Isla Bennett
Fingernail splitting, or onychoschizia, is a common condition that causes horizontal splits across the width of the nail plate. It is often caused by repeated wetting and drying of the nails, occupational exposure to chemicals, and the use of certain nail cosmetics and procedures. Individuals in occupations that require frequent hand washing or those who work with chemicals are at an increased risk for developing brittle nails that are prone to splitting. While onychoschizia may simply be a cosmetic issue, it is recommended to consult a medical professional if the condition becomes bothersome, as there may be an underlying cause such as a medical condition or medication.
| Characteristics | Values |
|---|---|
| Condition | Onychoschizia |
| Other names | Nail peeling, nail splitting, brittle nails |
| Cause | Repeated wetting and drying of the nails, occupational exposure to chemicals, use of nail cosmetics and nail-hardening agents |
| Symptoms | Horizontal splits across the width of the nail, longitudinal splits or ridges in the nail plate |
| Associated conditions | Onychorrhexis, psoriasis, lichen planus |
| Treatment | Cautious use of nail-hardening agents, determination of underlying medical causes or medication-related causes by a medical professional |
| Related conditions | Splinter hemorrhages, nail psoriasis, lichen planus, onychomatricoma |
| Signs | Reddish or purple lines below the nail that darken to brown or black, thin red or reddish-brown lines |
| Causes | Injury to the nail, inflammation of blood vessels, bacterial infections, chronic kidney disease, kinase inhibitors |
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What You'll Learn
Horizontal nail splitting
Onychoschizia, commonly known as nail peeling or nail splitting, is a condition that causes horizontal splits across the width of the nail plate. It is characterised by brittle and splitting nails. Horizontal nail splitting is quite common in newborns, affecting about a third of them. It is also seen in children up to two years of age due to their thin nails.
To prevent horizontal nail splitting, it is recommended to reduce how often you wet and dry your nails. Wearing plastic or rubber gloves over thin cotton gloves while doing housework, including food preparation, can help. Keeping nails trimmed short and applying thick moisturisers or petroleum jelly can also improve nail hydration and prevent splitting. Nail-hardening agents containing formaldehyde may increase nail strength, but they should be used cautiously as they can cause brittleness and other nail problems.
In cases of severe horizontal nail splitting, a person may need to consult a healthcare professional. They may recommend removing the nail completely or stitching the nail bed. If possible, they may reattach the nail using either stitches or glue.
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Longitudinal nail splitting
Frequent wetting and drying of the hands is the most common cause of brittle nails. This condition may also be caused by the use of nail cosmetics, such as nail polish, hardeners, and polish removers or solvents. Occupational exposure to chemicals such as acids, alkalis, cement, solvents, and thioglycolates can also contribute to longitudinal nail splitting. Additionally, underlying medical problems, such as endocrine system diseases, tuberculosis, Sjögren syndrome, and malnutrition, can be factors.
Certain medical conditions, such as psoriasis or lichen planus, are associated with longitudinal nail splitting. The use of oral medications containing vitamin A (oral retinoids) can also contribute to this condition.
To improve brittle nails and reduce nail splitting, it is recommended to reduce the frequency of wetting and drying the nails. Wearing plastic or rubber gloves over thin cotton gloves while doing housework and food preparation can help protect the nails. Keeping nails trimmed short and applying thick moisturizers or petroleum jelly can also improve nail hydration and reduce splitting. While nail-hardening agents containing formaldehyde can increase nail strength, they should be used cautiously as they may cause further brittleness and other nail problems. It is advised to only apply these hardeners to the free edge (growing end) of the nail.
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Onychoschizia
The most common cause of onychoschizia is repeated wetting and drying of the nails, with frequent hand-washing being the usual culprit. Manicures, nail polish and remover, nail biting, and repeated trauma such as typing can also contribute to nail splitting. Dehydration and nutritional deficiencies, such as a lack of iron, selenium, or zinc, likely play a role as well.
Some skin diseases, such as psoriasis and lichen planus, may feature onychoschizia. In addition, bacterial infections such as endocarditis, an infection of the heart valves, have been linked to the condition. Studies show that 15% to 33% of people with endocarditis have splinter hemorrhages. People with chronic kidney disease also report them, and they are found in 60% to 70% of people taking kinase inhibitors.
Diagnosis is typically made based on the appearance of the nails, but blood tests may be necessary to check for iron deficiency, thyroid problems, or kidney issues. Treatment involves discontinuing nail polish and applying moisturiser. Some people have reported favorable results with gel nails or biotin supplementation if there is a vitamin B7 deficiency.
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Splinter removal
It is important to note that splinter hemorrhages are not caused by actual splinters. They are small areas of bleeding that occur when the blood vessels under your nail bed sustain damage. They are called splinter hemorrhages because they resemble wood splinters under your nail.
Now, to remove a splinter, it is recommended to follow these steps:
Wash and Dry the Area:
Firstly, wash your hands and the affected area with soap and water, and gently pat your skin dry. This helps prevent infection. If the splinter is made of wood, avoid soaking the area in water, as the splinter may expand and become more difficult to remove.
Inspect the Splinter:
Use a magnifying glass to determine the size and direction of the splinter. If it is deeply embedded and no part of the splinter is exposed, you may need assistance from a friend or family member.
Sterilize Your Tools:
Clean a pair of tweezers or a small needle with soap and water to remove any debris. Then, sterilize the tools by wiping them with rubbing alcohol or heating them over a flame. Allow them to cool and dry before use.
Remove the Splinter:
If part of the splinter is sticking out, use the tweezers to gently pull it out in the same direction that it entered the skin. If the splinter is completely embedded, use the needle to gently pierce the skin at one end of the splinter. Continue to use the needle to push out part of the splinter, and then use the tweezers to pull it out.
Clean and Dress the Wound:
After removing the splinter, clean the area again with soap and water. Apply petroleum jelly or antibiotic ointment to reduce the risk of infection, and cover the area with a bandage until it heals.
It is important to note that some splinters may require medical attention, especially if they are deeply embedded or located near sensitive areas like the eye. If you are unable to remove the splinter easily, it is best to seek professional medical assistance.
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Splinter haemorrhages
When splinter haemorrhages first form, they appear reddish or purple, but they will darken to brown or black within a few days. They usually move with the nail as it grows. They can affect one or multiple nails. In healthy individuals, they are more common in men than in women and are more frequent in older people and dark-skinned individuals.
If you notice splinter haemorrhages and have not had any recent injuries, it is important to consult a healthcare provider to determine the underlying cause. There is no specific treatment for splinter haemorrhages themselves, but any necessary treatment will be targeted at the underlying cause.
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Frequently asked questions
Your fingernails may be splitting easily due to a condition called onychoschizia, which is caused by repeated wetting and drying of the nails. It can also be caused by occupational exposure to chemicals, nail cosmetics, or certain medications.
Onychoschizia causes horizontal splits across the width of the nail plate, and it may be accompanied by longitudinal splits or ridges (known as onychorrhexis). Together, these conditions are sometimes called "brittle nails."
You can try using nail-hardening agents containing formaldehyde, but use them cautiously as they can cause brittleness. Apply these hardeners only to the free edge (growing end) of the nail. If you are concerned about your nail splitting, consult a medical professional to determine if there is an underlying cause.
Splinter hemorrhages are small areas of bleeding under your nails that look like thin, red or reddish-brown lines. They are usually caused by trauma to the nails, but they can also be a sign of an underlying medical condition. If you are concerned about splinter hemorrhages, consult a healthcare provider.
