Ever have a beautiful woman walk up to you, thrust her fingernails in your face and say, “Why do my nails keep splitting like this??” I have.

One of the rare hazards of being a dermatologist is being accosted with skin, hair, or nail questions at social settings. Broken, split, weak, or brittle nails are common, so I get this question a lot.

Nails are an appendage of skin and are made up of protein. Nails need moisture to stay healthy and pliable. They dehydrate much like your skin dehydrates. Dry nails are brittle: instead of flexing, they fracture and split from the tips backward. Once a nail is split, it is difficult to stop the split from spreading. Nail splitting occurs more frequently in winter when your skin and nails are  dry.

Nail polish can help protect your nails; however, nail polish remover worsens dryness. Therefore, the more frequently you paint and remove polish, the more your nails dry out. If you paint your nails, then touch up chips rather than remove the polish frequently. Keep the polish on for as long as you can before removing.

What else can you do to strengthen weak nails?

Apply to your nails a moisturizer with urea, like Eucerin Hand Creme. This puts moisture back in the nails and keeps them pliable.

Avoid excess washing. Soap and water dry your skin as well as your nails. (I can write you a doctor’s note that says you are not allowed to wash the dishes. If you must, then wear gloves).

Remember that once a nail is split, it cannot be repaired. The key is to keep the base of the nail healthy so when it grows out to the tip, it stays strong and intact. Fingernails grow 3 mm each month, so a 2-3 mm split will take a month to grow out.

There are lots of products that promise to strengthen or harden nails. Most of them are a waste of money, for example,  gelatin tabs. Gelatin tablets are animal collagen derived from bone. The collagen is broken down into protein by your digestive system. As such, taking gelatin tabs is no better than eating a piece of chicken or any other protein. Eat plenty of protein as part of a complete diet, but don’t bother with supplements.

Don’t waste money on calcium or other “mega-nail” vitamins. There is no calcium in nails and loading up on vitamins will not make nails grow faster or stronger.

There is some evidence that taking biotin, a B-complex vitamin, at 2.5 mg each day can help weak nails by improving protein synthesis. Remember though, if you start taking biotin today, it will be June before you see improvement because you can only improve nail that hasn’t yet grown.

Just like trimming dead ends can help your hair, trimming split ends can help your nails. Try to clip off the split part, but avoid being too aggressive because you can spread the split farther. With a little effort and a lot of patience your nails will be hard as nails.

Oh, and next time, a least buy me a drink.

Photo: KW Sanders (flickr)

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Ceramic hair straighteners are everywhere, including my bathroom. It’s not mine, I’d have to use a regular iron if I wanted straight hair. But many women use flat irons to get a sleek, cosmopolitan hairstyle. Ceramic irons are meant to be safer for your hair because they heat your hair evenly.

Flat irons work by breaking the structural bonds in hair, then letting them reform. The heating and cooling alters your hair’s structure making it smooth and straight. Unfortunately, this heating also damages your hair. Repeated use of a flat iron causes hair to become brittle and break. This can lead to hair loss and frayed, fly-away ends. Wet hair, fine hair, and colored or chemically treated hair is more likely to be damaged by straightening.

Minimize damage by following these tips:

1. Use your flat iron at a low setting. Treated hair and fine hair burns easily. Thick hair can tolerate higher temperatures. Temperatures above 350 degrees Fahrenheit will damage most hair after 5 minutes of use.

2. Use on dry hair only, preferably with a hair product designed to be used with a flat iron.

3. Do not straighten your hair every day. Optimally you should use your flat iron only once a week.

4. If you feel that your hair is thinning, that you are loosing your hair, or that your hair is becoming more and more difficult to straighten, then stop using your iron.

5. There is nothing you can do to make your hair grow out faster. If you hair breaks, it can take a year or longer to grow it back to the length you desire, so treat your hair well.

Photo: whatsnextonline, flickr.com

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“It’s like a mini tanning bed for your fingers. ”

Artifical nails are a $6.3 billion dollar industry. There are nearly 60,000 nail salons in the US — 5 times as many Starbucks! Many of these nail salons use UV light, which might increase the risk of skin cancer on your fingers.

Researchers from the M.D. Anderson Cancer Center at the University of Texas noticed that some of their patients with skin cancer on their fingers (an uncommon place to get skin cancer) reported having had UV light for artificial nails. Such UV light has been shown to damage cells’ DNA (the genetic code in all cells) and to cause mutations that lead to skin cancer.

There are several types of nails. The most popular is acrylic, a two part process where a liquid monomer is combined with a powder polymer. It hardens in seconds, but takes an hour for the final hardness to set. Ultraviolet light is used to speed up the hardening.

A second type of artificial nail is the UV-gel. These are more flexible and have a high-gloss finish than acrylics. As their name suggests, ultraviolet light is used to harden the nails.

UV light is also used for a topcoat sealant. Because artificial nails yellow from UV light (especially tanning booths), a top coat can be used to protect the nail. This topcoat is cured (or set) using UV light.

The amount of radiation that your fingers get from the nail treatment is comparable to what you would get in a tanning booth. Because nails are done every 2-4 weeks (one would hope), that can add up to a significant amount of UV exposure over years.

No large scale studies have been done to examine the danger of using UV light for nails, but these patients suggest that there is likely a risk, especially if you have fair skin or have a history of skin cancer.

Photo: Monibela (flickr)

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Mr. Obama has handled many difficult issues with aplomb, but is all this stress causing him to go gray?

A New York Times article highlighted (pun intended) Mr. Obama’s overnight graying. It is widely believed that stress causes you to go gray prematurely. In fact, it does not.

Hair turns gray because the pigment cells stop making pigment. The color in your hair is made by melanocytes (the same cell responsible for the deadly skin cancer, melanoma). We aren’t sure what makes the melanocytes stop making pigment.

Every hair on your body goes through three phases: 1. a growing phase, 2. a resting phase, and 3. a falling out phase. The longer your growing phase, the longer your hair will grow. Women have longer growing phases than men, which is why women can grow hair that is several feet long, but men cannot.

It might be that as we age, shortened stages of hair growth lead to less pigment. When only a little pigment is produced, we have gray hair. When no pigment is produced, we have white hair, which can appear faintly blue (hence the term blue-haired ladies).

Another factor in graying hair is hydrogen peroxide. Hydrogen peroxide is a natural oxidant; we produce an enzyme called catalase that breaks down hydrogen peroxide turning it into water and oxygen. As catalase function decreases, the levels of hydrogen peroxide increase. High levels of hydrogen peroxide block the production of pigment, leading to gray hair.

Most men and women start getting gray hairs in their 30′s and 40′s. How much gray hair you have depends on your race (white people gray faster than Asians or blacks) and your genetics (some people turn gray in their 20′s). On average, half of people aged 50 are at least 50% gray.

So how do I explain how Mr. Obama went gray in less than 100 days?  Perhaps it’s the same reason why Paul McCartney at nearly 67 years old does not have a gray hair on his head:  it’s a natural color, but it ain’t natural. Maybe Mr. Obama’s new gray hair is job stress after all — now that he is president he has had time for a cut but not a color.

Photos: Paul McCartney John Packer I Blank Slate Photography. President Obama by Jurvetson (flickr)

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What makes a hair day a really bad hair day? Static electricity. What causes it and how can you stop it?

As a kid, during the winter, I would love to shuffle my feet across the carpeted living room and wait for my little brothers’ to come by. When they came around the corner — Zap!– I’d touch them, and a jolt of electricity would snap from my finger to their arms. It is this same static electricity that causes hair to float away or to resist your styling like it has a mind of its own. What causes this static buildup, and what can you do to prevent it?

Static is when you (or your clothes) become charged. That is, they develop a net positive or negative charge. Scuffing your feet across the rug causes you to accumulate negative charges from it. During the winter the air is dry. This acts as an insulator, helping you keep charged. When you touch something that is not charged, the negative charges jump from you to the object, causing a spark. When you comb your hair, the negative charges move from your hair to the plastic comb or brush. This leaves your hair positively charged and the brush negatively charged. Because all of your hairs have a positive charge, they repel each other, flying away. This can also be seen when kids slide down a plastic playground slide. Their hair loses negative charges and becomes positively charged. The hairs repel each other and the stand on end.

A common reason for y0ur hair to be susceptible is that it becomes dried out. This happens when your hair is washed excessively or treated with hair color or straighteners. All of these strip the natural oil off your hair. In particular, 18-methyl eicosanoic acid (18-MEC) is a natural oil that your hair follicles secrete to protect the hair. Once 18-MEC is stripped off your hair, it cannot be replaced for the lifetime of that hair (which can be years for women or men with long hair).

To prevent this, try to minimize chemical treatments to your hair. Do not scrub your hair daily with oil-stripping, sudsy shampoos. Keeping the natural oils on your hair prevents the buildup of static charge and can prevent fly-away hair, even after taking off that wool hat you had on all day at the ski slopes.

Other tips to prevent fly-away hair in the winter include the following:

Apply a conditioner to your hair after every wash.

Use an ion hair dryer: there are no good studies to show that these work, but they might help add negative ions to your hair, preventing the positive charge fly-away.

Wipe your hair with a fabric softener. They are designed to neturalize static buildup and can instantly counter a charge buildup before your hair begins flying away from your head.

Photo: Kretyen, Flickr.com

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I saw several women last week for hair loss (alopecia). Hair loss is a common condition; it can be especially traumatic for women, because hair is often an important part of their identity and of their beauty. Traction alopecia is a type of hair loss that can be prevented if caught early, but can be permanent after it develops.

There are many causes of hair loss including medications, thyroid disease, iron deficiency, even having a baby. Most of these causes result in temporary hair loss — the hair eventually grows back. Some types of hair loss, however, are permanent; this is called scarring or cicatrical alopecia. A common scarring hair loss in women is traction alopecia.

Traction alopecia occurs when hair is pulled too tightly for long periods of time. It occurs often in girls and women who braid their hair, but can also be seen in women who pull their hair back tightly in a pony-tail or a bun. Over months and years the hair loss becomes permanent, and cannot regrow. It can be seen in men, but is more common in women. It can also affect children as well as in adults.

In traction alopecia the worst hair loss is in areas where the hair is pulled the tightest, usually the forehead and temples. It can be subtle at first, but becomes apparent over years as the hair line recedes from ear to ear starting farther and farther back on the head.

The hair is lost because the tension from pulling damages the hair follicles beneath the skin. The hair follicle is like a little factory working constantly to make hair. Each follicle is in an active state for years before it takes a short rest, sheds the hair, then starts all over again. Over time, pulling the follicle damages it and eventually the damaged follicle can no longer make hair. Because you cannot develop new follicles, as more and more follicles are damaged, more and more permanent hair loss results.

Unfortunately, traction alopecia is a scarring alopecia, so lost hair will not grow back. The best treatment is to release the tension on your hair as much as possible as soon as possible. This is often difficult because it requires adopting a different hairstyle (which can be distressing in itself).

Sometimes hair can be surgically transplanted from areas on your scalp with good growth to the scarred areas. This procedure can be expensive however, and is not covered by health insurance.

Using minoxidil or Rogaine might help promote new hair growth. The drug is meant for male pattern alopeica, not for scarring hair loss however, and using it might not help much.

If you have hair loss, then see your dermatologist. He or she can examine your scalp and can often prescribe medications, perform hair transplant surgery, or make suggestions on changing your hairstyle that can save your hair.

Post written by Jeffrey Benabio, MD. You might also like:

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Photo credit: Nilja Mumin

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OK boys. Face it, women sometimes like a manly beard. But do you have what it takes? It requires patience, persistence, (and just enough testosterone) to pull it off.

• The first step in growing a beard is deciding to grow one. This is no trifling matter. Growing a beard takes at least 4 weeks including enduring an uncomfortable itchy period and having to answer ridiculous questions like: “Are you trying to grow a beard?” from your friends and colleagues.

• Don’t shave. Despite the popularly held belief, shaving will not make your beard grow faster or thicker.

• Pick a time when you can get a running start like at the beginning of a vacation or even a long weekend.

• Resist the urge to trim or shape the beard. Let it grow as much as possible before shaving, even if you are going for the “goatee” look. The hairs on your face will be in various stages of growth; not all are actively growing at the same time, so you have to be patient to see where it will fill in and where it won’t.

• What if your beard is spotty? Unlike your scalp, the hair on your face will not cover every inch. Some men will have hair from their eyeballs to their neck. If you’re this guy, then feel free to shave areas to shape it. Most men will have some areas that are spotty or thin, like on their cheeks and chin. This is determined by genetic and hormonal factors. There is little you can do about it, so work with what you’ve got.

• What about applying Rogaine (minoxidil) to your face? Minoxidil is a drug that was used to lower blood pressure until it was found it also grows hair. In topical form, it causes hair growth on the scalp of men and women with hereditary hair loss. Why it works is not really known. In theory, Rogaine could help you grow a beard, but this is never been shown in studies, nor is it FDA approved for facial hair. Applying Rogaine (minoxidil) to your face would likely be irritating and can also cause acne. If ingested or if applied in excessive amounts, it could cause serious side effects like a drop in your blood pressure.

• Biotin is a dietary supplement known to help with hair and nail growth. Consider taking 2.5 mg of biotin each day.

• You might find that growing a beard gives you an itchy, red, scaly rash on your face. Try using a little dandruff shampoo like Head and Shoulders on your beard two or three times each week. You can also apply a mild over the counter steroid cream like hydrocortisone 1% once a day.

• When your beard starts growing, the hairs are often stiff at first; they will soften over time. Consider using a mild steroid like hydrocortisone 1% everyday to help with the itching.

• After 4 to 6 weeks you should have a good idea what your beard will look like. If after 6 weeks you find people saying: “Oh, are you trying to grow a beard?” consider the clean-shaven look.

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