By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

AVOIDING “WET TO DRY” EXPOSURE HELPS PREVENT BRITTLE NAILS

Question: I have very dry skin. The tips of my fingers crack in winter even though I use a very good hand cream. I also have brittle nails. I was wondering what causes this? Are there some supplements I could use? Is there anything else that might help? I am 67 years young.

Answer: The good news is that brittle nails and dry skin are not usually caused by any underlying medical condition or vitamin deficiency. Brittle nails do get more common with age, however. Also, if the fingers and fingernails are dry, cracked and brittle but the toes and toenails are fine, then there is usually a factor external to your body that is the cause of the problem. These environmental factors can range from the weather to the kind of work you do, whether in the home or on the job.

This time of year the weather is often a major culprit. This is primarily because winter is usually associated with low humidity. This external dryness causes many people to have dry red, cracked hands and brittle nails. Frequent handwashing, where the nails first become wet then are dried is a major cause of brittle nails. Washing dishes and doing housework where hands are in contact with water and chemicals also weakens nails.

There are several things that you can do to moisten your fingertips and strengthen your nails, even in the winter. First is to keep you nails short and free from snags and rough edges. Filing your nails daily can help prevent splitting and breaking. Moisturize your nails and hands frequently, up to 20 times a day. In fact, every time you wash your hands or they are exposed to water, you should follow up by using a moisturizer. Work the hand cream in around your nails and cuticles. Also moisturize your nails after you have filed them. Many people use a nail hardening nail polish in the winter and have found this to be helpful for brittle nails.

Avoid frequent exposure to water and chemicals. Try to decrease your hand washing and dish washing. Many people wash every dish as soon as it is dirty. Try doing one load of dishes a day. While this is a longer exposure to water, it is only one episode of “wet to dry.” Wear gloves when doing housework that involves contact with chemicals.

During your daily bath, however, it’s a good idea to thoroughly soak your nails and immediately afterwards apply a moisturizing cream to the skin around them. This helps keep the nails and the area around them from drying out. You needn't choose one of the expensive moisturizers. Plain old hand cream or petroleum jelly will work just as well.

Calcium, in any form, is good for your nails. Whether it be low-fat milk, calcium supplements or calcium-enriched foods, be sure your calcium intake is adequate. Many people have found the supplement Biotin to be helpful for nails, but it can take a while to see results. Other supplements such as gelatin may help -- a fellow physician friend of mine says that he recommends daily gelatin to all his patients who have arthritis, so you may get some additional benefit from trying gelatin.

Finally, things usually get better in the spring, but you should have good nail habits year round.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.