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Received: 30 July 2019    Revised: 11 September 2019    Accepted: 29 October 2019

DOI: 10.1111/srt.12818

ORIGINAL ARTICLE

Nail StrainStress Meter NM 100: A novel in vivo method to

characterize biomechanical properties of nails

Paola Perugini1,2  | Stefano Sacchi1 | Giorgio Musitelli1

1
Department of Drug Sciences, University of
Pavia, Pavia, Italy Abstract
2
EticHub s.r.l., Academic Spin-off, University Background: Nowadays, nail care products are extremely important both in medical
of Pavia, Pavia, Italy
and cosmetic fields. Actually, there are only a very few “in vivo” methods to evaluate
Correspondence the safety and the efficacy of nail products.
Paola Perugini, Department of Drug
Methods: The new apparatus, based on a recently patented technology, is developed
Sciences, University of Pavia, Via Taramelli
12, 27100 Pavia, Italy. for the “in vivo” evaluation of nails in terms of thickness, structural firmness, flatten-
Email: paola.perugini@unipv.it
ing, and bending properties. The device analyzes nails by an “in vivo” non-invasive
methodology in a timely way and with high accuracy. The assessment of the resist-
ance to compression measures the cohesion of the nail matrix (nail firmness), while
the evaluation of the resistance to transversal deformation detects the elasticity of
the nail plate. Furthermore, the apparatus is able to assess the nail thickness and the
flexibility of their distal edge.
Results: The instrument provides nail thickness and several parameters reflecting
mechanical properties of nail plate: Viscoelasticity expressed as viscoelasticity index
(VI), structural strength/ firmness expressed as Firmness Index (FI), and viscoelastic-
ity of the distal edge expressed as Bending Index (BI).
Conclusions: The instruments described in this work represent an innovative appara-
tus for the safety and efficacy evaluation of nail products in several fields: cosmetics,
pharmaceuticals, and medical devices.

KEYWORDS
evaluation of nail alteration, indentometer, nail biomechanical properties, nail
characterization, nail elasticity, nail firmness, nails thickness

1 |  I NTRO D U C TI O N
Nails mainly consist of hardened and compacted keratin and have the
form of a roughly quadrangular, whitish-pink, and semitransparent
plate, in which it is possible to distinguish a free distal edge, a central
portion or nail body that has a small, whitish sickle-shaped zone at
the base, called the lunula or half-moon, two lateral edges inserted in
a skin fold or nail groove, and a proximal portion, called root, deeply
and firmly embedded in the rear portion of the nail groove.1
The upper surface of the nail plate is free and in human societies
has always been a part of the body subjected to special attention,
decorated and treated for ornamental purposes, for example by col-
oring with enamels, reconstruction or by superposing of artificial
structures (artificial nails).
Furthermore, in the last years, a number of nail diseases have
increased causing significant social, psychological, and physical con-
sequences; the patient pain has grown up together with a lot of new
medical treatments now available. 2-8

Skin Res Technol. 2019;00:1–9. wileyonlinelibrary.com/journal/srt © 2019 John Wiley & Sons A/S.     1 |
Published by John Wiley & Sons Ltd
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2       PERUGINI et al.
Topical treatment avoids adverse effects associated with sys-
temic therapy, thus improving patient compliance and reducing
treatment costs.
However, the effectiveness of topical therapies is limited be-
cause of the poor permeability of the lamina to the therapeutic
agents.
Research over the past decade has focused on improving trans-
dermal permeability by chemical treatments, penetration enhancers,
and mechanical and physical methods.9
In recent years, nail care products, which comprise enamels or
masks intended for the wellbeing of the nail plate and of the adjacent
parts, have become increasingly important in the market both in terms
of medical treatment and associated cosmetic treatment. In fact, the
use of cosmetic enamels is widespread and understandable to cover
the blemishes of nail abnormalities. It is necessary to underline that
the constant use of an inappropriate cosmetic formulation can seri-
ously compromise the effectiveness of medical treatment.10,11
The increasing market has also enhanced the value of prop-
erties of cosmetic products, not only with regard to the areas of
application of the products themselves, but also with regard to
the effects attributed to the cosmetic product. In this connec-
tion, a standard covering cosmetic products has been introduced
at European level, (EC) regulation 1223/2009, which requires the
verification of the safety and efficacy requirements not closely
correlated with the actual nature of the cosmetic product. The
safety requirement stated by law is particularly important in the
case of pathological conditions.
For these purposes, it is fundamental to use validated instrumen-
tal methods able to verify such effects. In particular, to verify the
safety, effectiveness, and performance of a cosmetic formulation,
it is essential to develop suitable experimental designs performing
“in vivo” evaluations, that is, in the real conditions of use, which may
take place over very different periods of time (from a few minutes
to months), depending on the kind of product and the functionalities
to be ascertained.
Unfortunately, until now, only a few instrumentations were
available for “in vivo” nail evaluation and therefore able to de-
termine the effect of the products. To solve this problem, sev-
eral techniques have been proposed for the characterization of
keratin structure, like near-infrared fourier transform (NIR–FT)
Raman spectroscopy, attenuated total reflectance Fourier trans-
form infrared (ATR–FTIR) spectroscopy or confocal laser scanning
microscopy (CLSM). Furthermore, NIR Raman spectroscopy and
transonychial water loss (TOWL) are extensively employed to
quantify nail water content.12-15
On the contrary, only a very few studies have been performed on
mechanical properties of nails. In this context, it is very important to
  Measurement range Step number Measurement uncertainty
Distance 0-10 (mm) (±0.02) 1-10 30-70 µm/10 N
Load 0-10 N Continuous ±0.02 N ± 2%
underline how nail lamina is submitted to several mechanical forces
having a particularly pronounced effect both on nail configuration
and also in the development of some kind of nail deformities, like
psoriasis and koilonychia.16,17
The aim of the present work is to present an available and suit-
able instrumentation able to perform mechanical characterization of
nails, to meet the need for qualitative and quantitative characteriza-
tion of treated and untreated nails, whether they are living nails, recon-
structed or structures associated therewith such as artificial nail plates
or polymers for nail reconstruction or having decorative functions.
Another aim of this work is to set up procedures to carry out
“in vivo” tests with non-invasive technique, intended to characterize
nail plate and to assess safety and efficacy of pharmaceutical and
cosmetic nail products.
2 | M ATE R I A L S A N D M E TH O DS
2.1 | Apparatus description
The apparatus Nail StrainStress Meter NM 100 (Courage &
Khazaka), herewith below described is developed using a patented
technology specifically developed to study the stress-stain behav-
ior of nails.18
The system comprises test sites working on portions of both in
vitro and in vivo cutaneous appendages including a plurality of sup-
ports adapted to work on a portion of nail or of the structures as-
sociated therewith undergoing tests, configured to form supporting
and/or fulcrum surfaces for said samples with respect to a charac-
terizing stress exerted on them. The system includes a correspond-
ing plurality of stressing elements for applying and for measuring
the intensity and duration of the stresses applied. The behavior of
a cutaneous appendage under test is continuously monitored by a
digital image acquisition system (5 MPixel USB color camera, reso-
lution: 2592 × 1994 Pixel). Furthermore, since the nail must be per-
fectly horizontal and aligned with the supports, the digital camera
to monitoring analyses is essential. It is possible to have two digi-
tal cameras on the instrument: The first one provides a lateral and
complete view of the profile of the analyzed nail and the second
one, perpendicular to the first one, shoots the upper surface of the
nail. Both the cameras can work simultaneously, and the captured
images are displayed in real time and simultaneously on a monitor.
The device features a high precision force dosimeter. Special tips
can be driven automatically in steps down on the nail in a descent
rate range between 0.3 and 15 mm/min, and the force is constantly
monitored. The tip is directly connected to a load cell; in that way,
the load cell measures the force applied to the nail by the tip. In this
TA B L E 1   Nail StrainStress Meter NM
100 Technical Data
PERUGINI et al.
process, an electric signal is generated by the load cell and this signal
is opportunely transformed and converted by a dedicated software.
The morphological and deformation data are acquired in real time
throughout all the phases of a test protocol. The technical data of
the instrument are reported in Table 1.
As soon as the head meets the nail, the force increases till the preset
maximum value. The result is a curve of force and distance (force deflec-
tion diagram). All data can be saved and exported to Excel® or directly
elaborated by dedicated software. By the analysis of these data, inter-
esting information about mechanical properties of the nail is obtained.
The device is delivered with three different measurement sets
(Name: set 1, set 2, and set 3) for the assessment of different me-
chanical properties.
The sets are easily and quickly replaceable. Each set consists of
two specific parts: The lower one (support), that provides a static
mechanical support to the lower side of the nail and the upper one
(tip) moving vertically from a start position to the bottom toward the
upper side of the nail plate. The start position of the tip is adjusted
to reduce the distance between the upper nail surface and the tip
to run the shortest and quickest analysis. Furthermore, the descent
speed of the tip and the maximum strength value are adjustable and
set up before the beginning of the analysis.
2.1.1 | Set 1
The first set is specifically designed to study the viscoelastic behav-
ior of the nail plate under a force that produces a cross deformation
running a sort of three-point flexural test (Figure 1).
The specimen is supported on two precision-machined edges, and
load is applied at its midpoint. In this configuration, the lower part pro-
vides a couple of horizontal and parallel supports characterized by a
tapered and polished surface. Instead, the tip is a parallelepiped with a
rectangular base and rounded corners. The larger side of the cross-sec-
tion of the tip is parallel to the supports, and it comes down centrally
between them. The nail plate is deflected vertically. The specimen is
deformed, and resistance at various loads is recorded.
(A) (B)
F I G U R E 1   A, Set 1 tip and support and B, positioning of nail in
set 1
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      3
2.1.2 | Set 2
The second set is specifically designed to perform a compression test
in order to study the structural strength/ firmness of the nail plate.
In this set, the support is a cylinder cut obliquely, polished and
beveled to provide a smooth comfortable base for the bottom side
of the nail portion to be analyzed. The probe is a pin with the contact
end flat and smooth (Figure 2). It is used to determine the behavior
of the nails under crushing loads. Moving vertically at controlled and
previously set speed, the probe gets in contact with the sample. In
that way, the specimen is compressed between the tip and the sup-
port and deformation at various loads is recorded.
Furthermore, the set 2 allows also to determine easily and ac-
curately the thickness of the nail plate, expressed in microns, in the
analyzed point. In fact, the probe runs free before to get in contact
with the sample surface and, because of the total probe path with-
out sample is fixed, it is possible to calculate the thickness of the
sample by sottracting the position of touch between the probe and
the nail surface from the total probe path by the following equation:
T = Tt − Pt
Where,
T = Thickness of the nail plate,
Tt = Total path of the probe (set at the beginning of the
experiment),
Pt = Path of the probe to reach the nail surface (first force de-
tected when probe touch nail).
2.1.3 | Set 3
The third set performs a cantilever test: The action is provided by
a parallelepiped shaped probe with a rectangular section that pro-
duced a longitudinal bending of the distal edge of the nail (Figure 3).
(A) (B)
F I G U R E 2   A, Set 2 tip and support and B, positioning of nail in
set 2
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4       PERUGINI et al.
(A) (B)
F I G U R E 3   A, Set 3 tip and support and B, positioning of nail in
set 3
In this case, the support has a semicircular vertical end. Also, in this
test the probe get off parallel to the base and the deformation is
produced transversely with respect to the central longitudinal axis
of the nail. In this test, the bending capability of distal edge of the
nail is recorder in a stress-strain diagram.
In all sets, stress and strain are detected and plotted as a stress-
strain diagram, which is used to determine mechanical properties
of nail plate. Figure 4 shows a typical diagram obtained from, as an
example, set 2.
Table 2 shows all set specifications.
2.2 | In vivo nail evaluation
In order to evaluate precision of the instrument data 18 healthy
volunteers, females aged between 21 and 58 years were enrolled.
Middle (R3, L3) and ring finger (R4, L4) nails of both right (R) and left
(L) hands were evaluated.
In order to guarantee accuracy and precision of the data, it is
required to follow these initial stages of preparation and evaluation
of the nail:
• Accurate cleaning of the nail plate
• Acclimation period (strictly depending from season, temperature,
and humidity) of at least 30 minutes.
• Evaluation of morphological characteristics of nail in terms of
integrity, shape and curvature by using a digital microscope
and a dedicated software to measure free edge length and
curvature.
Critical issues concerning nail analysis such as difference among
fingers, acquisition of data in different positions on the nail plate and
analyses over time were also considered.
All measurements were made in an air-conditioned room with
controlled temperature and humidity (T = 22°C, relative humidity
[RH] = 70% ± 5%). Subjects were preconditioned in the room for at
least 15 minutes before the measurements were made.
The instruments used in the evaluation of skin parameters in-
volve contact between nails and a series of probes that do not cause
discomfort, pain, or damage the skin.
3 | R E S U LT S
3.1 | Set up of “in vivo” test protocol
The test protocol consists of subjecting the nail to a controlled de-
formation and measuring the force required to obtain the same, or,
alternatively, quantifying the strain of the nail as a result of applica-
tion of a predetermined force.
F I G U R E 4   Example of stress-strain
diagram obtained from mechanical
analyses
PERUGINI et al. |
      5

TA B L E 2   Set specifications
Descent rate Mechanical
Set Step number (mm/min) Force (N) property Parameter

1 5 1.5 2-5 Viscoelasticity Viscoelasticity

of nail plate Index (VI)
2 1 0.3 2-6 Structural Firmness Index (FI)
strength/ firm-
ness of the nail
plate
3 5 1.5 2-4 Viscoelasticity Bending Index (BI)
of the distal
edge

To do this, it is absolutely necessary consider two aspects: the posi-

tioning of the subject and the monitoring of actual analysis.
The positioning of the subject and the sample is a critical step.
The allocation must be stable and comfortable. To do this, the de-
vice is equipped with a fully adjustable stand. This stand supports
independently, but at the same time, the forearm, the hand, and
the distal phalanx and it is adjusted according to the needs of the
subject.
After several analyses, middle and ring fingers seem to be the
best candidate to be used for reproducible data.
In fact, analyzing thumb and pinkie can be very difficult because
subject has to rotate the hand in the first case and because of the
dimension of the nail in the second case. Sometimes, pinkie's nail
is smaller than the support (set 1) and analysis cannot be correctly
performed, as shown in Figure 5.
Table 3 shows the mean free edge length and curvature of volun-
teer nails. Results show that there is no difference between middle
(R3, L3) and ring fingers (R4, L4) and between right and left hands.

F I G U R E 5   Set 1 with pinkie finger, showing the support

(set 1) is wider than the nail
3.2 | Viscoelasticity of nail plate

The test may be carried out both by choosing the right probe
related to the aim of the study and with monitoring load and strain
applied into the study. In fact, using the different sets it is possible to
monitor different aspect of mechanical properties of nails.
3.1.1 | In summary
• Using the set 1, the nail is subjected to a transversal deformation.
The slope of the curve gives information about the viscoelastic
property of the nail plate.
• Using the set 2, the nail is subjected to a compressive defor-
mation. The slope of the curve gives information about the
structural strength of the nail plate, this kind of analysis makes
possible an accurate determination of the nail thickness point
Figure 6 shows results of viscoelasticity index data obtained from all
subjects analyzing the middle and the ring fingers. Transversal defor-
mation always gives a good result with a highly reproducible slope
(standard deviation within the same subject is around 0.64 for at least
3 repetitions).
Statistical analysis performed using the Mann-Whitney t test, in
which a significance level of 5% was chosen, so changes were con-
sidered statistically significant for P < .05, permitted to highlight that
the only statistically difference was evident between R3 and L4 data
(P = .0302).
TA B L E 3   Mean free edge length and curvature, expressed in
mm, and standard deviation of data collected from all volunteers.
R = right hand; L = left hand; 3 = middle finger; 4 = ring finger
Parameter R3 R4 L3 L4

by point. Free edge 1.37 1.44 1.39 1.32

• Using set 3, the nail is subjected to a longitudinal deformation. length (mm) (±0.662) (±0.789) (±0.760) (±0.599)

The slope of the curve gives information about the elasticity of Curvature (mm) 8.09 7.85 7.97 7.60
(±1.543) (±1.454) (±1.376) (±1.455)
the distal edge (border) of the nail plate.
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6       PERUGINI et al.
F I G U R E 6   Mean viscoelasticity data and standard deviation
obtained from middle (3) and ring (4) fingers, on right hand (R) and
left (L) hand
F I G U R E 7   Mean viscoelasticity data and Standard deviation
obtained from ring right fingers (R4)
This result can be justified from the fact that all volunteers were
right handed, so the R3 finger is more stressed thus presenting the
lower viscoelasticity value.
In order to evaluate the repeatability of the instruments over time,
3 subjects were analyzed twice in a week, at the beginning (t0) and
after 6 days (t6d). Subjects were trained to not use nail products for
the all test period. Results shown in Figure 7 highlighted that results
are very reproducible with a percentage of variation of about 10%.
(A) (B)
In order to evaluate whether a different nail position during the
analysis can affect results, viscoelasticity analysis in three different
areas of nails (C: center; L: left angled; R: right angled), as shown in
Figure 8, were performed on four volunteers.
Results reported in Figure 9 show clearly that position did not
greatly affect results. Anyway, it is essential to use the digital camera
to monitor exactly the position of nails during analysis.
3.3 | Nail plate thickness
Table 4 reports results concerning thickness, expressed in µm, of
nails of volunteers using the set 2. Subjects were divided into 2
groups, depending on age, and analyses were performed on middle
(3) finger, on right (R) and left (L) hands.
Results show that value is reproducible with very low standard
deviation.
3.4 | Nail plate firmness evaluation
Figure 10 reports the mean Firmness index obtained on middle (3) fin-
ger, on right (R) and left (L) hands of 4 volunteers at three different force
intervals: 0-1N, 2-3N, and 3.5-5N. Results show clearly that Firmness
Index is different depending on the different forces applied in the study.
However, analyses obtained before and after different treatments
are extremely useful for evaluating the influence of specific treatment of
the sample. The results of firmness analyses carried out on 4 volunteers
by soaking nails in water for 10 minutes at 37°C are reported in Table 5.
However, in all cases, the instrument is able to detect index varia-
tion after nail soaking in water for 10 minutes at 37°C (tw). These vari-
ations are ranging between 15% and 60% depending on fingernail.
3.5 | Bending properties of plate distal edge
Figure 11 shows Bending Index results obtained analyzing all fin-
gers of left (L) hand of 3 volunteers. A diagram representative of
the mean response of a cutaneous appendage to a longitudinal
bending stress.
(C)
F I G U R E 8   Scheme of different
positioning during analysis: A, center
position; B, left angled position; and C,
right angled position
PERUGINI et al.
F I G U R E 9   Mean viscoelasticity data and standard deviation
obtained from middle (3) and ring (4) fingers, on right (R) and left
(L) hands in three different positions (C: center; L: left angled; and
R: right angled)
The elastic response to the longitudinal bending stress is very dif-
ferent among nails depending on their geometry, thickness, and length.
4 | D I S CU S S I O N
The new instrument developed in this work gives information about
mechanical properties of nails, very important parameters to assess
products whose claims are regarding the increase of nail resistance
against external physical and chemical stresses. Furthermore, changes
in nail mechanical properties are also related to alterations (brittle nails
and fungal infections) and some systemic pathologies, like as psoriasis,
thus the evaluation of elasticity and firmness of nail plate can be used
as a diagnostic tool or a sign for a successful therapy.7
Usually, in mechanical analysis, if the strain increases linearly
with increase in the pressure applied on the sample by the probe,
the material is purely elastic. Nails, however, display viscoelastic
behavior, where the stress-strain relation is not always linear and
the response of the cutaneous appendage is highly dependent on
the time and the speed of application of the stress, as well as on
other factors such as state of hydration and particular treatments
of the cutaneous appendage.16,17 For this reasons, it is very im-
portant to obtain data regarding both viscoelasticity and firmness
of nail plate. These parameters are normally used together, and
they are useful for evaluating treatments of nail reconstruction
and reinforcing products.
TA B L E 4   Thickness, expressed in µm, and standard deviation of
data collected from all volunteers
Age range R3 R4 L3 L4
21-35 392 (±3.6) 398 (±2.8) 393 (±1.8) 397 (±2.6)
36-58 473 (±1.5) 467 (±1.7) 507 (±2.6) 447 (±3.5)
Note: 3, middle finger; 4, ring finger; L, left hand; R, right hand.
|
      7
In order to define correctly the procedures to use the device de-
scribed in this work, several critical issues have been studied. In fact,
the in vivo nail analysis can run in a reproducible way only if a good and
stable position of the volunteer is found and if it is possible to fix and
recorder the exactly same nail position for analysis over time. This is
crucial when evaluating efficacy of some sort of nail products, because
it is very important to record parameters always from the same area on
the nail. Thereby, the position of the nail is monitored and corrected
if necessary. These parts are not directly involved in the analysis pro-
cess but are essential for a correct operation. In particular, the cameras
ensure the monitoring and maintenance of the correct position of the
distal part of the nail: In all the three types of analysis using the three
different sets, this portion of the nail is involved, and in particular its
upper surface, and for this reason this area must be horizontal (vertical
with respect to the movement direction of the probe) so that the probe
can go down perpendicular on the midline of the third phalanx.
Other parameters very important to consider before starting
with mechanical analysis of nails are the evaluation of their surface
characteristics, free edge length, and curvature.
Especially, nail curvature seems a very important parameter
for nails helping them to adapt to daily upward mechanical forces.
Recently, Sano et al hypothesized that the treatment of nail de-
formities, like koilonychia and pincer nail, can be revolutionized
by elucidating the relationship between mechanical force and nail
configuration.16
In our work, all analyzed nails were very similar for morphological
and curvature properties (Table 3). In fact, the main aim of this work
was to define a suitable protocol and to investigate the repeatability
of data collected from the device.
In this context, the device demonstrated to be able to assure
very reproducible data.
The evaluation of viscoelasticity of nail plate is of great impor-
tance in pharmaceutical and cosmetic fields because this property
allows nails to deform under force or stress applied to reduce their
breakage. In some alterations in which nail plate is very hard or
F I G U R E 1 0   Mean Firmness index obtained from middle
(3) finger, on right (R) and left (L) hands at three different force
intervals: 0-1N, 2-3N, and 3.5-5N
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8       PERUGINI et al.
FI % variation (tw
vs t0) 0-1 N 2-3 N
R3 −60.47 (±3.719) −50.69 (±4.829)
L3 −15.29 (±1.223) −15.80 (±2.365)
F I G U R E 1 1   Mean Bending index obtained from all fingers of
left (L) hand of 3 volunteers
thicker, like nail psoriasis or nails treated for a long time with harden-
ing products, the very low flexibility and elasticity of nail plate give
them more fragile and easy to break.
Results shown in Figure 7 highlighted that results are very repro-
ducible with a percentage of variation of about 10% that it is very
good value considering the usual in vivo variability obtained with all
other bioengineering techniques.
The device can be measured punctually nail thickness and the
results show in Table 4 seem to highlight that there are differences
between young and aged people. These results are not significantly
different because of the small number of volunteer for each group
but it represents a good start point for diagnosis in elderly peo-
ple.19,20 Furthermore, the evaluation of thickness and of its variabil-
ity on the same nail is important also because in some conditions
ranging from stress to kidney and thyroid disease, the presence of
scales or ridges on nails appeared. 21,22
The knowledge of the structural strength of nail plate is es-
sential to understand the state of the nail plate and the effect of
specific treatment, like the efficacy of hardening products. Nails
are composed of 3 different layers of keratin portions: the dorsal,
intermediate, and ventral nail plates 12. For this reason, the re-
sponse to a compression force in a specific area of the nail plate is
related to the force applied. Results shown in Figure 10 highlight
clearly that Firmness Index absolute value is depending on the
force applied. Moreover, in the same force range used, the values
between right and left hands are quite similar. At very low value
of applied force, only the response of the superficial layer can
be recorded whereas increasing the force interval it is possible
to evaluate the response of intermediate and ventral portions of
nails.
TA B L E 5   Percentage mean of variation
of Firmness Index (FI) and standard
3.5-5 N
deviation on data obtained after soaking
−45.45 (±2.155) nail in water for 10 min at 37°C (tw) to
−17.75 (±1.082) respect to basal ones (t0)
It is important to note that all nails analyzed in these experiments
had a thickness between 390 and 400 µm and a smooth surface in
order to avoid any external variability. In fact, the aim of this work is
to establish the capability of the instrument.
The choice of the force interval during an in vivo evaluation de-
pends on thickness and condition of nails. Obviously, the same set
condition must be maintained throughout the study.
The Firmness Index decreases after soaking nails in water and
these results found may be attributed to the effect of water that
embed outermost portions of nails. It is important to note that the
firmness variations are the same independently from the force interval
chosen for the study.
The set used to evaluate the elastic deformation of final edge of
the plate requires medium-long length nails, quite uncommon in peo-
ple of all ages, and hard to achieve in case of weak, fragile, or problem-
atic nails. However, this parameter reflects a specific nail property to
resist perpendicular deformation, and it could be used also to verify
clinical status of healthy nails and the suitability of artificial fingernails.
5 | CO N C LU S I O N S
The device described in this work permits for the first time to ob-
tain important in vivo information about mechanical properties of
nails, in particular viscoelasticity and firmness of nail plate. These
properties can be used to evaluate healthy state of nails and/
or diagnose some local or systemic hills. Furthermore, changes
in mechanical properties of nails can be very useful for verify-
ing the effectiveness and safety of cosmetic and pharmaceutical
products, especially for those claiming reinforcing and hardening
effects.
In order to guarantee accuracy and repeatability of data, it is re-
quired to follow some principles: use of standardized protocols for
the apparatus use; acclimation period for subjects before analysis
(strictly depending from temperature and humidity); accurate prepa-
ration of nail before analysis; and evaluation of morphological char-
acteristics of nail in terms of shape and curvature.
This device presents several advantages: In fact, it is friendly use,
customizable, and non-invasive technique. As demonstrated in this
work, data obtained with this instrument are obtainable in a short
time and they are reproducible. Advantageously, the instrument may
be used in various fields, including analytical laboratories, beauty
saloons, research institutes in the clinical, forensic, pharmaceutical,
cosmetic, and in the biological field in general.
ORCID
Paola Perugini  https://orcid.org/0000-0002-8774-8534
PERUGINI et al. |
      9

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16. Sano H, Ogawa R. Clinical evidence for the relationship between
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