Why do my nails look weird?

In psoriasis, the nail can become dented, pitted and/or discoloured. — Photos: Filepic

I noticed that recently, my nails have become brittle and easily breakable. I was told that this is because I lack some minerals in my body. Is that true? What is the cause of brittle nails?

Nails that are soft and thin, and split or break easily, i.e. brittle, are also called onychoschizia.

It is quite a common problem.

They are typically caused by repeatedly wetting and drying your nails, e.g. if you do a lot of washing with your hands or go swimming regularly.

Yes, this is indeed the simplest and most common cause.

If that is indeed the reason, it will only affect your fingernails and not your toenails.

Less common causes may include iron deficiency or underlying illnesses.

These tend to affect both your fingernails and toenails.

How can I make it go away?

Brittle nails that are caused by repeated washing or wetting can be protected by using moisturisers.

You should also protect your nails and hands when you are using detergents, chemicals or washing liquids by wearing rubber gloves.

You need a blood test to test for iron deficiency.

If you are indeed deficient in iron, you will need iron supplements until you recover.

Of course, the doctor also needs to find out the cause of your iron deficiency.

I have a cousin who has dented nails, which also have little pits in them. What is the cause of this?

Nail psoriasis can cause pitted, dented or crumbling nails.

The nails may even change colour to yellow or brown.

Psoriasis causes extremely scaly skin that flakes away, so the skin buildup underneath the nails can sometimes cause the nail to be separated from the nail bed.

There might even be some bleeding under the nail.

If you have psoriasis, you need to see a dermatologist, who will be able to treat all the affected parts of your skin, including your nails.

For psoriasis in nails, the dermatologist may give you:

• A strong corticosteroid cream or steroid injections
• Tazarotene for nail pitting and discolouration
• Calcipotriol for the buildup of skin under your nail
• Laser treatment.

I think some of my nails have turned yellow too. Do I also have psoriasis?

You may be having a nail fungal infection.

When you have fungus on your nails, they may become thick, discoloured and break off easily.

It is actually more common in your toenails than your fingernails because your feet are more exposed to fungus in the environment than your hands.

Sometimes, when you have a crack or break in your nails, fungus can enter that crack and grow.

You are at higher risk if you sweat a lot, go around barefooted in wet locker rooms (athlete’s foot), or go for manicures and pedicures.

This condition is usually not painful.

The doctor may prescribe antifungals or fully remove your nail, which will grow back.

Certain nail conditions, like a ram’s horn nail, require professional help and advice from a podiatrist or dermatologist on how to cut it properly.

My husband has a toenail that is very thick and hard. It is almost like a horn. What causes it?

This is called onychogryphosis. It usually affects the toenail, especially the big toe.

It happens when the nail becomes overgrown and thick.

You may even notice that one portion of your husband’s toenail has grown thicker than the others.

Some people call it “ram horn’s nails”, because it resembles a ram’s horn.

It is usually caused by genetics.

Sometimes, it can be caused by injury to that toenail (and big toes usually get stubbed before the other toes), poor blood circulation, psoriasis or a skin condition called ichthyosis.

Oh? My husband has difficulty cutting that toenail off, and it keeps growing back. He is active in sports, and would like to wear sports shoes, but this is getting in the way.

Your husband will need to see a podiatrist or dermatologist to help him cut that nail.

They will show him how to do it properly at home.

Be aware though that your husband may need to go to the doctor several times because it will regrow.

The only permanent treatment for it is to remove your husband’s nail bed completely.

Yikes, that sounds alarming! My son also has an ingrown toenail on his fourth toe. Is this dangerous?

An ingrown toenail can sometimes cause pain and swelling, and even become infected – that is when it gets dangerous.

What causes an ingrown toenail?

Sadly, a lot of it is due to genetics again.

But it can also be caused by not keeping your nails trimmed neatly, if you frequently wear tight socks or shoes, or physical injury to that particular toenail.

Your son can try to soak that nail in warm water three to four times a day.

He also needs to wear comfortable shoes that let his feet and nails “breathe” and “grow”.

His feet need to be kept dry.

If nothing else works, your son may need surgery.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email [e-mail]. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.