Onychorrhexis

Onychorrhexis, also known as brittle nail syndrome, is a condition that affects the nails and causes them to become brittle, break easily, and develop ridges or splits. In this condition, the nails become weak, fragile and prone to breaking, making it difficult to grow them long and maintain their appearance. In severe cases, the nails may also become deformed, making it difficult to perform everyday tasks such as typing, writing, and even simple hand movements.

Causes

Onychorrhexis is a condition characterized by brittle, thin and fragile nails that easily break or split. There are several causes of onychorrhexis, including:

1. Age: As people age, the nails can become more brittle and dry, leading to onychorrhexis.
2. Exposure to harsh chemicals: Frequent exposure to harsh chemicals such as detergents, soaps, and solvents can weaken the nails, making them more susceptible to onychorrhexis.
3. Medical conditions: Certain medical conditions, such as hypothyroidism, anemia, and psoriasis, can cause onychorrhexis.
4. Nutritional deficiencies: A lack of certain nutrients, such as biotin, iron, and zinc, can lead to weak and brittle nails, making them more prone to onychorrhexis.
5. Fungal infections: Fungal infections, such as onychomycosis, can cause the nails to become brittle, discolored, and deformed, leading to onychorrhexis.
6. Physical trauma: Physical trauma to the nails, such as from frequent nail biting or manual labor, can weaken the nails and increase the likelihood of onychorrhexis.
7. Nail polish: The use of harsh or toxic nail polishes, as well as frequent use of nail polish removers, can weaken the nails, making them more susceptible to onychorrhexis.
8. Water exposure: Excessive exposure to water, such as from frequent swimming or prolonged soaking in water, can cause the nails to become soft and brittle, increasing the likelihood of onychorrhexis.
9. Psoriasis: Psoriasis is a skin condition that can cause the nails to become brittle, discolored, and deformed, leading to onychorrhexis.
10. Smoking: Smoking can cause the nails to become brittle and yellow, increasing the likelihood of onychorrhexis.
11. Certain medications: Certain medications, such as chemotherapy drugs and retinoids, can cause the nails to become brittle and fragile, leading to onychorrhexis.

It is important to note that onychorrhexis can also be a symptom of an underlying medical condition, and therefore it is important to seek medical attention if you suspect that you may have this condition.

Symptoms

Here are the main symptoms of onychorrhexis:

1. Brittle nails: The primary symptom of onychorrhexis is brittle nails, which tend to break or split easily. This can make it difficult for people to maintain the appearance of their nails, as they may constantly have broken or jagged nails.
2. Horizontal or transverse ridges: Another common symptom of onychorrhexis is the presence of horizontal or transverse ridges on the nails. These ridges can run from the base of the nail to the tip, giving the nails a ridged appearance.
3. Splitting of the nail plate: People with onychorrhexis may also experience splitting of the nail plate, which can cause the nails to become separated from the nail bed. This can result in painful and unsightly nails, and can also make it more difficult for people to perform everyday tasks that require the use of their hands.
4. Fraying of the nail plate: Fraying of the nail plate is another common symptom of onychorrhexis, and can result in the edges of the nails becoming thin and ragged. This can also make the nails more susceptible to breaking or splitting.
5. Discoloration: Some people with onychorrhexis may also experience discoloration of their nails, which can range from a yellowish tint to a more pronounced discoloration. This discoloration can be a result of various factors, including fungal infections, medical conditions, or the use of certain medications.
6. Thinning of the nails: Thinning of the nails can also be a symptom of onychorrhexis. This can result in the nails becoming more fragile and susceptible to breaking or splitting.
7. Pain: In some cases, people with onychorrhexis may experience pain in the affected nails, particularly if the nails have become separated from the nail bed. This pain can be exacerbated by activities that put pressure on the affected nails, such as wearing tight-fitting shoes or typing on a computer keyboard.

Onychorrhexis can be caused by a variety of factors, including aging, genetics, medical conditions, and environmental factors such as exposure to harsh chemicals or frequent use of nail polish. Additionally, people who engage in activities that put a lot of stress on their nails, such as playing musical instruments or using their hands for manual labor, may be more susceptible to onychorrhexis.

Diagnosis

There are several diagnostic tests that can be used to diagnose onychorrhexis and determine its underlying cause.

1. Physical examination: The first step in diagnosing onychorrhexis is a thorough physical examination of the nails. The doctor will examine the nails for signs of fragility, splitting, and other characteristic features of the condition. They may also examine the surrounding skin for signs of fungal infections or other underlying skin conditions.
2. Nail clippings: In some cases, the doctor may take nail clippings to test for fungal infections or other underlying conditions. The clippings can be examined under a microscope to look for signs of fungal growth or other abnormalities.
3. Blood tests: Blood tests can be used to check for deficiencies in vitamins and minerals that are important for nail health, such as iron, biotin, and vitamin C. The doctor may also test for other medical conditions that can cause brittle nails, such as thyroid disorders or autoimmune diseases.
4. Allergy testing: Allergy testing can be used to determine if an allergy to certain chemicals or products is causing the onychorrhexis. This may include patch testing, in which a small amount of the suspected allergen is placed on the skin to see if it causes a reaction, or skin prick testing, in which a small amount of the allergen is introduced into the skin to see if it causes a reaction.
5. Nail biopsy: In some cases, the doctor may perform a nail biopsy to obtain a sample of the nail for further examination. The biopsy can be used to look for signs of fungal infections, autoimmune diseases, or other underlying conditions that may be causing the onychorrhexis.
6. Imaging tests: Imaging tests, such as X-rays or MRI scans, can be used to look for any underlying medical conditions that may be causing the brittle nails. For example, X-rays can be used to look for any signs of osteoporosis or other conditions that may be causing the nails to become brittle.
7. Family history: The doctor may ask about the patient’s family history to determine if there is a genetic component to the onychorrhexis. If other family members have similar symptoms, this may suggest that the condition is hereditary.

These are the main diagnostic tests that can be used to diagnose onychorrhexis. In some cases, the doctor may use a combination of these tests to get a more complete picture of the underlying cause of the condition. It is important to note that the specific tests used will depend on the individual case and the underlying cause of the onychorrhexis.

Treatment

There are several treatment options available for onychorrhexis, including both over-the-counter and prescription products. The main goal of treatment is to improve the strength and appearance of the nails and to prevent further damage. Here are some of the most commonly used treatments for onychorrhexis:

1. Nail Strengthening Products: There are many over-the-counter products available that are designed to strengthen nails and prevent breakage. These products usually contain ingredients such as biotin, keratin, and vitamins that help to strengthen the nails. Some of the most popular nail strengthening products include:

• Nail strengtheners: These are polishes or treatments that are applied to the nails to help strengthen and protect them.
• Biotin supplements: Biotin is a B-vitamin that is essential for healthy nail growth. Taking biotin supplements can help to improve the strength and appearance of the nails.
• Keratin supplements: Keratin is a protein that is found in the nails, skin, and hair. Taking keratin supplements can help to improve the strength and appearance of the nails.

2. Moisturizing Products: Keeping the nails and surrounding skin moisturized can help to prevent further damage and promote healthy nail growth. Some of the most effective moisturizing products include:

• Cuticle oil: Cuticle oil is a product that is designed to moisturize the cuticles and surrounding skin. It can help to prevent dryness and cracking, which can lead to further damage to the nails.
• Hand and nail cream: Hand and nail cream is a moisturizing product that is designed to hydrate the skin and nails. It can help to prevent dryness and cracking, which can lead to further damage to the nails.

3. Medical Treatments: In some cases, onychorrhexis may be caused by an underlying medical condition, such as a fungal infection, psoriasis, or eczema. In these cases, treating the underlying condition can help to improve the appearance and strength of the nails. Some of the most commonly used medical treatments for onychorrhexis include:

• Antifungal medications: If onychorrhexis is caused by a fungal infection, antifungal medications may be prescribed to clear up the infection and improve the appearance of the nails.
• Topical corticosteroids: Topical corticosteroids are medications that are applied directly to the skin to reduce inflammation and itching. They can be used to treat conditions such as psoriasis and eczema that can cause onychorrhexis.
• Oral medications: In some cases, oral medications may be prescribed to treat onychorrhexis. For example, retinoids (vitamin A derivatives) may be prescribed to improve the appearance of the nails.

4. Lifestyle Changes: Making certain lifestyle changes can also help to improve the appearance and strength of the nails. Some of the most effective lifestyle changes for onychorrhexis include:

• Wearing gloves: Wearing gloves when washing dishes or doing other activities that expose the nails to water can help to prevent further damage to the nails.

References