I have an 86-year-old client whose nails are white and dry and peel beginning at the free edge, working its way up toward the cuticle. She receives a manicure every other week and does not use a nail strengthener at home. Also, her polish won’t stay on for more than a few days. The skin around her nails looks healthy. I’ve asked her to see a doctor, but she says she’s too old to worry about it. Could the condition be caused by a yeast infection or overuse of a nail strengthener?
Whiteness, dryness, and peeling of the nails are usually signs of brittle nail syndrome, which is caused by dehydration or loss of moisture in the nail plate, which is very common in order clients. If the nails are also white, it may be due to the fact that they are lifting or are not attaching to the nail bed, a condition known as onycholysis. If this is the case, the client may have a yeast infection because many cases of onycholysis are caused by yeast. The diagnosis can only be made by a dermatologist who will take samples of the nail to see if there is in fact a yeast fungus present. As for nail strengtheners, products containing formaldehyde can cause the nail plate to separate from the nail bed, so I would strongly encourage clients with this nail condition to use a formaldehyde-free nail strengthener. Regular manicures are OK, but avoid over-manipulation of the cuticles as well as over-vigorous cleaning underneath the nail plate because this can lead to lifting. Problems with polish adhesion are very common in clients with brittle nail syndrome. The only suggestion is to keep the nails well moisturized and apply two coats of base coat prior to polish application.--Richard K. Scher, M.D.