Pathogenesis, Clinical Signs and Treatment Recommendations in Brittle Nails: A Review

Marco A. Chessa, Matilde Iorizzo, Bertrand Richert, Jose L. López-Estebaranz, Dimitrios Rigopoulos, Antonella Tosti, Aditya K. Gupta, Nilton Di Chiacchio, Nilton G. Di Chiacchio, Adam I. Rubin, Robert Baran, Shari R. Lipner, Ralph Daniel, Soumya Chiheb, Chander Grover, Michela Starace, Bianca M. Piraccini

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


Nail plate brittleness (or fragility) is a common complaint affecting up to 20% of the population, especially women over 50 years of age, with fingernail fragility being more prevalent than toenail fragility. Nail brittleness is characterized by nails that split, flake and crumble, become soft and lose elasticity. The main clinical presentations are: onychoschizia, onychorrhexis, superficial granulation of keratin and worn-down nails. According to causative factors, we can distinguish 2 forms of nail fragility (NF): a primary “idiopathic or brittle nail syndrome” form and NF secondary to different causes such as inflammatory nail disorders, infections, systemic diseases and general conditions, traumas and alteration of the nail hydration. Optimal management requires treatment of the primary cause of brittle nails, when possible. In idiopathic NF oral supplementation, vitamins (especially biotin, also known as vitamin B7), trace elements and amino acids (especially cysteine) have been reported to be useful. In addition, several products, such as topical moisturizers and lacquers could be considered to restructure the affected nail plate and to reduce psychological impacts of this common problem.

Original languageEnglish (US)
Pages (from-to)15-27
Number of pages13
JournalDermatology and Therapy
Issue number1
StatePublished - Feb 1 2020


  • Aging
  • Nail brittleness
  • Nail cosmetic
  • Nail fragility
  • Onychorrhexis
  • Onychoschizia

ASJC Scopus subject areas

  • Dermatology


Dive into the research topics of 'Pathogenesis, Clinical Signs and Treatment Recommendations in Brittle Nails: A Review'. Together they form a unique fingerprint.

Cite this