Zoe Diana Draelos, M.D., is a consulting professor of dermatology, Duke University School of Medicine, Durham, N.C. She is investigator, Dermatology Consulting Services, High Point, N.C., and a Dermatology Times Editorial Advisor and co-medical editor.
How many times weekly does the dermatologist get asked about nail splitting? A lot. Most patients ask about fancy vitamins and nail polishes that claim to improve nail health. Remember that nail health is an appearance claim without substantiation, as the nonliving nails really cannot be healthy because they are dead!
Q. Why do nails split?
Remember that nail health is an appearance claim without substantiation, as the nonliving nails really cannot be healthy because they are dead! Nevertheless, it is important to offer advice to the female patient who frequently requests advice on nail-splitting prevention.
The best treatment for splitting nails is to minimize nail trauma. This means shortening the nail plate, not typing on a computer keyboard with the nail tip, wearing gloves when using surfactants or solvents, etc. The skin around the nails is a good indication of the condition of the nail. Cracked peeling cuticles cannot be present without dehydrated nails. Use the cuticles as an indication of nail health. Splitting nails is analogous to hand eczema.
Q. Are the new photocured nail shellacs safe?
A: Nail shellacs have taken the nail industry by storm. The shellacs are pigmented polymers that are cured and bonded to the natural nail by UV radiation. The shellacs are long-wearing, chip-resistant, fade-resistant, and beautifully smooth as glass. They are polymerized to the nail in three layers, each followed by exposure to the UV source.
The nail materials are completely safe, but I do have some concerns about the UV radiation source. The UV has a blue/purple color. This is the wavelength of visible and UV radiation that is poorly filtered by the eye lens, allowing the damaging radiation to reach the back of the retina. Over time, this wavelength depletes the lutein antioxidant stores in the eye, leading to macular degeneration, the most common cause of reduced vision in the elderly.
I am concerned that the nail technicians and shellac enthusiasts may be predisposed to macular degeneration and possibly should ingest lutein in the form of a vitamin supplement or by increasing consumption of egg yolks, which are rich in lutein.
Zoe Diana Draelos, M.D., is a Dermatology Times editorial adviser and consulting professor of dermatology, Duke University School of Medicine, Durham, N.C. Questions may be submitted via email to firstname.lastname@example.org