Client Health

Under the Microscope: Onychorrhexis

Onychorrhexis describes the thinning and longitudinal ridging that often accompanies brittle nails.

What is it? Onychorrhexis just means brittle nails. When nails are brittle, they often split at the ends and have longitudinal ridging. The appearance of longitudinal ridging alone is referred to as onychorrhexis. The appearance of split ends alone is referred to as onychoschisis. Because onychorrhexis is a natural result of aging, it affects both men and women, and both the fingernails and toenails.

How do you get it? While the most common cause of onychorrhexis is age, there are times when onychorrhexis is not the result of aging. When this is the case, doctors look for a systemic health problem that is changing the structure of the nails. Onychorrhexis can result from bulimia, anorexia, and even cancer. It can also be the result of psoriasis, eczema, and other skin conditions.

How is it treated? No treatment for onychorrhexis as a result of aging exists, and the condition isn’t seen as a health concern. If onychorrhexis is the result of skin conditions such as psoriasis or eczema, once these conditions have been resolved, the nails will recover. The vitamin biotin has been shown to improve the overall strength of the nail. The recommended dose for brittle nails is 2.5 mg. daily. Because it takes an average of six months for a fingernail to replace itself, your clients should be committed to taking biotin for four to six months. Genadur, the first FDA-approved treatment to help strengthen fragile, brittle nails, recently became available by prescription. According to manufacturer Medimetriks Pharmaceuticals, Genadur helps improve the condition with a once-daily brush-on application that may start showing results in as little as 14 days.

What can a tech do? When a client comes in with splitting at the tips of the nail plate and longitudinal ridging, determine whether she has a skin condition such as psoriasis or eczema. If not, ask about the overall health of the client: Is she under a doctor’s care for any health problems? Is she taking medications with side effects to the nail? If she is under the care of a doctor for any health conditions, make sure the doctor is comfortable with her getting nail enhancements. The doctor might want to keep the nails natural so she can continue to use them as a gauge of what is happening internally. If a client has no known health conditions, but the skin around the nails looks compromised, or the nails show signs of pitting, refer her to a dermatologist. If she has no health condition and her cuticles are not compromised, go ahead with natural or artificial nail services.

What else? Some clients will have onychoschisis, splitting on the ends, but they have no evidence of longitudinal ridging. The culprit for splitting ends in an otherwise healthy nail could be environmental. Nails can split at the tips when the hands are frequently in solvents, such as alcohol or water, or if their nails tap frequently against a keyboard or piano keys.


Dr. Joseph Jorizzo and Dr. Dana Stern contributed to this article.


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