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Ask the Pharmacist
by Ron & Marla Chapleau

May 8, 2016
www.kincardinetimes.com
www.saugeentimes.com

Health

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Q) My nails are constantly splitting and breaking apart. Why does this happen and what can I do about it?

A) Most of my favourite medical terms refer to assorted nail conditions as they always seem to be at least 5 syllables long and sound more like a rare tropical disorder than a fairly run of the mill nuisance.

In this case, nail splitting is known as onychoschizia (as well as the equally easy to pronounce onychoschisis and the only slightly less foreign lamellar dystrophy) and is a very common affliction affecting an estimated 20% of the population.

Females are about twice as likely to be seen with this as males and the condition is more commonly seen in older individuals. While this is mainly a cosmetic issue, split nails can in fact be painful enough that they can limit your daily activities and impair your occupational abilities.

This condition often occurs together with onychorrhexis which refers to long-wise splitting or ridging of the nail plate. When these 2 conditions occur together, they may be referred to as brittle nail syndrome.

The most common cause of onychoschizia is frequent wetting and drying of the hands and as such this condition is seen far more frequently in occupations such as house cleaners, nurses, hairdressers and dish washers. It can also be caused by the repeated use of such nail cosmetics as hardeners, polishes and polish removers (the acetone containing ones are somewhat worse than the acetone free versions). Nail procedures also expose your nails to some degree of risk. All of these factors probably help explain in large part the preponderance of females affected.

The splitting may also be a result of trauma to the nail itself (such as hitting it with an object) or occupational exposure to various chemicals (salt, sugar solutions, cement, acids...).

Oral medications made from vitamin A (Accutane, Soriatane and others) may be the culprit or, far more rarely, it could be a symptom from a variety of diseases such as lichen planus, psoriasis, tuberculosis, Sjogren syndrome, malnutrition (iron deficiency is the most common reason after the external causes listed above although a zinc deficiency is also a possible source) and assorted gland & other skin disorders.

One tip to determine the cause is to compare the finger to the toe nails. If the finger nails are split but the toe nails remain strong, then an external factor (such as too much moisture exposure) is likely the underlying reason. As my last sentence implies, the condition may affect either the finger or toe nails and itsí presentation can vary greatly ranging from a single split at the growing end of the nail to multiple splits and loosening of that same edge.

Onychoschizia can be divided into two categories. The nail is either dry and brittle (too little moisture which is seen far more frequently during the winter due to low humidity and dry heat sources) or soft and brittle (more commonly seen during the summer). Treatment usually depends on which category your nail falls into.

 

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The dry type should be massaged frequently with moisturizers containing alpha-hydroxy acids or lanolin after the nail has been soaked in water for 5-15 minutes. Cotton lined rubber gloves should be worn as often as is possible when exposure to detergents or other chemicals occurs. Maintaining an adequate level of humidity in your bedroom also canít hurt although there is no proof to support whether or not this helps.

If your nails are too soft, minimize their exposure to liquids through the use of gloves. Damage from nail cosmetics frequently causes this type as well so minimizing their use can be helpful. Some feel that a once a week application of a clear nail prep may be beneficial and if polish is used ones with nylon fibers may add strength to the nail.

 Biotin, which is a vitamin, can help those with either type of nail disorder. In a small study (32 people) conducted in 1990, nail thickness increased by an average of 25% and the subsequent splitting of the nails was also reduced. While it is considered to be a very safe supplement (although it should not be taken in pregnancy) patience will be a virtue as it takes at least 6 months to show results and not everyone will improve (at least 1 in 3 should however).

Calcium, colloidal minerals and gelatin may also help but they have not been shown to be as reliable as Biotin.

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For more information about this or any other health related concerns, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination in Kincardine and Port Elgin Pharmasave.


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