What helps brittle nails?

Treatment Options for Brittle Nails

Biotin supplementation (2.5-10 mg daily) is the most effective first-line treatment for brittle nails, showing significant improvement in nail strength and thickness in 91% of patients within 5-6 months. 1, 2

Understanding Brittle Nails

Brittle nails (onychoschisis) are characterized by weak, inelastic nails that split, flake, and crumble. This condition affects approximately 20% of the population and can significantly impact quality of life due to cosmetic concerns and functional limitations 3.

Evidence-Based Treatment Algorithm

First-Line Treatment:

1. Oral Biotin Supplementation

   • Dosage: 2.5-10 mg daily
   • Duration: Minimum 3-6 months
   • Efficacy: 91% of patients show definite improvement with firmer and harder fingernails after an average treatment period of 5.5 months 2
   • Mechanism: Biotin is an important coenzyme for carboxylation reactions that strengthen nail keratin

2. Preventive Nail Care Measures

   • Avoid repeated trauma and excessive pressure to nails
   • Wear gloves while cleaning or doing household chores
   • Avoid cutting nails too short
   • Apply topical emollients to cuticles and periungual tissues daily
   • Avoid repeated friction 1

Second-Line Treatment:

1. Silicon Supplementation

   • Dosage: 10 mg daily
   • Form: Choline-stabilized orthosilicic acid 4

2. Topical Treatments

   • Water-based nail-strengthening solutions containing hyaluronic acid and Pistacia lentiscus
   • Application: Daily for 1-6 months
   • Efficacy: 76% of patients showed improvement in nail appearance after 6 months 5

Special Considerations

When to Consider Underlying Causes

Brittle nails may be a symptom of:

• Dermatological conditions
• Systemic diseases
• Nutritional deficiencies
• Medication side effects
• Occupational factors

Common Pitfalls to Avoid

1. Ineffective Supplementation: Despite popular belief, there is no evidence supporting the use of vitamin E, vitamin C, vitamin A, zinc, iron, copper, selenium, or vitamin B12 for improving nail health in well-nourished patients 4.

2. Ignoring Environmental Factors: Progressive dehydration of the nail plate due to environmental and occupational exposures plays a significant role in nail brittleness 3.

3. Expecting Quick Results: Improvement typically takes several months (3-6 months) due to the slow growth rate of nails.

4. Discontinuing Treatment Too Early: Biotin supplementation should be continued for at least 5-6 months to see optimal results 2.

Monitoring and Follow-Up

• Assess improvement after 2-3 months of treatment
• Continue treatment for at least 6 months for maximum benefit
• Consider clinical photography to objectively document improvement

Biotin supplementation remains the most evidence-based treatment for brittle nails, with high success rates and minimal side effects. Combined with proper nail care practices, most patients can expect significant improvement in nail strength and appearance.