Nail Dystrophy: Learn about Causes & Treatments

Nail dystrophy refers to poor nail formation, usually as the result of trauma or infection. When caused by trauma, the nail becomes discolored due to blood pooling underneath the nail. Over time, the nail breaks away from the nail bed until it detaches completely. A new nail will grow in its place, but it may not grow back properly if the nail bed is damaged in the process.

The Disadvantages of Nail Dystrophy

Nail dystrophy affects millions of people nationwide. And while nail dystrophy occurs more frequently in older women than in any other group, anyone can be affected by the dry, peeling nails it presents. Some of the disadvantage of brittle nails include:

  • Dry, brittle nails incur chalky streaks when coming into contact with hard surfaces
  • Nails are flaky and “shed” on a daily basis
  • Fingernails that split longways, causing unsightly fractures in the nail plate
  • Nails are painful when coming into contact with other objects
  • Unsightly nails lead to self-consciousness about appearance
  • Self consciousness about nails leading to withdrawal from public and social situations

Causes of Nail Dystrophy

Two common infections that cause nail dystrophy are onychomycosis and psoriasis. Onychomycosis is a fungal infection. The infected nail becomes discolored and falls off, similar to a trauma-related nail condition. Psoriasis has somewhat different symptoms. Yellow or brown lesions build up under the nail, leading to misshapen or split nails.Fungal infections are particularly common to the feet because of the warm moisture that gets trapped in socks and shoes. Fungi enter small cuts in the skin, generally near the cuticle of the toenail. It is difficult to treat fungal infections, but over-the-counter antifungal medications tend to work well in the short term. However, repeat infections are common. In extreme cases, surgery may be necessary to remove the nail, allowing the nail bed to be sanitized. Brittle nails, known as onychorrhexis, are common to about 20 percent of the population. Most sufferers are women. Brittle nails are overly prone to breakage. This type of dystrophy is generally the result of age or overexposure to soap and detergent. However, brittle nails may also indicate a more serious disease, including malnutrition, hyperthyroidism, or some other endocrine disorder.

The word “dystrophy” means malformation or poor formation, and when you have nail dystrophy it means that your fingernail or toenail has formed improperly for one of several likely reasons. For the most part, the reasons that nails form poorly are:

  • Trauma to the nail – stubbing your toe, smashing a finger, or any other type of trauma to the fingers and toes can cause the nail to suffer. You have to first address any injury to the digit before seeking to repair the nail, and there are times when the nail is lost altogether. This can cause the nail to re-grow in a flawed way, which can require more intense intervention.
  • Fungal infection – nail dystrophy is also frequently caused by a fungal infection in any part of the nail – this can include the nail bed or the nail itself. For the most part, any nails with a fungal issue will turn color, become brittle, and generally crumble or break easily. These usually need to be treated with special anti-fungal remedies, and there are times when the nail bed needs removal as well.
  • Psoriasis – though considered a skin disease, psoriasis can also lead to changes in the nails due to lesions that form beneath them on the nail bed. This is something that is very difficult to treat, and some people must have the nail removed in order to address the issue directly on the nail bed.

Clearly, nail dystrophy is an unattractive and deeply unwelcome issue. It can be hard to manage, but one of the best ways to do so is to use early intervention. Generally, the earlier that you get to work dealing with nail dystrophy, the better the outcome for any of the affected nails as they re-grow and recover.

Nail Dystrophy Treatment

Brittle nails may be treated with vitamin supplements. Biotin, zinc, and iron are known to improve nail strength. Sufferers may also try moisturizers, fortified nail polish, and a nail-protecting regimen that includes the avoidance of harsh soaps.

Peeling nails are usually a symptom of physical or chemical stress on the hands. Nutrient deficiencies and overexposure to water may also cause peeling nails. The problem may even be something as simple as cold, dry weather. Thus, peeling nails may be prevented or treated by carefully paying attention to lifestyle and environmental factors that affect the hands. Glycerin, petrolatum, and mineral oil moisturizers usually help.

Whether facing brittle, peeling, or split nails, moisturizers are beneficial for protecting the keratin that holds each nail together. After addressing trauma, infections, and diseases that may cause nail dystrophy, the best solution is to focus on properly moisturizing the nails each day. Through proper education, you can overcome brittle, peeling, and split nails.

If your nail dystrophy is severe enough, it may require a prescription treatment to keep it under control. Learn more about your condition and available treatments today.

Treatment for nail dystrophy depends on the underlying cause. Here are some general approaches that might be used to treat nail dystrophy:

Topical treatments for Nail Dystrophy

These are applied directly to the nails. For fungal infections, antifungal nail lacquers like ciclopirox or amorolfine might be used. In cases of psoriasis affecting the nails, topical corticosteroids might be prescribed.

Oral Medications for Nail Dystrophy

For more severe or resistant fungal infections, oral antifungal medications such as terbinafine or itraconazole might be prescribed. For nail psoriasis, oral medications like methotrexate or acitretin can be used.

Injections for Nail Dystrophy

In some cases, corticosteroid injections into the nail matrix might be used to treat nail psoriasis.

Phototherapy for Nail Dystrophy

A treatment called PUVA, which combines a drug called psoralen with ultraviolet A light, might be used for severe cases of nail psoriasis.

Biologic Therapies

For severe nail psoriasis that does not respond to other treatments, biologic medications such as adalimumab or ustekinumab might be used.

Nail Care and Cosmetics: Sometimes simple measures such as keeping the nails short, avoiding trauma, and using nail hardeners or nail varnishes can improve the appearance and health of dystrophic nails.

Fingernail Surgery

In rare cases, if the nail dystrophy is severe and causes pain or distress, surgical removal of the nail might be considered.

Vitamin and mineral supplements: Sometimes, nail dystrophy can be due to nutritional deficiencies. Ensuring an adequate intake of vitamins and minerals such as biotin, zinc, and iron might be helpful.

Address underlying conditions: Nail dystrophy might be a sign of an underlying health condition. Managing these conditions effectively might improve the health of the nails. For example, good blood sugar control in diabetes can sometimes improve nail health.

It’s very important to have an accurate diagnosis for the cause of nail dystrophy, as the treatments can be very different depending on the underlying cause. Always consult a healthcare professional, preferably a dermatologist or a specialist in nail disorders, for personalized medical advice and treatment options.