Fingernail problems can be solved by a dermatologist
By Allen Douma, M.D. Tribune Media Services
Q. My fingernails used to be quite smooth. But over the last few months theyve developed ridges that run the length of the nails. They also break easily, and the top layer sometimes peels off. Can you offer any clues as to the cause of this and what I can do. R.F., Valparaiso, Ind.
A. I can offer some clues. But, as you will read, many things may cause nails to change, so I suggest that you seek advice from a dermatologist (the nails are an outgrowth of the skin).
Fingernail and toenail problems are very common, and many people respond poorly to the treatments they have tried. While these problems are not usually serious medically, they can affect quality of your life.
Determining the cause is important to choosing the right treatment. But thats often difficult because there are so many possible causes.
Like everything else, the strength and health of your nails is influenced by heredity. And, like the skin, everybodys nails tend to become dryer and more brittle with age.
Some types of nail disorders affect only one or a few nails and are because of injury caused by local trauma or infection. Nails injured by trauma, while painful for a while, tend to completely repair themselves over time.
Chronic inflammation and fungal or bacterial infections in and around the nail bed can affect the nails. One of the most common is a fungal infection called tinea unguium. Symptoms include lusterless and brittle nails. Diagnosis must be made by laboratory examination of nail tissue looking for the fungus.
Antibacterial and antifungal creams or lotions, even isopropyl alcohol, hydrogen peroxide or camphor, can combat these infections. Some fungal nail infections are difficult to control and require oral prescription medicines.
Many household and workplace materials irritate the skin around the nails and cause the nails to split. Sometimes, even prolonged exposure to water and detergents alone can result in separation of the nail from the nail bed (onycholysis). Wearing gloves can protect your nails, especially when you are working with strong irritants.
Allergic reaction to certain chemicals, including even some found in nail beauty products, can cause nail disorders. You should try going without such products to see if that helps.
Systemic (throughout the body) disorders can affect the nails as well. Nail disorders such as discoloration and thickening, for example, may be symptoms of psoriasis or thyroid problems. Reaction to certain drugs can result in nail changes. Also, a nutritional deficiency may show up in the nails. One of the causes of the ridge lines you mentioned is anemia iron deficiency anemia in particular.
I suggest you review your medical and lifestyle history over the past six months to look for a possible culprit. Try to recall any drugs, diseases, exposures to chemicals, trauma or change in diet at the time your nails started changing. Take this information to a dermatologist for consultation.
Some people claim that vitamin E, zinc, calcium and gelatin are effective in treating all kinds of changes in their nails. But only the B vitamin biotin has been shown in studies to be effective sometimes. Also, anything that increases circulation to the skin and extremities, such as quitting smoking and exercising, will probably help.
UPDATE ON ITCHING: I want to share information e-mailed to me from a reader in Ontario, Calif.
A year ago I began being seized by frenzied itching and rashes as I climbed into bed, where my husband was already asleep. It would wake him up and drive us both crazy.
After several months of this maddening pattern, it dawned on me that I would often begin itching a little as I read the paper, then it would spread on my body wherever I had touched my newsprinty fingertips. Now I always wash my hands every time Ive handled any printed material, and it has helped tremendously.