and hygiene. Approaches to a healthy diet and proper nail hygiene are listed below.

  • Nutrition: Eat a balanced diet, based on lean proteins, fresh fruits and vegetables and whole grains. Avoid "junk food." Iron and calcium deficiencies are easily addressed by taking supplements. Biotin, as a supplement, can help to strengthen brittle nails.
  • Hygiene: Keep your nails trimmed and avoid biting your nails and picking at your cuticles. Resist the urge to change your nail color every few days; it is best to wait at least a week between manicures and pedicures. You should also avoid picking off your nail polish as this takes a layer of cells off of your nails.

Questions your doctor may ask about brittle fingernails

  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Have you ever been diagnosed with diabetes?
  • Any fever today or during the last week?
  • Do you currently smoke?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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