Nail Care Tips and Tricks

Officially dermatologists care for skin, hair and nails.  So here’s a few tips on nail care.  If you are like me, your nails could always use some work. Although I do a good job following the tips below (minus taking Biotin on a regular basis), I still have to battle splitting and peeling of my nails because I am a busy Mom, doctor, housecleaner, cook and gardener whose hands are constantly in motion.

• Clip your nails relatively short and do not bite the nails. Imperfections show up less in short nails.
• Don’t cut, trim, bite or push back your cuticles. Cuticles are our natural barrier that prevents damage to the nail matrix.  The nail matrix is located beneath the cuticle.  Damage to the nail matrix can cause ridging of the nails and even permanent nail damage.  Interfering with the cuticles is also a prime site for infection.  Many worry that the cuticle will grow “half way up the nail”  if they do not push them back.  Don’t worry, the cuticle will naturally be shed once it has fulfilled its barrier function.  Many of the unwanted nail changes arise from dehydration of the nails and cuticles.  Massage a moisturizer into the nail and cuticle area once or twice a day to prevent dryness, splitting, and hangnails. A long term favorite has been Elon nail moisturizer  and more recently I am trying one by Dermelect.  However, any thick ointment such as Vaseline or Aquaphor will help prevent the nail changes associated with dehydration of the nails.
• Wear gloves while doing chores, such as washing dishes. Excessive exposure to water can lead to further dehydration and fungal infections of the nail bed. One simple thing that can help is to wear cotton gloves inside of the rubber gloves used to wash dishes.
• Use a nail moisturizer. Nail polish may help to keep nails strong and protected from the environment (and looking nice, too). If your nails are very dry or falling off, you might want to consider one of the nail moisturizers above instead of polish. Nail polish can further accentuate dehydration of the nails and should be avoided in severely damaged nails.  Avoid use of acrylics or other nail wraps. Fake nails can trap bacteria and fungus that may cause infection.
• Bring your own tools.  If you have a professional manicure, consider bringing your own implements, regardless of how the salon cleans their instruments.  Do not let the manicurist traumatize your cuticles in any way.
• Avoid the mechanical foot baths at salons.  A number of outbreaks of skin infections have been reported from the foot baths used in salon pedicures.  Often the cleaner used does not protect against the culprit mycobacterium.  In addition, with mechanical baths, bacteria, fungi and mycobacterium often grow in a reservoir that is not completely emptied between customers.
• Take Biotin.  A multivitamin and good nutrition encourage nail growth.  In addition to a daily multivitamin, Biotin is another vitamin that encourages healthy hair and nail growth.  Most multivitamins do not have even the Recommended Daily Allowance (RDA) of Biotin, so an additional Biotin supplement is required.  Most supplements contain megadoses.  Any extra will be secreted in your urine, so no need for those megadoses.
• Vinegar soaks.  Nails and the skin surrounding the nails are often infected with bacteria.  For mild infections, vinegar soaks are very effective.  I often instruct patients to do a vinegar soak, 15 minutes a day a 3-7 times a week depending on the intensity of the infection.  This can be done with any temperature water and white vinegar.  The recipe is not exact, but about 1 Tbsp to a mug of water OR a ½ cup to a foot basin of water.

Finally, I cannot overstress how important it is to avoid all unnecessary trauma to the nail and the nail bed.  It is especially important to avoid traumatizing the cuticles and the distal nail fold (the end furthest from the wrist underneath the nail). It is very tempting to try to stick things under the separated nail to try to clean out debris, etc.  This should always be avoided, and debris should be removed with a soft brush, toothbrush or nail brush and soapy water under the nails. 

In upcoming blog posts, I will discuss two new products for nails that I have been trying out.  Jamberry nails and Dermelect products.  If you can’t wait.  Check out their sites for a head start.  The above photo is my before photo for trying out Dermelect.

These are some additional nail tips from the American Academy of Dermatology for Healthy Nails and Manicure Tips.