Detailed History: It's crucial to gather more information about their scratching habit – the frequency, intensity, and any associated scalp conditions. Rule out other causes: Some medical conditions can cause splinter hemorrhages, so it's important to consider those possibilities.   Online Consultation: I'd recommend an online consultation to discuss this further. This would allow me to ask more specific questions and potentially get a visual of their nails and scalp.

Reduce scratching: Advise them to try to minimize scratching their scalp, as this can lead to further nail damage. Keep nails trimmed: Keeping nails short can help prevent further injury and hemorrhages.   Moisturize: Keeping the nails and cuticles moisturized can improve nail health.