Your nails don’t always stand up to the use you put them to, and when they don’t, they crack!

Just yesterday, an 80 year old patient asked me why his fingernails were dry, brittle and splitting on the ends.  He’d always had strong nails.  He wanted to know if I thought Knox Gelatin Capsules would work for him; it’s what his mother used when she had nail problem. They didn’t work for her, but he didn’t know what else to do.

Almost every day I’m asked by someone for advice to fix their brittle, splitting fingernails because the problem is so common. It can happen at any age, but it’s definitely one of those “as we age” stories. If your nails are splitting, there are things you can do to improve them, but there are also common ‘remedies’ that actually make the problem worse.

THE PROBLEM:

Your nails dry out as you age, losing their natural oils which act as a glue to hold the nail layers together. If you have thin fingernails and dry skin to begin with you can expect this to happen to you ‘sooner rather than later’.  Exposing your hands to harsh soaps, cleaning products, solvents and rough work makes things worse. At first your nails begin to ‘fray’ on the edges, becoming brittle. Eventually the layers split.  Nail hardeners make this worse because the alcohols, formaldehyde and other chemicals in the nail hardeners really dry out your natural oils. (Crazy fact: Nail hardeners actually contain more of these chemicals than nail polishes!  It’s these chemicals that make the nails feel harder at first, but- whammo- after a few weeks the splitting is worse than ever.)

THE FIX:

Dermatologist’s 3 Simple Tricks To Treat Cracked And Splitting Fingernails:

1. Hydrate and add oils.  Use creams, oils and ointments on your nails everyday after they’ve been wet. My favorite is good old Bag Balm with it’s wool alcohol (aka lanolin).  Some of my other favorite hydrating ingredients for nails are Shea Butter, Jojoba oil, avocado oil, or other rich natural oils.  The thicker the cream the better, and oils or ointments are best. The trick is to use something that stays put for awhile and doesn’t just rub off right away.  Plus, you always moisturize skin and nails immediately after water exposure; applying moisturizers to dry nails is a waste of time.  Put your moisturizer on within minutes after your bath or shower, or after washing your hands.  Do it as often as possible.  You can use a hand cream during the day (I love my Intensive Hand Cream, which is non-greasy), but use a thicker product like Bag Balm at bed time. If your nails are really bad, apply Bag Balm to them numerous times a day after washing your hands.
2. Clip and file your nails when they’re wet. Clipping and filing dry nails makes the splits worse so always do it after water exposure.  Towel off the water and then use sharp nail clippers to trim your nails, followed by gently filing the edges.  You can also very gently buff the nail edges to keep the splitting layers from catching on things and progressing down the nail.
3. Wear gloves when you do rough work or get your hands into harsh chemicals. Obviously you want to protect your brittle and splitting nails from the things that make them worse.

Gelatin capsules don’t work but vitamin supplements formulated specifically for nail growth may help. I’ve had patients who feel that their nails grew a lot faster and stronger once they started taking supplements. Nail supplement formulations appear to vary, though most contain biotin.  I tell patients to go to their favorite high quality natural food store and ask the vitamin specialist for their best nail formula.  It’s important to know that many of the ingredients in these supplements are lavishly present in whole foods like fruits, vegetables, whole grains, nuts, natural oils, beans and fish.  Eating a richly nutritious diet is key to supporting healthy nails and vitamin supplements should be used in addition to, not in place of a healthy diet.

Your fingernails grow slowly, about 1mm per month.  As you age, the growth slows down even more.  This means it will take several months for the dry and split portion of your nails to grow out.  Depending on the condition of the rest of your existing nails, it could take as long as a year for proper nail care, good diet and your vitamin supplements to stop the nail splitting, so hang in there and don’t give up.

Lastly, there are internal diseases that can affect your nails, the most common being thyroid problems and anemia.  Some skin diseases affect the nails as well and cause splitting.  If your nails don’t improve, see your doctor.

I’d love to hear any tricks or products you’ve found to improve your brittle and splitting fingernails.

If you found this information helpful you may also want to read:

Pandemic Of Dry Hands; Hand Sanitizers, The Swine Flu And Tips To Save Your Hands

Natural Skin Health; Dermatologist’s Diet Recommendations For Healthy Skin

Dermatologist’s 3 Simple Steps For Sandal Ready Feet By Spring

Photo:

http://www.flickr.com/photos/tonythemisfit/2432720887/ Tony The Misfit

Do you know that tretinoin, the active ingredient in Retin A, breaks down in sunlight?

And, do you know that if you apply it to moist skin, it’s more likely to cause peeling and skin irritation?

Lastly, do you know that some of the common and really good ingredients in other skin care products aren’t compatible with tretinoin?

Used correctly, tretinoin does amazing things for skin. I love tretinoin and have personally used it for over 25 years. My skin looks better now than it did then. I’ve also written thousands of prescriptions for it in that same period of time and I’ve helped the same number of patients integrate it into their skin care treatments.

Just this last month I had interesting conversations with two of these patients, both of whom expressed gratitude for my recommending tretinoin and attributed the healthy condition of their skin to their years of tretinoin skin therapy:

The first patient is a woman in her early 60s with rosacea and a history of skin cancer who said that she had more wrinkles 15 years ago when she started using tretinoin than she does today. Her pores appear smaller and her skin texture is better, and she feels it’s the tretinoin that’s helped.

The second patient just turned 39 and looks like she is in her mid-twenties. She started using tretinoin at 27 and says she, too, looks better now than she did then. While getting a pedicure to celebrate her birthday, the woman giving her the pedicure was astonished when she found out that my patient was over 30.

Tretinoin therapy is well worth the effort in my opinion, but there are tricks to doing it right.

The three key tricks I tell my patients for using Retin A (tretinoin) correctly

1. Always apply it to your skin at bedtime, never use it during the day.
2. Never apply it at the same time you also have products on your skin that contain glycolic acid or benzoyl peroxide .
3. Always wait at least 15 to 30 minutes after washing your skin and applying any other skin care products before you apply tretinoin. I personally keep my tube of tretinoin on my bedside table and read a little to pass the time before I apply it.

My tube of tretinoin sitting on my bedside table

Additional treatment tips to help skin tolerate tretinoin therapy

• Start tretinoin therapy by using the product twice a week (every third night) and slowly increase to every night over a month or two as your skin adjusts. A little scaliness and irritation is normal at first, but if the treated skin becomes really sensitive, back off and wait. Let the skin return to normal then begin treatment again. Slowly try to increase to every night as your skin adjusts.
• Apply a ‘pearl-sized’ portion to the face. Use the same amount for the neck and/or chest.
• If your skin continues to become irritated and just won’t adjust to tretinoin treatment, then switch to entirely non-irritating cleansers like Toleriane Cleanser or Nobel Zinc Soap. Many cleansers are too irritating for tretinoin treated skin.
• If your skin becomes red and irritated for any reason (eg. wind burn, sun burned, harsh skin care products, surgical or cosmetic procedures etc.), don’t apply tretinoin until your skin has entirely returned to normal. This is because tretinoin irritates irritated skin!

Important things to know about tretinoin treatment

• Tretinoin-treated skin is very exfoliated and should not be waxed for hair removal.
• Any doctor or skin care specialist performing a procedure such as a chemical peel, microdermabrasion, laser or light treatments etc. needs to know you are on tretinoin. They may ask you to stop it for a period of time before and after your treatment.
• Anyone who is or may be pregnant should not use tretinoin.
• Anyone using tretinoin must sun protect their skin or they will have more skin sun damage than if they never used tretinoin, again because tretinoin skin is very exfoliated.

Lastly, why bother with this tricky and sometimes inconvenient skin care treatment?

Scientific studies and my medical experience give me so many reasons to be a big fan of tretinoin:

• It has proven itself to reduce, reverse, and prevent wrinkles. The younger a person starts (teens and twenties), the more benefit they receive, but it’s never too late!
• It helps lighten and prevent age spots.
• It builds collagen to thicken and increase the structural strength of treated skin.
• It helps to decrease a person’s risk of developing skin cancer.
• Skin just looks better and younger when they use tretinoin.

I’ve used tretinoin for over 20 years and will continue to do so. I see the benefits every day in the mirror and for me these benefits outweigh the inconveniences. How about you? What are your stories?

If you found this information helpful, you may want to read:

5 Steps For Smart Sun Protection

How To Get The Most Out Of Your Anti Aging Skin Care

How To Unclog Your Clogged Pores

• Strappy sun dresses, tank tops and bathing suits are part of summer. Is your skin ready for you to wear what you want, or do you have to wear clothes that hide pimples on your back and chest?
• Tune up your skin for summer’s clothes with some simple tweaks to your skin care.

A lot of people have acne on their back and chest, but you don’t see it because they cover it up with clothes. There’s also not a lot of advice out there for treating back and chest acne which means that I see many of these folks in my dermatology practice.

Most of my back and chest acne patients have the type of acne called pityrosporum folliculitis. This type of acne is caused by a different acne germ than the more common form of acne called acne vulgaris, and it needs different treatment in order to improve. Pityrosporum folliculitis is caused by a yeast called pityrosporum. To treat it, you need to use medicines and skin care practices that get rid of this yeast and most regular acne treatments don’t.

Here’s the 5 step plan I give my dermatology patients to treat their back and chest acne:

1. Wash the back and chest skin with medicated products that specifically treat this type of acne. Products need to kill yeast and unclog the pores. I developed my Back Acne Kit in order to makes this step easy for my patients. It has one cleanser with 2% zinc pyrithione to kill yeast and another with 10% benzoyl peroxide to unclog pores. The cleansers are applied with an exfoliating cloth to help the medicines penetrate into the skin. There are some tricks to using these two medicines and the kit comes with complete instructions.
2. Keep the back and chest skin as sweat and oil free as possible. The yeast germ that causes this type of acne feeds on oil and sweat. Showering at least once a day with the medicated cleansers is important, but so is showering as soon as possible after workouts or any other sweaty activities. If it’s not possible to shower immediately after sweating, I recommend, at least degrease the skin with rubbing alcohol and changing into a clean dry shirt.
3. Special skin treatments such as ‘back facials’ and light skin peels can really help. These are done in the dermatologist’s office or by aestheticians. I usually recommend they be done every month until the skin clears up.
4. Diet matters with back and chest acne. The yeast thrives on sugar rich oily skin. Eating low carb, low fat foods puts the yeast on a starvation diet. My Alkaline Mediterranean diet is perfect for people with back acne; it provides you with nutritionally rich foods while closing the restaurant to the yeast.
5. As an absolute last resort, a little careful sun exposure often helps this type of acne. Sun exposure is highly controversial, and I only recommend it to my patients with severe back and chest acne who aren’t improving enough in spite of doing everything I’ve already mentioned-AND who have a big event where they need clear skin (like prom, a wedding etc.) Then, and only then a little mid day sun unfortunately can help clear back and chest acne in a pinch. Sun works because it suppresses the skin’s immune cells that are fighting the yeast in the pimples. 5 minutes of mid day sun, without a sun burn, can sometimes help heal the pimples pretty fast. Sun of course causes permanent damage to the skin in the form of freckles, wrinkles and skin cancers. The damage can never be reversed, so sun is of course a last resort and only done for the short period of time before the event. Tanning beds are an absolute no-no and should never be used.

Photo Attribution:

Dr. Dr. Bailey:
Your antioxidant skin care program has been such a help for my post menopausal skin.  Thank you.  I was wondering if you have any suggestions regarding cosmetics for flaky skin that is prone to breaking out.  Is there any difference between eye shadows, liners, powder and blushes or is one just as good as the other as long as the skin care program is sound?
Thank you, Helen

Dear Helen,
I’m so glad to hear that My Antioxidant Kit is helping your post menopausal skin! Thank you for your feedback.

I wonder why your skin is flaky and breaking out.  Common skin conditions that occur as we age and that cause facial skin to flake and break out include rosacea and seborrheic dermatitis.  You may want to see your dermatologist to see if you may have one of these conditions.

What ever the cause of your skin problems, it’s hard to put makeup on flaky skin. Makeup color goes on heavier in the scaly areas and looks uneven.  To create an even skin surface before putting on makeup many of my patients find it helpful to first cleanse and gently exfoliate their skin with nondrying  Noble Zinc Soap and the Facial Buf Puf.

The second issue is that adult skin that is prone to ‘breaking out’ is often actually sensitive and easily irratated.   The goal with makeup is to create the aesthetic appearance  you want without irritating your skin problems. This means figuring out what products flair up your skin and avoiding them.   Look for products that claim to be gentle and hypoallergenic.   Anti aging ingredients in makeup can be irritating so I recommend avoiding them; they won’t be present in therapeutic amounts and you’re already using great anti aging products in the antioxidant kit. This goes for your moisturizer as well.  Your moisturizer and makeup should sooth and support the antioxidant kit products, not irritate your skin; they should ‘dial in’ the moisture and appearance you want- and that’s all!

My favorite type of gentle, hypoallergenic makeup for sensitive skin is mineral make up. I especially like the loose powders. Powders don’t need to be preserved like liquids do and so they have fewer chemical ingredients that could irritate your skin.  There are great foundations, eye shadows and blushes that are loose or compressed powders and that are made with high quality natural ingredients. They look great and the minerals often provide additional sun protection on top of your sunscreen giving you an anti aging bonus. Eyeliners on the other hand have to be moist or waxy which means they’ll need some chemical preservatives.  The good news is that eye products are formulated to be extremely gentle so they are rarely a problem for sensitive skin.

Mineral makeup brands that I or my patients have had consistently good experience include:

1. Drug store brands like Almay and Neutrogena and Physician’s Formula.
2. Department store brands like Clinique and Prescriptives.
3. Spa and boutique brands like Bare Minerals, Glo Minerals and Jane Iredale.
4. Natural food store brands like Dr. Hauschka, Hemp Organics and Mineral Fusion.

There are many other good mineral makeup brands that I haven’t listed.    Try the products before you buy them.   Ideally you want to wait 24 to 48 hours to see if your skin tolerates a product before you buy it.

One last important point about makeup and post menopausal skin is that we often should use less of it as we age. This seems counter-intuitive but unfortunately makeup can accentuate wrinkles and sagging skin.  This is because makeup products migrate into our creases during the day, making them more visible. The lesson here is that there’s no substitute for powerful anti aging skin care and good sun protection, like the Antioxidant Kit that your using.

I hope this helps.

Warm Regards,

Cynthia Bailey MD, Dermatologist

If you found this information helpful, you may also want to read:

Facial Skin Care For Problem Skin With Rosacea, Seborrhea and Clogged Pores

Disclaimer: Please realize that availing yourself of the opportunity to submit and receive answers to your questions from Dr. Bailey does not confer a doctor/patient relationship with Dr. Bailey. The information provided by Dr. Bailey is general health information inspired by your question. It should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem (and is not an extension of the care Dr. Bailey has provided in her office for existing patients of her practice). Never ignore your own doctor’s advice because of something you read here; this information is for general informational purpose only.

Dermatologist Dr. Cynthia Bailey answers your questions about skin care and skin problems

Dear Dr. Bailey,

I have facial seborrhea dermatitis, rosacea and clogged pores in the T zone, plus age spots. I am 49 years of age. I recently tried Obagi Blender which caused acne. I have Solbar sunscreen which also causes some breakout and seems a bit heavy/oily. With my skin so problematic and sensitive, I thought to try your green tea cream, zinc soap for the seborrhea, but am unsure about sunscreen and when to work on the congestion and age spots. My dermatologist really isn’t into cosmetic treatments, but does have me on Oracea for my rosacea, but is not approved for long-term use. Complicated, I know, but hope you can help. I though about Rodan + Fields new line, but it has fragrance and is really pricey.

Thanks, Lisa

Dear Lisa,

You sure have the double, triple, quadrupedal whammy of facial skin issues-and your not alone!

I can’t tell you how many patients I see with exactly your combination of skin problems, including myself.  You have tried some good products, you have some good ideas and your on the right track.  Assuming that your doctor has correctly diagnosed your rosacea and seborrheic dermatitis, I totally agree with your idea to try the Noble Zinc Soap and the Replenix CF Cream to quiet these skin conditions.

I have found Replenix CF Cream and Noble Zinc soap to be wonderful skin care products for helping to calm both rosacea and seborrheic dermatitis. These are also the foundational products for many of my anti aging skin care regimens.  They are oil free and should not clog your pores.  Plus, they are non irritating, and in fact very soothing for facial skin rashes.  Both of those are key characteristics for skin care product tolerance in people with sensitive skin.

I also applaud you for your determination to use a high quality, micro zinc oxide sunscreen like Solbar Zinc.  I love this product, but it does have a heavy feel.  It is actually oil free, but the water resistant base feels oily.  I recommend Solbar Zinc for wet, sweaty activities, but most people don’t use it as their every day sunscreen in my practice.  I recommend instead that you try the Citrix Sun Screen. It has a drier feel yet the same excellent UVA and UVB protection as the Solbar Zinc because it too is a micro zinc oxide sunscreen.  Patients find that it is non-irritating, doesn’t sting eyes and won’t clog pores.

I can’t stress enough the need to wear a  5% or higher Micro Zinc Oxide Sunscreen EVERYDAY!

Broad spectrum UVA and UVB sunprotection is critical for anyone who wants to lighten their age spots.  Micro Zinc Oxide is the best sun screen ingredient for complete, broad spectrum UVA and UVB sun protection in my opinion. Sunscreen needs to be applied every day, regardless of what activities are on the adgenda and regardless of what time of year it is.

I tell people to put their sunscreen on with their skin care products first thing in the morning.  I have them wash, put on Repleinx CF Cream followed immedietly by any other products they use. They then finish with Citrix.  Make-up of course goes on top as the last product applied.  No need to wait and let things dry.  Skin products are like the different foods we eat, they all get mixed up when they reach their final destination so they can be applied together.

Your last question is about  products that actually fade age spots.  Picking age spot fading products is tricky for people with rosacea and seborrheic dermatitis because these conditions make the skin sensitive, and age spot lightening products are usually irratating.  You need to chose these with your doctors help.  My favorite anti aging and age spot fading skin care product for patients with rosacea and seborrheic dermatitis is Retin A (tretinoin) at the lowest strength.  I find that if I can really quiet down the 2 rashes, I can sneak up on the skin and get it to tolerate the Retin A (starting twice a week and working up slowly as tolerated).  This is tricky though, so you need your doctors help.  Plus, Retin A is a prescription, Retin A use makes skin more sun sensitive and it can’t be used when pregnant.

Bring this information to your doctor and see what he/she has to say.  Best of luck!

Warm Regards,

Cynthia Bailey MD, Dermatologist

Disclaimer: Please realize that availing yourself of the opportunity to submit and receive answers to your questions from Dr. Bailey does not confer a doctor/patient relationship with Dr. Bailey. The information provided by Dr. Bailey is general health information inspired by your question. It should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem (and is not an extension of the care Dr. Bailey has provided in her office for existing patients of her practice). Never ignore your own doctor’s advice because of something you read here; this information is for general informational purpose only.

If you found this information helpful, you may also want to read:

Early Skin Cancer Detection Saves Lives; You Need An Annual Full Skin Exam

Dermatologist’s Tips for Dry Flaky Skin On Your Face and Scalp; Tis the Season for Seborrhiec Dermatitis