INTRODUCTION
Nail plate brittleness is a common condition that primarily affects women over the age of 50 years.1,2 Contact irritant and allergens as well as excessive water exposure are known risk factors, but it can also occur among healthy-term newborns and in women during pregnancy.3,4
Nail brittleness is characterized by nails that split, flake, and crumble, become soft, and lose elasticity. Fingernail fragility is much more common than toenail fragility.2 This condition is mostly idiopathic, but could also be a consequence of various causes, including inflammatory nail disorders, trauma, and systemic diseases.1,2 The main clinical presentations include: onychoschizia, onychorrhexis, and superficial granulation of keratin. Mix presentation could also be seen. Of these, onychoschizia manifests with distal nail plate splitting and is considered to be the most common clinical presentation.1,2
The treatment of nail brittleness primarily aims to reduce the interruption of manual activities as well as improving the aesthetic aspect, as the condition is noticeable. Optimal management requires treatment of the primary cause of brittle nails, when identified. For idiopathic nail brittleness, there are several therapeutic options. All patients should be encouraged to avoid contact irritants and allergens (such as nail polish and detergents), limit exposure to water, and use emollients on a daily basis.2,5 Several studies have found that taking oral supplements, particularly vitamins (including Biotin [vitamin B7], could be beneficial.5–9 These findings, however, are primarily based on non-comparative small case series and case reports. An oral bio-mineral supplement containing amino acids, vitamins (C, E, B6 [pyridoxine], and biotin), and minerals was found to be effective in a single randomized controlled trial of 48 participants.5
Nail brittleness is characterized by nails that split, flake, and crumble, become soft, and lose elasticity. Fingernail fragility is much more common than toenail fragility.2 This condition is mostly idiopathic, but could also be a consequence of various causes, including inflammatory nail disorders, trauma, and systemic diseases.1,2 The main clinical presentations include: onychoschizia, onychorrhexis, and superficial granulation of keratin. Mix presentation could also be seen. Of these, onychoschizia manifests with distal nail plate splitting and is considered to be the most common clinical presentation.1,2
The treatment of nail brittleness primarily aims to reduce the interruption of manual activities as well as improving the aesthetic aspect, as the condition is noticeable. Optimal management requires treatment of the primary cause of brittle nails, when identified. For idiopathic nail brittleness, there are several therapeutic options. All patients should be encouraged to avoid contact irritants and allergens (such as nail polish and detergents), limit exposure to water, and use emollients on a daily basis.2,5 Several studies have found that taking oral supplements, particularly vitamins (including Biotin [vitamin B7], could be beneficial.5–9 These findings, however, are primarily based on non-comparative small case series and case reports. An oral bio-mineral supplement containing amino acids, vitamins (C, E, B6 [pyridoxine], and biotin), and minerals was found to be effective in a single randomized controlled trial of 48 participants.5
