Nail & Skin Disorders

The Nail Doctor

The Nail Doctor on brittle nail syndrome, psoriasis and acrylics, and breakage. 

Q: I’m 62 years old and other medications I’m taking are Estratest. Pravachal, and Synthroid. What can I do to have healthy nails that will grow and not break?

A: You are describing brittle nail syndrome. Oral biotin (see your doctor first) is recommended for brittle nails and has proved successful. Applying acrylic to brittle nails may temporarily improve the condition, but in some clients it leads to other infections. Yeast is the most common fungus seen in lifting nails and brittle nail syndrome, and it is not highly responsive to Grisactin. There are many effective topical treatments. In this particular situation the fungus on the inside of the upper arm and groin area is probably not related to thin, brittle nails. Also the fact that you are taking Synthroid means you have a history of hypothyroidism or and underactive thyroid. People with underactive thyroids, even if taking medication for it, may have a susceptibility to thin, brittle nails. In view of your thyroid disorder and the persistence of brittle nails, a one-time consultation with a dermatologist may be very valuable.

Q: My client has psoriasis of the nails and has been wearing acrylics for three years. All her nails are detached from the nail bed at the free edge. About four months ago she developed pseudomonas spots on about six of her nails. I soaked off the acrylic on these nails and the spots came back. She went to the doctor for a blood test and nothing showed up. What could be the problem? How should I treat it?

A: Clients with nail psoriasis should not wear acrylics because the acrylic can sometimes aggravate the condition. This can be due to an allergic reaction or a phenomenon called Koebner Phenomenon, in which a minor injury to the nail worsens the psoriasis and can cause increased lifting from the nail bed’s free edge. Psoriasis nails are more susceptible to both yeast and pseudomonas infections. Therefore, clients with nail psoriasis should see a dermatologist who will take samples of the nail to determine if there is a yeast or bacterial infection present and prescribe the proper treatment. A blood test will not detect a nail infection.

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