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expert advice for nail care

Doctors Expert Advice for Nail Care: cuticles, fingernails, hangnails and more

Expert advice for nail care is important but it's not something you often get from a dermatologist. Dermatologists are the doctors who specialize in nails as well as all skin and skin related structures like hair. We are the singular experts in nail structure. It's odd that we don't talk about nails much! In this post I am going to give you a nail specialty physician's level of tips for your nail care.

I was originally inspired to write this post because I was getting my first pedicure of the summer season. I'm updating it on a winter escape to a sunny place. It's officially sandal season! I think neatly trimmed and polished nails are a beautiful thing - and a finishing touch to grooming that I love - BUT improper nail care can weaken your nails. It can even be hazardous! 

expert advice for nail care from dermatologist dr cynthia baileyMedical advice for nail care will help you prevent some of the common nail grooming problems like infections, yellow nail discoloration, chipped and split nails and white spots on the outside of your nail plate. Dermatologist Dr. Cynthia Bailey

Patients, readers and journalists ask me for my nail care recommendations and advice. It's fun to write this article on nail care for my readers.

Here's a list of questions and answers I usually cover when I'm teaching people about nail, cuticle and hand care.

Should you cut your cuticles?

No! You can push them back but don't cut them.  Your cuticles form an excellent and necessary seal to keep water and germs out of an important fold between your nail and your skin.  When you break this fold water and germs get into the pocket. They live happily on your warm body and will proliferate. Eventually these germs can enter the protective skin layer lining the skin side of the fold where they cause an infection called paronychia.  This infection can become quite severe and require antibiotics and surgical drainage.  It’s not worth the risk.

Are dark polishes bad for your nails?

No, it’s the formaldehyde type of ingredients that are bad for your nails.  Dark polish can cause a yellow staining to the nails that can be buffed off.  Buffing of course thins the nail plate, making them slightly more fragile.

What causes the white spots on the outer surface of the nails?

Some polishes have ingredients that etch nails.  It is often the formaldehyde related ingredients in polishes (formalin, methylene glycol etc. and they are not always obviously labeled on products because of the complexities of chemistry reactions).  If your polish is causing the white spots on your nails then what you'll see is a chalky white flaking on the outside of the nail when you take off your polish.  It will be on all your nails at exactly the line where your polish was. You can buff this white etching off the nail plate, but again buffing thins the nail.

Superficial nail fungal nail infections can cause white spots too. A fungal infection is unlikely to happen on all of your nails and will be distributed randomly on the nails. If you have any questions about it you should see your dermatologist.  

Will nail hardener polish fix soft, splitting, brittle nails?

Beware!  Nail hardeners have a lot of formaldehyde type ingredients.  It's these ingredients that causes the initially 'hardening' of the nails but then they cause nail splitting.  I see patients with brittle nails try to 'harden' their nails with these products and unfortunately end up with even worse splitting and fissuring on the end of their nails. It's such a 'catch 22' because the softer and more brittle your nails are the more susceptible they are to damage with nail hardeners.  Soft and brittle nails are also more susceptible to developing dryness and fissures from nail polish removers used to take off the nail hardener polish.  I never recommend nail hardeners.  Instead I recommend moisturizing nails. I outline that below.

Dermatologist's Tips for Dry, Cracked and Splitting Nails

Dry and splitting nails benefit from the same care that you would give to dry and chapped skin. This means using a moisturizer to trap water!

Heel dry, cracked and splitting nails using a moisturizer that adds oils and holds moisture in the nail plate.  

expert advice for nail care with bag balmUse creams, oils and ointments on your nails every day after they’ve been wet. My favorite nail remedy is good old Bag Balm with its wool alcohol (aka lanolin).  Another lanolin containing cream is Cutemol.  Some of my other favorite hydrating ingredients for nails are shea butter, jojoba oil, avocado oil, or other rich natural oils. 

Love the bag balm for nails that split. It’s in a cute container and I bought a few extras to give to friends as a party favor. Judy H 

advice for nail careGlycerin and AHA's (alpha hydroxy acids like glycolic acid and lactic acid) are great ingredients too for holding water in your nails. Use my Glycolic Acid Body Lotion to skin and nails after the shower to soften skin and hydrate nails. Another option is AmLactin Cream.

advice for nail care and to heal nail splitting and dry handsFind richly hydrating glycerin in my Dry Skin Hand Cream.  This is my favorite hand cream every. It is non-greasy and keeps my hands and nails soft. I'm prone to dry hand skin and I have thin nails that are prone to splitting and hangnails. This hand cream is essential for me and there is nothing else like it. 

 

Keep your nails moisturized to prevent dryness and splitting. Tips for moisturizing your nails:

  1. The thicker the cream the better when it comes to moisturizing nails. Oils or ointments are best. It's why Bag Balm works so well. The trick is to use something that stays put and doesn’t just rub off right away. 
  2. Get the best results when you moisturize skin and nails immediately after water exposure; applying moisturizers to dry nails is a waste of time. 

Put your moisturizer on within minutes after your bath or shower, or after washing your hands.  Do it as often as possible.  You can use my Dry Skin Hand Cream, (which is non-greasy), but use a thicker product like Bag Balm at bed time. I even have nifty cotton gloves you can wear at night to keep the Bag Balm in place on your nail and off of your bedding. If your nails are really bad, apply Bag Balm to them numerous times a day after washing your hands. 

How long does it take to heal dry split nails?

Remember it takes 6 months or more to grow your nails from the cuticle to the end of your fingernail.  If you have damaged, dry, split nails you need to moisturize them for at least this long in order to see entirely new healthy nail plates.

Heal splitting nails by clipping and filing your nails when they’re wet.

Clipping and filing dry nails makes the splits worse because they will travel down the linear structure of your nails. Nails are composed of layers of keratin that run like plates stacked on top of each other. Nails grow along linear grooves on the skin under your nails and this leads to longitudinal ridging in nail structure that can split too.

Soften nails before clipping or filing by wetting them for a few minutes.  Towel off the water and then use sharp nail clippers to trim your nails, followed by gently filing the edges.  Always file your nails towards the middle to prevent the linear ridges from fraying.

You can also very gently buff the nail edges to keep the splitting layers from catching on things and progressing down the nail.

Heal dry and splitting nails by wearing gloves when you do rough work or get your hands into harsh chemicals.

Contact with harsh chemicals and soaps will strip nails of precious oils and damage keratin protein. This makes nails more fragile, dry and leads to splitting. You want to protect your brittle and splitting nails from harsh chemicals so that your damaged nail structure can heal. 

How do you care for hangnails?

Hangnails are long splits of dry dead skin attached to the underlying living skin, which is why they hurt when they snag on things.  Clip hangnails with sharp and clean cuticle scissors after you have soaked your nails in water for a few minutes just as you would your fingernails.  Towel off the excess water before clipping them.  Just clip off the small dry hangnail and be sure not to cut into your skin. 

Always be sure your cuticle scissors are clean, and you may want to disinfect them first: you can wash them in soapy water with a clean brush then pour rubbing alcohol on them before use.

Some final notes about nail and cuticle care:

I've created a hand and nail care kit to provide you with the best moisturizers and handy cotton gloves to help you heal dry and splitting nails. I call it my Dry Hand Skin Repair Kit.

expert advice for nail care dermatologist healing creams for splitting nails

Reference:

Relhan V, Goel K, Bansal S, Garg VK. Management of chronic paronychia. Indian J Dermatol. 2014;59(1):15–20. doi:10.4103/0019-5154.123482