Brittle nails in menopause: splitting, ridging and peeling

What changes

The nail plate is made of keratin produced by the nail matrix beneath the cuticle. Estrogen influences keratin production and skin hydration, and nails share the same collagen and moisture environment as the skin around them.

After menopause, nails typically become thinner, hold less water, grow more slowly and split or peel more readily. The combination is described clinically as brittle nail syndrome and it affects a substantial proportion of women over 50.

Vertical ridges are not a deficiency

This is the most common misconception in the area and it drives a great deal of unnecessary supplementation.

Vertical ridges running from cuticle to tip are an expected consequence of ageing of the nail matrix. They are the nail equivalent of fine lines and they are not a marker of vitamin or mineral deficiency, despite being confidently described as one in a great deal of online material.

Horizontal ridges are different. Deep transverse grooves, known as Beau's lines, indicate a temporary interruption of nail growth, usually from a significant illness, high fever, chemotherapy or severe stress several weeks earlier. They are a record of an event, and they grow out.

What is worth checking

Brittle nails do have genuine medical causes, and the relevant ones at this age are:

• Iron deficiency, very common with heavy perimenopausal bleeding, and the cause of spoon-shaped nails in its more advanced form
• Thyroid disease, which affects nail growth and texture in both directions
• Fungal nail infection, which causes thickening, discolouration and crumbling, often in a single nail first
• Psoriasis, which causes pitting and separation of the nail from its bed
• Repeated wetting and drying, and acetone-based removers, which are the most common cause of all and are entirely environmental

What has evidence

Protecting nails from water and chemicals does more than anything taken by mouth. Gloves for washing up and cleaning, and avoiding acetone removers, address the dominant mechanical cause.

Moisturising the nail and cuticle, particularly with products containing urea or lactic acid, has reasonable support.

Biotin is the supplement most associated with nails, and the evidence is weak: the studies behind the claim were small, uncontrolled, and conducted in people with brittle nail syndrome rather than the general population. Biotin also interferes with several laboratory assays, including thyroid and cardiac tests, causing genuinely misleading results — a reason to mention it before blood tests.

When to see someone

Get a single nail behaving differently from the others assessed, particularly with a dark streak running lengthways, which needs examining rather than watching.

Ask for ferritin and thyroid function if brittleness is marked, and mention any biotin supplementation before blood tests are taken.