Beyond the Polish: A Dermatologist’s Guide to Truly Healthy Nails

By Dr. Archana Kotkar Board-Certified Dermatologist

In my practice, I often see patients who are meticulously dedicated to their skincare routine but completely overlook the health of their nails. We tend to think of nails as merely a canvas for polish or an aesthetic accessory. However, your nails are so much more than that.

They are complex structures made of keratin, and their appearance can be one of the first visible signs of your overall health. Brittle, discolored, or ridged nails aren’t just a cosmetic concern—they can be your body’s way of sending you a message.

Achieving strong, healthy nails isn’t about expensive salon treatments. It’s about understanding what your nails need and adopting simple, consistent habits. Let’s dive into the science of nail health from a dermatologist’s perspective.

The Anatomy of a Healthy Nail: What’s Normal?

First, it’s helpful to know what we’re working with. The nail plate (the hard part you see) grows from the matrix, which is under the skin at the base of your nail (the lunula or “little moon”). The cuticle is a crucial seal that protects this matrix from bacteria and infection.

Healthy nails are:

• Smooth with a consistent surface, free of major pits or ridges.
• Uniform in color, with a pink nail bed and a white free edge.
• Firm but flexible, not brittle or prone to breaking.

The Foundation of Healthy Nails: Your At-Home Care Routine

Proper nail care is gentle care. Aggression is the enemy of health here.

1. Moisturize, Moisturize, Moisturize!

Just like your skin, your nails and cuticles need hydration. When nails are dry, they become brittle and prone to splitting.

• Action: Apply a thick moisturizer or a dedicated nail cream to your hands and cuticles every time you wash your hands and especially before bed. Look for ingredients like urea, phospholipids, or alpha-hydroxy acids.

2. Master the Gentle Manicure

• Filing: Always file in one direction with a soft, fine-grit file. Sawing back and forth weakens the nail layers, leading to peeling.
• Cutting: Cut nails straight across to prevent ingrown toenails. You can gently round the edges.
• Cuticle Care: Do not cut your cuticles. They are a vital barrier. Instead, after a shower, gently push them back with a soft towel or a wooden stick.

3. Protect Your Hands

• Gloves are a must: Wear waterproof gloves when doing dishes, cleaning with chemicals, or gardening. Prolonged exposure to water and detergents strips natural oils from the nail plate, leaving it weak and dry.

4. Be Polish-Smart

• Give Breaks: Constantly wearing nail polish, especially gel or acrylics that require filing and harsh chemicals for removal, can thin and damage the nail plate over time. Take breaks between manicures to let your nails breathe and recover.
• Skip Acetone: Choose acetone-free nail polish removers. Acetone is extremely drying and damaging.

You Are What You Eat: Nutrition for Strong Nails

If your nails are weak, the problem might be internal. Nails are built from the inside out.

• Biotin (Vitamin B7): The most famous nail vitamin. Studies suggest high doses of biotin can help strengthen brittle nails. Find it in eggs, nuts, seeds, and salmon.
• Protein: Nails are made of keratin, a protein. Ensure you’re getting enough high-quality protein from sources like lean meat, fish, beans, and lentils.
• Iron: Iron deficiency (anemia) can cause pale skin and spoon-shaped nails (koilonychia). Focus on leafy greens, red meat, and fortified cereals.
• Zinc: Zinc is crucial for cell growth and division, including in the nail matrix. A deficiency can cause white spots. Find it in seafood, pumpkin seeds, and chickpeas.
• Hydration: Drink plenty of water. Dehydration shows up in dry, brittle nails.

Decoding Your Nails: Common Problems and What They Might Mean

As a dermatologist, I often examine nails for clues about systemic health. Here’s what some common changes might indicate:

• Brittle, Splitting Nails: Most often caused by external factors: repeated wetting/drying, exposure to chemicals, or overuse of polish. Can also be linked to aging or an underactive thyroid.
• White Spots (Leukonychia): Usually the result of minor trauma to the nail matrix (like bumping your finger) and are harmless. Not typically a sign of calcium deficiency.
• Vertical Ridges: These are often a normal sign of aging, like wrinkles for your nails. They become more prominent as we get older.
• Yellowing: Can be caused by nail polish stains or, more seriously, a fungal infection (onychomycosis).
• Pitting: Small, pinpoint dents in the nail surface can be associated with psoriasis or alopecia areata.
• Dark Vertical Bands: A band of pigment from the cuticle to the tip can be benign in darker skin tones but must always be evaluated by a dermatologist to rule out melanoma, a serious skin cancer.

When to See a Dermatologist

While many nail issues are benign, please schedule an appointment if you notice:

• A new or changing dark streak on your nail.
• Nails that are pulling away from the skin beneath (onycholysis).
• Signs of infection: Pain, redness, swelling, or pus around the nail.
• Severe brittleness or distortion that doesn’t improve with gentle care.
• Changes you are concerned about. We are experts in the skin, hair, and nails and can provide a proper diagnosis and treatment plan.

The Final Takeaway

Healthy nails are a reflection of healthy habits. By being gentle with your nails, protecting them from harm, and nourishing your body from within, you can build a strong foundation for nails that look and feel their best—with or without polish.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Please consult with a qualified healthcare provider for diagnosis and before starting any new treatment.