Treatment for Nail Changes in Alopecia Areata

Q:

Hello,

Have been diagnosed with Alopecia Universalis, not a problem from a cosmetic point of view as I’m over 65, comfortable with myself as a person, and have a positive outlook on life and a strong faith.  The only thing that is bugging me is my finger and toenails.  The pitting and destruction of the nail bed is a problem.  Wondered what the best thing I can do at this point.  I have had the nails covered with an acrylic at a nail studio and for the most part, this seems to work until they get long and snap off.  Should I be taking a special vitamin such as Biotin or Zinc?
Thanks,

A:

This is a good question and I personally could not find your answer myself anywhere. I discussed it with some of my dermatologist colleagues (when it comes to nails, they are more involved with this condition and have probably seen or treated more similar cases of nail changes with Alopecia Areata or Alopecia Universalis.

Here are two of the answers I received from other doctors who see this condition more than me:

1.    Um…I see a fair number of patients with significant deformities of their nails including clubbing, rippled nails, flaking, dents in the names and the distal phalanges with granulation tissue and fullness all starting after they started getting those acrylic manicures. They are pretty rough and they often get damaged nail beds.

2.    Hey Parsa, Unfortunately there isn’t much you can do for the nail pitting that you see with Alopecia Areata or Alopecia Universalis. You can cover it with acrylics – that would be fine, but would damage the nail further over time. Nail polish and manicuring would be preferred treatments. Using Biotin would be fine to promote healthier nails but wouldn’t get rid of the underlying problem. You can also try potent topical steroids to see if that would make a difference.  Hope this helps.