Nail brittleness causes several clinical symptoms including splitting, softening, lamellar
exfoliation and onychorrhexis. Brittle nails are a common complaint. It is often an
idiopathic condition, but can also be a symptom of a large number of dermatological nail
disorders. Although brittle nails have been linked with many internal diseases, the high
frequency of nail fragility in the general population makes it difficult to prove the
validity of any such association. Environmental and occupational factors that produce a
progressive dehydration of the nail plate play an important part in the development of
idiopathic nail brittleness. The lipid content of the nail is influenced by sexual hormones
and decreases after menopause. This explains the high prevalence of brittle nails in
postmenopausal women.
Management of brittle nails requires preventive and protective measures to avoid nail
plate dehydration. Affected individuals should wear cotton gloves under rubber gloves
during household tasks, avoid repeated immersion of the hands in soap and water, and
keep their nails short. Nail varnishes may be protective, but the use of nail varnish
remover should be limited since it exacerbates brittleness. Local therapies are useful in
the treatment of nail brittleness. Application of a petroleum jelly preparation on wet nails
at bedtime helps to retain the moisture in the nail plate. Frequent topical application of
preparations containing hydrophilic substances such as phospholipids, hyaluronic acid,
alpha-hydroxy acids and proteoglycans may favour nail plate rehydration.
Nail wrapping limited to the distal portion of the nail may afford protection and
camouflage in recalcitrant fragility of the nail keratin. Oral treatment with biotin 2.5 mg
per day for several months or even all year round can be useful as it may improve the
synthesis of the lipid molecules that produce binding between nail plate corneocytes.