On the Nail

If you’ve noticed vertical ridges on your nails, you are not alone! Finger nail ridges are quite common and can be a result of several factors. Read on to learn more about why nails develop ridges, what you can do to fix them, and when to seek medical attention. 

Causes of Fingernail Ridges

Ridges, known medically as onychorrhexis, are often a clinical sign of brittle nails. There are many reasons that nails might become brittle and appear bumpy, rippled or grooved.

1. Aging: Ridges are akin to wrinkles on the nails. As we age, the nail growth plate (nail matrix) tends to become thinner and more brittle, which can lead to the formation of ridges. Aging can also lead to decreased peripheral circulation–less blood flow to the extremities–which compromises nail health.
2. Genetics: Just like some people are predisposed to thin hair or thin skin, you can also be genetically predisposed to thin nails. This leaves you more vulnerable to ridges.
3. Environmental factors: Exposure to chemicals or excessive water can exacerbate nail ridging. Acetone polish removers, in particular, can cause severe dehydration of the nail, leading to worsened ridging. Alcohol-based hand sanitizers can have a similar effect.
4. Medical Conditions: Certain medical conditions, such as Lichen Planus, psoriasis, eczema, and thyroid disorders, can cause ridges to form on the nails. Illness or extreme stress can cause Beau’s Nails, which are horizontal ridges that can impact one or several nails. 

Treatment Options

The treatment of fingernail ridges will depend on the underlying cause. In some cases, the ridges may disappear on their own once the underlying cause is addressed. However, in other cases, treatment may be necessary. It’s important to treat the nails as opposed to simply camouflaging the problem with a nail ridge filler.

• Hydration: Keeping the nails and cuticles healthy and moisturized can help to reduce the appearance of ridges. This can be done by applying a moisturizer, such as the Dr. Dana Deep Hydrating Formula, to the nails and cuticles. Oil-based formulas absorb better than creams, which can just sit on top of the nail or cuticle. 
• Exfoliation: Proper gentle exfoliation can help the appearance of ridges and wavy nails. The 3-step Dr. Dana Nail Renewal System features a first-of-its-kind glycolic acid to gently exfoliate and help rejuvenate the nails. Step 2 of the system is the tri-grit Priming Want, which is specifically designed to safely and effectively remove ridges, discoloration and peeling and leave nails smooth and shiny. Be cautious using abrasive buffers, as they can be very damaging to the natural nail. 
• Avoiding trauma: To prevent further trauma to the nails, it is important to avoid biting your nails and to use gloves when working with harsh chemicals or exposing your nails to extreme temperatures.
• Medications: If a medical condition is causing the ridges, medications may be prescribed to treat the condition.
• Nail Care: Keep your nails clean, dry, and trimmed. Wear gloves if you are exposed to excessive amounts of water, such as while washing dishes. 
• Cuticle Care: Taking proper care of your cuticles, which help protect the nail matrix, can also help prevent ridges from forming. Do not cut your cuticles; instead, gently push them back after a hot bath or shower.
• Exercise: Regular cardiovascular activity will help blood flow to the nails, which will help with ridging. Hand massage is another good option. 
• Avoiding harsh chemicals: This includes nail polish remover with acetone, which can be very dehydrating and exacerbate ridges.

When to Seek Medical Help

It’s important to note that nail ridges are usually not a sign of a medical problem; however, if you notice changes in the appearance of your nails, it’s always best to consult a dermatologist or other healthcare provider to help determine the underlying cause. Understanding what’s causing the ridging can often help determine the proper course of treatment. You should always seek medical attention if ridging develops suddenly and is severe, as it could be a sign of a more serious condition.

We teach our kids basic hygiene, such as washing hands and brushing teeth, but we often neglect to teach them the importance of taking care of their nails. It’s not just about keeping them clean, however (although that’s a great start!); it’s also about preventing damage and helping you discover any underlying health concerns that may leave clues on the nails.

Read on for tips on helping your child develop healthy nail habits. 

1. Keep nails trimmed. Short nails stay cleaner and break less often. Why is this important? While the “gunk” under the nail is most commonly just keratin debris, it can also include dirt and bacteria. Longer nails provide more surface area for bacteria to collect. Dermatologists recommend that an adult trim a child’s nails until the child is about 9 or 10 years old; after that, children can trim their own nails if they feel comfortable doing so.  

• Trim nails after taking a bath or shower. Nails are softer then, so trimming is easier.
• Use a nail clipper or nail scissors to trim nails.
• Cut fingernails almost straight across. Round a little at the corners to keep the nails strong.
• Cut toenails straight across. This reduces the chance of getting an ingrown nail.
• Smooth rough edges with a nail file (we recommend our Precision Glass File for a more gentle, sustainable alternative to emery boards, which can leave microtears on the nail)
• Cuticles protect the nail root, so it's best to not cut the cuticles.

2. Keep nails clean: As mentioned above, it’s essential to clean under the nails, but there are some methods that are safer and more effective than others. Hand washing is key - make sure to include the tips of your fingers and nails when teaching your child proper hand-washing skills. 

In terms of using tools, I don’t love nail brushes, which can’t be sterilized and can potentially harbor bacteria and other organisms. Cleaning under the nails with a tool like an orange stick can be effective, but make sure to be extra gentle - overly vigorous cleaning can cause the nail to separate from the nail bed (onycholysis). 

3. Hydrate the fingernails. Nails need moisturizing to keep them healthy and flexible, especially when the air is dry. When nails aren’t hydrated, they can split more easily. The best time to apply hydration is immediately after washing the hands or after taking a bath or shower. Nails absorb oils and ointments better than creams and lotions.  

4. Limit the use of nail polish remover to once or twice a month.Nail polish remover is extremely drying. Try to find a remover without acetone, which is especially dehydrating to the nails.
   
   
5. Take care of hangnails right away — and the right way. Chewing or tearing off that hanging bit of skin can cause an infection. To take care of a hangnail, I recommend washing hands well with soap and water and then using a clean cuticle nipper or nail scissors to cut off the hanging bit of skin at the base.

6. Prevent toenail problems with good nail care. Just because toenails are often out of sight does not mean they should be out of mind. Follow these tips:

• When buying shoes, leave wiggle room for toes. Cramped toes can lead to painful ingrown toenails.
• Change socks daily. Dirty socks can lead to toenail infections.
• Wear flip-flops rather than going barefoot in public places. Walking barefoot in public places (think: beaches, pool decks, locker rooms, hotel bathrooms) can lead to a toenail infection, athlete's foot, or plantar warts. 

7. Check your nails. Children's nails are usually healthy, but teaching them to check their nails at a young age develops a healthy habit. Checking nails is important because the first sign of health problem can show up in a nail. These signs include a dark streak and a nail that starts to crumble and fall off. If either happens, it's time to see a board-certified dermatologist. 

The right way to embrace the latest TikTok nail trend

If you’re on #nailtok, you’ve likely seen many videos about nail slugging on your FYP. This trend, an evolution of the popular Korean skin slugging, is an effective way to hydrate and revive dry or damaged nails. Many of the TikTok videos, however, have skipped a crucial step. Read on for the right way to get the most out of nail slugging!

What is Skin Slugging?

Skin slugging, a Korean skincare trend that became popular on TikTok in 2022, involves a three-step skincare routine and is often done as an overnight treatment: 

1. Exfoliate the skin.
2. Hydrate with a moisturizing cream, serum or lotion.
3. Apply an occlusive, such as petroleum jelly, to seal in the hydration.

What is Nail Slugging?

When skin slugging was adapted for nails, the important exfoliating step was often (erroneously) removed and just included moisturizer and occlusion. Much like with the skin, however, the most effective way to hydrate the nail and cuticle is to start with exfoliation. The nail slugging process should look like this:

1. Gently exfoliate with an AHA-based product.
2. Apply a hydrating/strengthening oil or gel.
3. Add occlusive ointment all over the nail bed and cuticle.

The Dr. Dana Nail Renewal System is perfect for Steps 1 and 2 in nail slugging! It begins with a gentle exfoliation via Glycolic Acid to remove damaged nail cells and is followed by a hydrating and strengthening oil. This is the ideal method for delivering nail- and cuticle-loving ingredients and will help transform dry, damaged or brittle nails into healthy, smooth, shiny nails.

What are the benefits of nail slugging?

The main benefit of nail slugging is hydration, for both the nail and the cuticle, and should be considered by anyone with dry, brittle nails or damaged cuticles. As the nail’s natural protective seal, the cuticle is the key to a healthy, beautiful nail. It is like the grout in your shower between the tiles - it keeps moisture and organisms out of the nail unit.  When that seal is removed (such as during an aggressive manicure) or becomes dry and dehydrated (culprits include excessive water exposure from handwashing and dishes, nail gels/dips, and harsh polish remover), it becomes compromised–picture old, dry grout–and water and moisture is able to enter the nail unit. This can cause all sorts of problems, including chronic paronychia (redness and swelling at the skin behind the cuticle).  If the cuticle compromise persists chronically, the nail will eventually grow irregularly (white patches, bumps, thickening, discoloration). Healing the cuticle will help prevent infection and assist in healthy nail growth, and nail slugging is a great way to start the healing process

As you can see, restorative treatments that hydrate the cuticle, such as slugging on top of the Dr. Dana Nail Renewal System, help maintain the health of your nail.

What makes nail slugging better than just using cuticle oil?

Applying an occlusive layer after using the cuticle oil or moisturizer seals in the products so they will penetrate deeper. It also provides a protective barrier to help prevent moisture loss. 

How often should I be slugging my nails?

Nail slugging will be effective if done one or two times a week. It can be done as often as every night, but the exfoliation step should only be performed once a week. The oil should be applied under the occlusive every time you are slugging. 

Did you know that simply looking at your nails can tell you a lot about your overall health? Nail changes can be indicative of internal health issues, and since your fingernails and toenails are highly visible (unlike, say, your kidney or other organs), they can provide clues that can help you seek treatment earlier. Your naked nails will provide the best view, especially with color variations, so make sure to give them a close look between polish applications. If you notice any changes or have any concerns, it is important to see your dermatologist for further diagnosis.

Nail Shape and Your Health

While all nails are unique, there are generally similarities in the overall shape of healthy fingernails. Deviations in the shape of your nail can provide clues to potential health conditions. 

Koilonychia, characterized by concave, spoon-shaped nails, can indicate iron deficiency anemia. Additional causes of Koilonychia include other disorders where iron is not metabolized effectively, such as Hemochromatosis and Plummer Vinson Syndrome. Aging can also cause age-related Koilonychias, so it’s important to have a medical workup done by a physician to determine the root cause.

Clubbing of the fingers or toes, also known as digital clubbing or hypertrophic osteoarthropathy (HOA), presents as the downward sloping of the nails, softened nail beds and bulging and/or red fingertips. Clubbing can be hereditary but is more often a sign of an underlying disease. In 80% of cases, secondary or acquired (non-inherited) clubbing is caused by lung cancer or lymphoma. Other potential health problems indicated by clubbing include cardiovascular disease or other chronic illnesses. 

Nail Color and Your Health

Fingernails changing hues without polish? Your nail color can also provide clues to internal health concerns. 

Yellow Nails: Most commonly, a yellow tinge on nails is due to nail polish, which can dye the nail beneath it. In some cases, though, it can be Yellow Nail Syndrome, in which nails appear thick and have a yellow/green color. These nails often lack a cuticle and a lunula (the half-moon on the bottom of your thumb nail and big toe nail) and are extremely slow growing. Yellow Nail Syndrome is associated with lymphatic disease and/or lung disease. Please check with your physician for treatment options for this often-chronic disorder.

White Nails: While there can be many causes of white nails, two of them are associated with internal disease. The first, known as “Half and Half Nails” or “Lindsey’s Nails,” presents with the bottom half of the nail (closest to the cuticle) white and the top half pink. This can signify kidney failure and should be checked immediately by a medical professional.

The second, known as “Terry’s Nails,” is when the bottom two-thirds of the nail is white and the top third is pink. This can be suggestive of Cirrhosis, congestive heart failure or diabetes mellitus, so you should see your physician for further diagnosis.  

Additionally, you may see horizontal white lines on your nails. Mee’s Lines, which run parallel to the lunula and (the half-moon at the bottom of the nail) and don’t blanch with pressure. These lines can be a sign of arsenic or other exposures. Muehrcke’s Lines which are rare, are parallel white lines that extend all the way across the nail and disappear with pressure applied. They most commonly occur as a result of malnutrition or low protein states. 

Brown or Black Nails: Dark brown or black stripes along the length of the nail are most often caused by stimulation of the pigment-producing cells in the nail.  This occurs due to trauma related to injury to the cuticle area or aggressive cuticle pushing/cutting/picking/biting, these pigment-producing cells “wake up” and start making more pigment that can appear as bands. This is usually a benign process and pigmented bands in the nail are common—especially in people with darker complexions—because, like the skin, the nail has pigment-producing melanocytes.  Rarely however, these brown or black colorations can be a melanoma. Melanoma is a potentially fatal form of cancer that is usually associated with the skin, but it can develop in the nail, as well. Some signs that it could be melanoma include a single dark brown or black band on only one nail (most commonly the thumb, index finger and big toenail) and/or brown pigment surrounding the nail. If caught early, nail melanoma is curable, so it is imperative to see a dermatologist for a thorough exam when it’s unclear what caused the brown/black pigmentation.

Black vertical lines: Known as Splinter Hemorrhages, these short lines look like splinters but are most often a result of nail trauma. More rarely, they can indicate endocarditis or trichinosis.  

Red spots: Red dots in the lunula (the moon above the cuticle) can be caused by many conditions, including Alopecia Areata, Lichen Planus, Psoriasis, Rheumatoid Arthritis or a connective tissue disease. 

Nail Texture and Your Health

While there are many factors that can make nails less smooth than we’d like, including improper gel/dip removal, sometimes the nail’s surface can signify a potential past or current health concern.

A horizontal depression in the nail plate, called a Beau’s Line, is usually due to the growth interruption of the nail from illness, fever or trauma. 

Pitting that occurs in a pattern (as opposed to random indents) is often an effect of Alopecia Areata.

Nail peeling (Onychoschizia) and longitudinal ridges (Onychorrhexis), which can cause the nail to split or break, can signal medical conditions such as Hypothyroidism, Raynaud’s Disease and protein deficiency, although this is rare. These conditions can cause nails to be brittle. 

Onycholysis, when the nail separates from the nail bed, can occur due to trauma, Psoriasis, Hyperthyroidism or certain medications. 

Overall, your nails can provide a lot of insight into conditions that you may or may not know you have. It’s important to see a dermatologist or other medical practitioner whenever you notice changes to ensure proper diagnosis and treatment. 

The nail salon.

A hallowed place for many—and one that we came to miss greatly during the most intense parts of the pandemic when we really weren’t leaving our homes. Perhaps you mastered some version of at-home gel removal and manicures but now you’re happy to return to a place where a professional is taking care of business.

(And if you love to do your nails at home, much of this advice about manicure tools will apply to you too!)

While many factors—like location, cost of services, and ambience—may weigh into the nail salon you choose, safety and cleanliness must be near the top of the list, as well.

Nail Salon Hygiene 101

It’s always important to take note of (or ask about) the safety practices employed by your salon to prevent the spread of bacteria and other microbes.

First, it’s helpful to understand a few of the key terms that are factors in the hygiene practices of someplace like a nail salon.

• Sanitization: A procedure that leads to proper and thorough cleaning of an object or surface. This can be done via hot water and soap or a dishwasher.
• Disinfection: A process that kills the small # of pathogens remaining on a surface after sanitization. In salons, achieved with liquid disinfectants like alcohol, 10% bleach, or professionally formulated disinfection products. It’s important to note that to be effective, these solutions must be prepared according to instructions—and items must soak for at least 10 minutes. The solutions should be replaced daily or according to manufacturers’ directions.
• Sterilization: This process kills bacterial spores. But unlike disinfection, it uses very high temperatures and pressurized steam to kill pathogens. Places like hospitals, doctors’ and dentists; offices use autoclaves to sterilize—but it is not considered necessary in a salon setting.

Now, we can get into more specifics about what to look out for when picking a spot for your manicure or pedicure.

The Eye Test

First impressions count big time here. When you walk in, ask yourself a few questions.

• Does the overall appearance seem clean? This includes the floors.
• Are the technicians’ licenses displayed and up to date and do the photos match up with said technicians?
• Do the technicians wash their hands before and after each client?
• Are the products properly sealed in well-labeled containers?
• Is the salon well ventilated?

Inspect the Nail Files and Other Manicure Tools

You want to make sure that everything used on your hands or feet is being sanitized and disinfected properly. And it’s absolutely fine to ask about how this is done if you’re not clear. Don’t be embarrassed!

Now, sometimes salons use one-time use products, meaning they are only used on one client and then thrown away—or given to the client to take home. This can often include items such as emery boards, orange sticks, pumices, buffers, and toe separators. If items like this are being reused, there may be a cleanliness issue.

Bonus Tips for the Best Manicure (and the Safest)

If you are concerned about the salon adhering to disinfecting guidelines and want to take your health into your own hands, consider bringing your own stainless steel tools and sanitizing them at home by cleaning them in hot, soapy water, boiling, and then drying and storing them in a dry place. Also, make sure that you never visit a salon if you have an open wound or any active infections in the area where you are receiving your service, as this could put you at risk for developing a skin or nail infection. Last (but not least), never ignore abnormalities that appear after a salon service.  If you are concerned about an issue—be it an allergy to a product or a possible infection—then seek care from a board-certified dermatologist immediately.

Sustainability and Nail Tools

Obviously being eco-conscious and caring about the environment and sustainability are important factors in making decisions about where you spend your money in all parts of modern life—and that includes your nails and nail care.

Items that the manufacturer designs to be disposed of after one use on a single client are called “disposable” or “single-use”. Reusing these items is considered an unsanitary, improper and unprofessional practice. Some additional examples of disposable items are cotton balls, gauze pads, wooden implements, disposable towels, toe separators, tissues, wooden sticks, and certain abrasive files and buffers. Items damaged during the cleaning and disinfecting process are considered single-use and must be discarded after every client.

While one-time use products are a way for nail salons to stay hygienic, and efficient, they aren’t always the best for the planet Earth as they create more waste. This is yet another reason that bringing your own tools from home can be a great idea. A file like the new Dr. Dana Precision Glass Nail File is non-porous and naturally hygienic, making it a great option. Plus, it helps reduce snags by creating a smooth nail edge. If you do bring your own tools, just be sure that you follow the manufacturer’s instructions to properly clean any items after each use.

Whether you realized it at the time, you have very likely suffered from an ingrown nail—and even more likely, an ingrown toenail. They can be painful and can cause larger issues if left untreated. So what causes ingrown toenails exactly, how can you tell if you have one, and what can you do about it?

Let’s get into it all.

What is an ingrown nail?

An ingrown nail—which is medically referred to as onychocryptosis—is when the corner or edge of the nail embeds in the surrounding skin. It most commonly affects the big toenail because the nail has sharp edges and when it pierces the surrounding nail fold tissue it can begin to grow into the skin.

Are ingrown nails more common on the hands or feet?

Ingrown toenails are definitely more common, although an ingrown nail can also occur on the fingers. With fingernails, the issue usually develops in people who have a nail dystrophy called a pincer nail. This means the fingernail has a very exaggerated over-curvature which can cause it to grown into the skin surrounding the nail more easily.

What are some of the most common causes of ingrown nails?

There are a number of factors that can contribute to causing an ingrown nail. These can include:

• If you cut your nails too short, it can make them more prone to embedding into the skin, leading to an ingrown nail.
• If you cut your nails on a curve, as opposed to straight across, you are creating a shape that is more likely to become an ingrown nail.
• Certain people have nails that are just more prone to embedding because the nail has an exaggerated curved shape.
• Wearing shoes that don’t fit properly can cause an ingrown toenail, like around your big toe.
• A common cause of ingrown toenails in athletes is repetitive toe trauma.

What are the symptoms of an ingrown nail?

The nail plate has sharp edges, so when it embeds into the skin around your nail, it can result in significant pain, redness at the surrounding skin, inflammation, and swelling. When the embedded nail is not removed, a granuloma—aka a mass of vascular tissue—can develop in response to the trauma.

What does an ingrown nail look like?

An ingrown nail can look like a growth because it is the body’s way of attempting to wall off the sharp object that is piercing the skin. In addition to the nail digging into the nail fold, there is also a heap of tissue that develops overlying the site where the nail is embedded. Other signs of an ingrown nail include swelling, redness and sometimes drainage or pus (if infected).

What should I do if I think I have an ingrown nail?

• Try epsom salt soaks in cool water to help alleviate inflammation.
• Wear shoes where the nail does not make contact with the shoe. For example, open toe, well-fitting sandals are ideal in the summertime.
• An over-the-counter anti-inflammatory medication like Ibuprofen can help with your discomfort.
• Keep the area as clean and dry as possible.
• Do not try to dig into the nail fold with tools or to perform a home surgery.
• If the pain and inflammation persist, contact a professional.

Can nail techs do anything to help ingrown nails?

Many nail technicians are very proficient and skilled at caring for clients who suffer from chronic ingrown nails. Sometimes a simple clipping of the embedded section will create immediate relief by removing the embedded segment.

When it comes to trimming the toenails, nails are best cut straight across, as opposed to on a curve. This will prevent embedding or ingrown nails and you should feel free to ask your nail technician to do this for you.

This means that shape wise, a square would be preferred to round—although squoval (square with a bit of filing on the edge) is totally okay, too. Also, it is important to not cut the nail too short as that will make it more prone to embedding into the skin. Those who suffer from ingrown nails should allow their toenails to grow a bit longer than is typical.

How can you tell if an ingrown toenail or fingernail has caused an infection?

When infected, there will be pus, or purulent drainage, around the area. And there can also be significant swelling, warmth, and extreme tenderness.

When should you seek a doctor’s help for an ingrown nail? How will a doctor treat it?

You should see your provider as soon as possible if you develop an ingrown toenail and you have any of the following conditions:

• Diabetes
• Severe nerve damage
• Poor blood circulation
• Infection

When ingrown nails occur often or if have a significant impact on your ability to move around, participate in activities, and are chronically painful, it is time to see a podiatrist or a board-certified dermatologist.

Most of the time, ingrown toenails heal without surgery. However, in more severe cases, your healthcare provider may need to remove part of the nail with a procedure called a nail avulsion. Surgery keeps the edge of the nail from growing inward and cutting into the skin. For children who have persistent infections, the permanent removal of a portion of the nail can also help.

During a partial nail avulsion, your provider injects a numbing medicine into your toe and then cuts away a portion of the embedded toenail. For recurrent ingrown nails these avulsion procedures can be done permanently with the assistance of a chemical to kill the nail root. This procedure is called a matricectomy and will enable the nail to subsequently grow in more narrowly which eliminates the risk of chronic embedding.

When an infection is present, it will be important for your doctor to drain and culture the infection. There is also a chance your treatment may include an oral antibiotic.

Listen, gel manicures are great for many, many reasons: the extra shine and the way they last without chipping, just to name a couple. But have you ever really thought about the science behind a gel mani and the effects it can have your nails? We thought so. But that’s where we come in because we love helping you figure out ways to have your healthiest, most beautiful nails—whether you use gel polish or not.

What is a gel manicure?

Gel polish technology is unique because it paints on like traditional nail lacquer, but the gel has a chemical composition that enables it to harden—or cure—to a glossy finish using a UV light. This means you don’t have to sit and wait while your polish dries. In addition, gel manis typically last two to three weeks and are much more chip-proof than a regular manicure or pedicure.

How much are gel manicures?

Prices will vary on gel manicures depending on where you live and the type of nail salon you choose. But they are typically about $5-$10 more expensive than a regular manicure. This often lands around $35.

Will getting gel nails cause damage?

Yes, gel manicures can result in a thinning of the nails. The Miami School of Medicine conducted a study that used ultrasound technology to demonstrate that that this was a possible side effect of gel manis. However, the authors of the study concluded that it was unclear whether the source of the thinning was due to the acetone soak required to remove the gel or the actual chemical composition of the gel polish itself.

Another cause may be if the gels are incorrectly removed. Over the many years of her dermatology practice, Dr. Dana Stern has observed that most of the damage from gel manicures occurs during the removal process which can be highly variable.

What is the proper method of gel removal?

If you are at a salon, ask how the product will be removed and make sure they won’t be using a gritty file, sander, or another similar tool to vigorously scrape the product off. These methods can cause tremendous—and sometimes irreversible—damage to the nail, as well as the cuticle and the nail matrix, the area where your nail starts to grow.

The companies that make these gel products have very little control over whether their products are being removed properly. Gel polish should come off easily after soaking in acetone. If it is not easy, something is wrong. Remember that acetone is also extremely drying to the nail and surrounding skin, but it is necessary in order to remove gels and many other artificial nail applications.

How often should I get gel manicures if I want to keep my nails healthy?

Dr. Dana’s advice is to enjoy the occasional gel manicure or pedicure before a big trip or a special event where chips are going to be a nuisance. But you should avoid doing them every two weeks, as this will lead to nail damage and dehydration. Dehydration also occurs from the long acetone soaks required to remove the product.

Okay, but what if I do continuously get gel manicures?

Dr. Dana reports that she sees tons of women in her office who get regular soak-off gel manicures, and many have the damage mentioned above like thinning of the nail plate or dehydrated and brittle nails. But some seem to tolerate these gel manicures and acetone soak removal with very little negative effect. The removal process is key here and we want to reiterate that this is often where significant damage can occur.

You also want to make sure you’re caring for your nails in between gel manicures. Just like we need to deep condition our hair from time to time, to help it recover from all the heat and chemicals we apply to it, we need to do similar treatments to ensure healthy, beautiful nails.

How can I get my nails back in shape if they have suffered damage from gel manicures?  

First, you will want to take a break from gel manis and regular polish altogether. This is the perfect time to take care of what Dr. Dana refers to as our “nail canvas”. When you do resume polish or gels or dips, the underlying nail will be healthier and stronger.

While you’re on a break from the salon, you can do a lot to bolster the health of your nails.  Anytime is a good time for Dr. Dana’s 3-step Nail Renewal System, but especially when you’re giving your nails a rest from gel polish and looking for an effective nail rehab solution. The easy-to-use system creates a glossy, natural nail in just 10 minutes—no polish required. This way your nails can look beautiful and presentable, as if you’ve gotten a natural nail mani.

What else should I be looking for in products to help rejuvenate nails that may be damaged by gel polish and acetone soak removal?

When taking a break from manicures, it is vital to have a good understanding of product ingredients so that you know what products to look for to enhance nail and cuticle health. There are loads of products on the market that claim that they help brittle, weak, dry, and dehydrated nails and cuticles.

Here are a few ingredients that will help your nails:

• Emollients and moisturizers that are rich in phospholipids such as sunflower oil, and Brazil nut oil.
• Keratolytics like alpha-hydroxy acids (AHAs) such as glycolic acid
• Strengthening agents like Pistacia lentiscus

Just like you care for your skin, don’t neglect your nail health.  Your nails are a significant part of your appearance and regular maintenance will give you great results, whether you decide to start getting gel manicures again or not.

Who among us hasn’t had a nail break at a very annoying moment like right before a big meeting or special event? Sometimes it’s a mere inconvenience or you think it looks bad, but occasionally a broken nail can be painful. What most of us often don’t consider are the causes behind breaking nails. Sometimes that can be brittle nails or dry nails, but there are also treatment and prevention options available that you may not know about.

Until now.

What makes nails more susceptible to breaking?

One of the most common breaking nail causes is brittle nails. Brittle nails are nails that are weak, peel, split, and break easily. The causes for brittle nails typically fall into two categories.

Genetic, Aging, and Medical Factors 

This first category includes the factors that are difficult to control, as some of them you may have just been born with. These can all cause or contribute to dry or brittle nails.

Genetics

• There is a statistically significant relationship between family history and brittle nails so if one of your parents has them, for example, there’s a good chance you might too.

Aging

• The physiology of your nails changes as you age and parts of the nail growth plate—or nail matrix—can become thinner or even atrophy which can cause ridges in the nail
• Aging also leads to less blood flow to your bodily extremities. For example, paralyzed patients have more brittle nails on the side where they do not have movement.

Medical Conditions

• Hypothyroidism (or underactive thyroid),
• Raynaud’s Disease, which causes some areas of the body like the toes and fingers to feel numb in certain circumstances.
• Severe protein deficiency

Environmental Factors

The second category are the environmental factors that can cause brittle nails and dry nails. You have much more control over these factors and can make lifestyle changes that could significantly improve the health of your nails.

Hydration + Water

• At this point in history, we are all washing our hands and using hand sanitizer more than ever—and it can take a massive toll on our nails and cuticles.
• Nails are extremely absorptive of water. Actually, they absorb water even more easily than our skin. So, what does this mean when it comes to the health of your nails? When water is constantly moving in and out of the nails, it puts a tremendous strain on the delicate nail cells, or oncocytes, This can result in weakening, softening and breakage. Your cuticles can become dehydrated which makes them more likely to lift and separate, causing hangnails or openings where infections can more easily gain entry.

Chemical Exposures

• Now, you may be thinking, “I don’t work with a bunch of chemicals…what do you mean?” But we’re guessing you may come into regular contact with something like nail polish remover. And if that remover contains acetone, it may be even more drying to the nails causing them to become brittle.
• All removers contain solvents like acetone, alcohol, ethyl acetate, or butyl acetate. Look for conditioning formulas that contain ingredients like soy or have added moisturizing benefits from oils. If you wear gel polish, the long acetone soak required to remove it can also be a major cause of dry or brittle nails. Even alcohol-based hand sanitizers can cause significant dehydration to both the nail and the cuticle barrier.

Weather

• We certainly don’t have control over the weather where we live but being aware of its impact on your nails can help.
• Exposure to extremes temperatures, both cold and hot, creates a flux nail cell state, constantly expanding and contracting. Consequently, this puts the nail under tremendous strain. This is especially relevant in the winter when we are often moving from cold to heated environments.

Products You Use

• Many so-called “nail strengtheners” still contain formaldehyde or formalin which can be very damaging to your nails. Formaldehyde will initially harden the nail—however, with time, the nail becomes brittle and is at risk for lifting or separating off of the nail bed.
• Formaldehyde can also cause severe allergic reactions in the surrounding nail folds. The skin becomes extremely irritated, swollen, and painful. There is also significant concern that these ingredients are carcinogenic.

What can I do to make my nails healthier to help avoid broken nails?

Think of a brittle nail that tends to break as something akin to overly processed hair that frizzes and has split ends. There are a few simple tips that can really help with your nail health.

First, try to keep your nails short—the smaller surface area will make nails less prone to breaking. If you’re doing anything that gets your hands wets—from dishes to gardening and everything in between—wear gloves. When choosing a nail file, go with glass. And if you’re picking a polish remover, choose one that is acetone-free if possible. Finally, take a nail polish holiday and consider putting color or clear polish on your nails every other week—with a nail treatment in between.

We condition and protect our hair to avoid these issues and we can try some similar tactics with nails. To help avoid future broken nails, choosing products with the right ingredients is key. The Dr. Dana Nail Renewal System is a 3-step nail system that treats brittle nails with formulas backed by science. Nails look glossy and shiny in just 10 minutes. But there is no polish involved and the whole process is mess-free. You can use this manicure-in-a-box to treat or prevent brittle, weak nails or to simply create a chic, long-lasting lustrous shine without the use of polish or harmful chemicals.

What should I do when I inevitably break a nail?

• First, you should clip the broken nail as close to the fingertip as you can. Next, using a glass/crystal file, gently file any snags, but be sure to avoid the split itself. We recommend our Dr. Dana Precision Glass Nail File.
• Try a do-it-yourself at-home silk wrap
  • Empty out a tea bag or grab a paper coffee filter.
  • Cut the teabag/coffee filter to the size of a small patch that can cover the break in the nail.
  • Paint the broken nail with a generous coat of base coat or nail glue.
  • While the base coat/glue is tacky, gently place the trimmed tea bag/coffee filter over the broken part of the nail. (It may be helpful to use a tweezer to hold and apply the tea bag segment).
  • Allow it to dry and then cover the nail with one or two more coats of base coat/nail glue.
  • After the base coat/nail glue has dried, you can polish with the color of your choice to camouflage the tea bag.
  • Note: Be aware that most nail glue contains acrylates, which are chemicals that can cause irritant and allergic dermatitis. Irritant dermatitis can occur after a single application, whereas the allergic version usually occurs after multiple exposures.

No matter how you like to wear your nails—polished or unpolished, long or more trimmed—a common wish many of us have is that our nails grow faster. From the person trying to fight the urge to bite their nails to the one who broke a nail so short they’re in pain, there are a million reasons to want nail growth. Unfortunately, it’s not something you can just manifest into existence. But understanding the science of the nails, the nail matrix, the causes of brittle nails and more can help you support healthy nail growth.

Let’s get into some of the basics first.

NAIL GROWTH

On average, how much do healthy nails grow per month?

A recent study showed average fingernail growth rates to be 3.47 mm/month in comparison to average toenails at 1.62 mm/month. However, even healthy nail growth rates tend to decrease as we age—and other studies have shown statistically significant differences in growth rates before and after the age of 40.

Aging aside, what are possible reasons for slow nail growth?

There are several variables that are associated with slower nail growth. For example, the nails can grow more slowly on your non-dominant hand. Nails grow faster in warmer months, so you may also notice seasonal changes. In addition, certain illnesses, like yellow nail syndrome, and compromised circulation can slow nail growth.

How does poor circulation affect nail growth?

 Like other parts of your body, nails receive their oxygen and nutrient supply from the blood stream. (However, it is a myth that “nails breath.”) Therefore, compromised blood flow to the fingers and toes—or peripheral perfusion—makes it harder for the delivery of rich, oxygenated blood to the nails.

Dr. Dana says she has even observed slower growth rates and the yellowing of the nails in patients whose hands are immobilized in a cast, as compared to the non-injured side, or in patients who are paralyzed on one side. These types of examples support the notion that compromised circulation can make nails grow slower.

But there are many other medical conditions that can lead to poor circulation and thus slow nail growth.  Raynaud’s phenomenon—which causes blood vessels in the hands and feet to spasm, especially in response to cold—is a classic example. Anyone suffering from a compromised lymphatic system, which can occur after radiation or certain malignancies, may also see a slowing of nail growth. Lifestyle can also be a factor. If you’re on the sedentary side, you may make your nails grow more slowly.

SUPPORT HEALTHY NAIL GROWTH

What are some easy ways to help your nails grow faster?

One way you help nails grow is to improve circulation. A healthy, active lifestyle is a big contributing factor, and of course promotes all sorts of other positive behaviors. But you can give yourself regular hand massages to help get the blood flowing to your fingers, as well.

The Dr. Dana Nail Treatment System incorporates a natural ingredient, Pistacia Lentiscus, which is derived from the sap of an evergreen tree that grows in the Mediterranean. Dr. Dana was intrigued by studies she had read on this Pistacia Lentiscus that indicated it might support nail growth. And although we have not done formal growth studies on the product, customers (and Dr. Dana herself) have shared their anecdotal observations about their healthy, faster growing nails.

What can I do to make my nails generally healthier?

There are a few things you can do to support your nail health and thus help your nails grow. First, try to limit your exposure to super hot or super cold weather. Exposure to extreme temperatures creates a flux nail cell state, constantly expanding and contracting. This puts the nail under tremendous strain and is especially relevant in the winter when we are often moving from cold to heated environments.

Protect Your Hands

You should also think about wearing gloves if your hands are going to have prolonged exposure to water. Nails absorb water even more easily than our skin. When that water is constantly moving in and out of the nails, it puts a tremendous strain on the delicate nail cells, or oncocytes. This can result in weakening, softening and breakage. Your cuticles can become dehydrated which makes them more likely to lift and separate, causing hangnails or openings where infections can more easily gain entry.

Treat Your Cuticles

It’s also very important to use a cuticle oil or treatment. A healthier cuticle means a healthier nail. This is one of the most important ways to keep the entire nail healthy because the cuticle is the nail’s natural protective seal. A dry, dehydrated or non-existent cuticle will result in a compromised cuticle seal, potentially allowing water and infections to enter the nail. This subsequently may cause an inflammation and infection of the skin surrounding the nail called paronychia.

Exfoliate and Condition Your Nails

We condition and protect our hair to avoid frizz and split ends and we can try some similar tactics with nails. This makes them less brittle, thus less likely to break and more apt to grow. The Dr. Dana Nail Renewal System is a 3-step nail system that treats nails with formulas backed by science.

Essential exfoliation is an important part of this process because it removes superficial damage and dead nail cells at the surface. This means you can more effectively treat and moisturize the nail, bringing “the canvas” back to a healthier state. Think of it as a facial for the nail. This is how the Dr. Dana Nail Renewal System works. Steps one and two are the exfoliation process, while step three is the deep hydrating and strengthening treatment. Plus, your nails look fantastic when you’re done—in under 10 minutes.

But there is no polish involved and the whole process is mess-free. You can use this manicure-in-a-box to treat or prevent brittle, weak nails or to simply create a chic, long-lasting lustrous shine without the use of polish or harmful chemicals.

Use Glass Files

And if you do break a nail, you can help it grow back stronger by using a glass file, like the Dr. Dana Precision Glass Nail File. This counts for general nail shaping and filing too.

Here at Dr. Dana, we believe that taking care of your nail health is just as important as that of your skin, hair, and the rest of your body. Strong, healthy nails are an indicator of a strong, healthy body. Plus, they look great. There are so many contributing factors when you talk about how to keep nails healthy—from which nail polish remover you choose to how you protect your nails while doing simple household chores like washing dishes.

Dr. Dana Stern has devoted her dermatological career to focusing on nail health—and that includes ways to protect nails and keep them from weakening or becoming brittle.

Let’s break down some of the most common questions when it comes to nail health so that you have a better understanding of how to get strong, healthy nails.

Is it true that if you want healthy nails you need to leave them polish free for the same amount of time as you wore the polish?

This is a random and arbitrary rule of thumb because everyone reacts differently to nail polish. There are many different polish brands and even the way polish is applied and removed can influence how the nails recover.

If your nails are tolerating prolonged use of nail polish, then go ahead and enjoy. But do note that a basic polish should typically be worn for about one week on the fingernails and two to four weeks on the toenails.

Weekly manicures do not necessarily cause damage to everyone’s nails. However, certain nail enhancements such as gel polish and acrylic removal can significantly thin the nail plate. This can cause brittle nails that are damaged and weaker than usual. That may indicate it’s time for you to take a polish holiday and work on your nail health. Using products that contain formaldehyde can also weaken nails because they cause the nail to harden and stiffen, preventing flexibility and often leading to separation and breakage.

What are the specific signs to look for to know if I need a nail polish holiday?

• Brittle Nails
  • Nail polish removers are solvents and tend to be very drying and dehydrating to the nail. The constant use of a remover’s harsh chemicals can lead to dry, brittle nails that are weak, peeling, and easily breakable.
• Keratin granulations
  • These white patches and surface changes to your nails occur often after wearing polish for a prolonged period. Think about that cranberry red from Christmas that you didn’t get around to properly removing until months later—and what the aftermath looked like. When the polish is removed, the superficial layers of nail cells are also stripped away, leaving uneven, white, rough patches. They will grow out and fade with time, but this can sometimes take weeks to months.
• Nail yellowing
  • The most common cause for nail yellowing is from polish itself. This happens because the porosity of the nail is variable. Certain people have more porous nails and are just more prone to pigment migration and thus, yellowing.
  • Nail polish remover also dissolves the polish and makes the pigments migrate and leach. Therefore, you may see more yellowing with the no-chip/gel manicures which require 10 min soaks in acetone for removal.
• Not all nail polish dyes are alike. The darker the color, the more pigment, which can lead to increased yellowing. While yellowing is an issue with all brands, the issue is more shade dependent than brand dependent.
• If you don’t use a good quality base coat to shield the nail, you may experience yellowing.

How can I keep my nails healthy between polish applications?

In between polish applications, it is important to care, maintain and prevent nail damage just like we do with our skin. Essential exfoliation is an important part of this process because it removes superficial damage and dead nail cells at the surface. This means you can more effectively treat and moisturize the nail, bringing “the canvas” back to a healthier state. Think of it as a facial for the nail.

This is how the Dr. Dana Nail Renewal System works. Steps 1 and 2 are the exfoliation process, while Step 3 is the deep hydrating treatment.

What are the best ways to keep your nail beds healthy and prevent infections?

• Cuticle care
  • This is one of the most important ways to keep the entire nail healthy because the cuticle is the nail’s natural protective seal. A dry, dehydrated or non-existent cuticle will result in a compromised cuticle seal, potentially allowing water and yeast to enter the nail. This subsequently may cause an inflammation and infection of the skin surrounding the nail called paronychia.
  • If the infection persists, it can eventually affect the appearance of the nail, causing white spots and depressions.
  • A dry and compromised cuticle can also be a set up for bacterial infections. In this scenario, the nail becomes red, swollen, warm and painful and will often need to be drained and treated with an antibiotic by a physician.
• Gloves
  • When working with chemicals or water, wear gloves to protect the nails and cuticle and help keep your nails healthy.
  • The nails are 1000 times more absorbent of water than the skin and that absorption puts a tremendous strain on nail cells leading to brittleness, weakness, and breakage.
• Short nails
  • Keeping nails shorter means the surface area is smaller and you can help prevent absorption of water and harsh chemicals.
• Dry manicures
  • This means no soaking in water, which puts a strain on the nail.

There are numerous polishes out there that are labeled 10-free, 5-free, etc. What are the top ingredients to avoid to protect nails when choosing a polish formula?

Here are Dr. Dana’s ingredients to avoid for healthy nails:

• Formaldehyde
  • This is used as a preservative in cosmetics and is a known carcinogen that is also linked to asthma, neurotoxicity, and developmental toxicity.
• Phthalates (DBP, DEHP, DEP and others)
  • This is a class of plasticizing chemicals used to make products more pliable. Phthalates disrupt the endocrine system and may cause birth defects.
• Toluene
  • This is a volatile petrochemical solvent that is toxic to the immune system and can cause birth defects.
• Formaldehyde Resin
  • This is used to helps polish adhere to the nails but is also an allergen and environmental toxin.
• Camphor
  • This is used as a plasticizer in nail polish. But if you inhale too much, it can lead to headaches, dizziness, nausea, and seizures.
• Triphenyl Phosphate
  • This is a plasticizer used to make polish flexible and durable, but it is also an endocrine disruptor and possible marine pollutant.
• Xylene
  • This is a solvent that keeps your nail polish from getting gloppy; it’s also a known allergen and possible carcinogen. It is a known human nervous system and respiratory toxicant, irritating to skin, eyes and lungs.
• Ethyl Tosylamide
  • This is a film forming plasticizer. In Europe, ET is considered to be a sulfonamide and based on the prohibition of sulfonamides in cosmetics, it may not be used in cosmetics and personal care products marketed in Europe.
• Parabens (methyl-, isobutyl-, propyl- and others):
  • This is a class of preservatives commonly used to prevent the growth of bacteria and mold. Parabens are endocrine—or hormone—disruptors, which may alter important hormone mechanisms in our bodies.

Does wearing a base coat help prevent nail damage?

Absolutely.  Wearing a base coat is an important step for any manicure because it provides a base protective layer. It is also crucial for polish adhesion and therefore for the life of your manicure.

 What other maintenance tips do you recommend to keep your nails healthy?

Do:

• Care for cuticles in between manicure appointments. Don’t forget to apply your favorite cuticle oil or cream throughout the day, especially in cold, dry months or when exposed to excess water, like going swimming in summer. Oil formulations are absorbed by the cuticle more effectively than creams are.
• Use a glass or crystal nail file instead of a cardboard emery board. Traditional cardboard emery boards create microscopic tears in the free edge of the nail that lead to splits and breakage. Glass creates a clean, free edge resulting in a smoother nail and polish that is less apt to chip.

Don’t:

• Use nail brushes. Dr. Dana often finds that when she has a patient with nail separation that does not respond to treatment, they are often using a nail brush. These devices can harbor yeast and bacteria and cannot be properly sterilized.
• Use nail products that contain harmful ingredients. Check out the above list for ones to watch out for, so you can maintain the healthiest nails possible. If you feel like you have a “miracle” nail strengthener, check the ingredients, chances are you will find formaldehyde or formalin.