Nails and cuticles: simple care that prevents problems

Nails don’t get much attention until something goes wrong: a split that snags every sweater, a fingertip that throbs after a manicure, a rash that shows up weeks after a new gel set. Most of these problems have simple, everyday causes, and most can be prevented with a few habits. Here’s what the skin around your nails is doing, and how to stay out of its way.

What your cuticle actually does

The cuticle is the thin strip of skin that sits at the base of your nail and overlaps it slightly. It looks like something to tidy up, but it has a job. It works as a seal between your nail and the skin fold around it, keeping water, bacteria and yeast from getting into the pocket where the nail grows.

That’s why the American Academy of Dermatology (AAD) is blunt about it: don’t cut your cuticles, and never push them back forcefully. If you like a neater look, push them back gently after a shower or bath, when the skin is soft. The AAD also lists nail biting and cuticle removal together as habits that damage nails.

A few other habits the AAD suggests:

• Keep nails clean and dry, so bacteria don’t grow underneath them.
• Cut nails straight across with sharp clippers, then round the tips slightly.
• File in one direction with an emery board rather than sawing back and forth.
• Don’t use your nails as tools to open cans or pry off lids.

Paronychia: when the nail fold gets infected

Paronychia is the medical name for inflammation of the skin fold around a nail. DermNet, the New Zealand dermatology reference, describes two kinds.

Acute paronychia

This one comes on fast, over hours, usually on one finger. The fold turns red, swollen and painful, and pus can collect. It’s most often caused by bacteria getting in through a small break: a bitten nail, a hangnail you pulled, a cuticle cut during a manicure. A 2022 review of common nail disorders in the Annals of Medicine lists nail biting and aggressive manicuring as typical triggers.

Chronic paronychia

This version creeps in slowly and lasts more than six weeks, often on several fingers. The fold stays puffy, the cuticle disappears, and the nail can grow in ridged or distorted. Chronic paronychia is mostly a wet-work problem. DermNet describes it as dermatitis (skin inflammation) combined with yeast, especially Candida, and says bartenders, healthcare workers and anyone with their hands in water a lot are at higher risk, as are people with diabetes.

Prevention is the same for both: don’t cut or pick at your cuticles, keep your hands as dry as you reasonably can, and wear gloves for wet chores. If a nail fold is red, hot and throbbing, has pus, or the redness is spreading, see your doctor or pharmacist. Acute infections sometimes need antibiotics or drainage, and chronic paronychia usually needs treatment for the dermatitis underneath, which is a job for a clinician.

Why nails get brittle, peel and split

Brittle nails are very common. The Annals of Medicine review puts it at up to 20% of people, with women affected about twice as often as men. The nails peel in layers at the tip, split, or break easily.

The main cause is not a missing vitamin. It’s the wet-dry cycle. The review explains that frequent contact with water and chemicals, repeated knocks and manicures disturb the way nail cells stick together and gradually dry the nail out. Every time your nails soak up water, they swell; when they dry, they shrink. Do that dozens of times a day, add dish soap and cleaning products, then the dry air of a Canadian winter, and nails start to come apart.

Polish remover adds to it. The AAD notes that most removers contain chemicals that dry the nails, and suggests applying a moisturizing cream afterwards.

What helps, based on the AAD and the review:

• Wear gloves for dishes and cleaning. For long wet jobs, the review suggests cotton gloves under vinyl ones, so sweat doesn’t soak your skin.
• Moisturize after washing your hands, and rub the cream into your nails and cuticles too, not just your palms.
• Keep nails short, so there’s less free edge to catch and split.
• Go easy on hardeners. The review advises caution, because some can make brittleness worse over time.

What about biotin?

Biotin (a B vitamin) is often suggested for brittle nails. The Annals of Medicine review says the evidence for it is limited. It isn’t harmful to ask your pharmacist about it, but it’s not a proven fix, and it won’t outrun a daily soaking in dishwater.

Gel and acrylic nails: the allergy to know about

Gel polish, hard gel and acrylic nails all rely on a family of chemicals called (meth)acrylates. They start as liquids or soft gels and harden when they’re “cured,” either under a UV or LED lamp or by mixing.

The problem is the uncured product. If liquid gel or monomer touches your skin before it has hardened, your immune system can learn to react to it. That’s allergic contact dermatitis, a delayed allergic rash from something that touched your skin. The British Association of Dermatologists (BAD) has warned since 2018 about a steep rise in these allergies and, in 2023, repeated the warning with a focus on home kits.

Signs can include:

• Itchy, red, swollen or blistered skin around the nails.
• Nails loosening or lifting from the nail bed.
• A rash on places your nails touch, such as the eyelids, face or neck.

Once you’re allergic, it’s for life. The BAD points out that acrylates are also used in white dental fillings, some bone cements and some diabetes devices such as glucose sensors and insulin pumps, so a nail allergy can complicate later care.

To lower the risk if you use a home kit, the BAD suggests:

• Read the instructions and use only the lamp recommended for that product, so it cures fully.
• Keep the product off your skin while applying.
• Don’t count on thin latex or vinyl gloves to protect you; the BAD says they don’t.

If you develop a rash after a gel or acrylic manicure, stop using the product and see your doctor. Patch testing, where tiny amounts of possible allergens are taped to your back, can confirm the cause.

Salon visits without the aftermath

A professional manicure is fine for most people, with a few precautions from the AAD. Ask the technician not to cut your cuticles. If you go often, consider bringing your own tools. Check that foot baths are cleaned between clients, and shave your legs after a pedicure rather than the day before, since small nicks let germs in.

When nail changes need a doctor

Some nail problems aren’t about care at all. The AAD advises seeing a dermatologist if a nail changes, swells or hurts, and says people with diabetes or poor circulation should have nail problems looked at promptly. A dark streak, a nail lifting off without an obvious reason, or thickening and discolouration are worth showing to your doctor rather than covering with polish.

The short version: leave your cuticles in place, keep your hands out of water when you can and moisturize them when you can’t, and treat gel and acrylic products with respect. Those habits prevent most of the splits, sore folds and rashes that send people looking for help. If a nail fold turns hot and painful or a rash appears after a manicure, get it checked rather than waiting it out. You can browse hand care products if you’re looking for a cream to keep by the sink.