19 Nail Changes That You Should Not Ignore

Here are nineteen nail changes that may indicate a medical condition.

A change in color, texture, or shape can be innocuous, but it can be an indication of a serious medical condition. If you see any of the following changes in your fingernails or toenails, you should consult a board-certified dermatologist.

1. Horizontal white streaks over nails: Horizontal white lines, also known as Muehrcke’s lines, that run over the nails may be caused by nutritional deficiency such as protein or zinc deficiency. These lines indicate that a section of the nail was interrupted while growing and did not receive all the nutrients or blood flow it requires. Muehrcke's lines may indicate more significant disorders, such as kidney disease or liver disorders.
2. Brown vertical stripe on nails: Hormones and some drugs can cause pigmented bands on the nails. The shape and distribution of the stripe indicate various problems. If the brown or dark stripe that extends from the cuticle to the free edge of the nail is growing broader, it may be a symptom of cancer, called melanoma, which is the most dangerous type of skin cancer.
3. Ridges on nails: Ridges or vertical lines or depressions on nails are commonly seen with aging. Ridges are wrinkles in nails, and smoothing out of ridges may cause thinning of the nails. Deep horizontal ridges known as Beau's lines imply that something caused the nail to cease growing for a short period. High fever, chemotherapy, a significant sickness, major surgery, blood transfusion, a vehicle accident, or any major stress to your system can all be triggered.
4. Horizontal depression on the thumb: A horizontal depression on the thumbnail that looks like a washboard is a classic symptom of a habit tic deformity, in which people repeatedly massage or pick the cuticle of their thumb with index finger during the formation of the nail.
5. Brittle nails: Brittle nails are also known as onychoschizia. Nails become brittle and break easily due to a dietary issue or toxins to which your hands are exposed. Nails form in the nail matrix, which is the root of the nail. If you are malnourished or lack specific nutrients, your body does not have the material to make good nails. Hence, if you have eating disorders, you may develop nail problems. Brittle nails can be a sign of iron deficiency anemia or thyroid dysfunction. Even dehydration can cause brittle nails that chip off easily. Hydration is extremely important to maintain the good health of the nails. Drink adequate water and eat hydrating foods such as cucumber and watermelon to prevent it. Overdoing manicures can weaken nails due to increased exposure to chemicals such as acetone.
6. Pitted nails: Psoriasis is one possible cause of pitting or forming small dents and craters in the nails. Psoriasis is a persistent skin disorder that causes an itchy, scaly rash. Nail involvement with psoriasis is related to a higher incidence of arthritis (psoriatic arthritis). Pitting occurs in almost half of the people with psoriasis and approximately 80 percent of people with psoriatic arthritis. Dented, pitted, or split nails can be an indication of alopecia areata, an autoimmune illness that causes hair loss.
7. Pale nails: Nails and fingernail beds appear pale and ghostly if you have anemia (low hemoglobin or red blood cell count). Pale nails may indicate heart or liver disease.
8. Blue nails: Blue nails indicate a lack of oxygen to the fingertips. This could be due to respiratory diseases, heart diseases, or a vascular condition called Raynaud's disease, which is an uncommon disorder of the blood vessels.
9. White spots: The appearance of white spots on nails is known as punctate leukonychia, which is caused by a slight trauma during the formation of the nail. It may be caused by fungal infection or allergic reactions.
10. Red streaks: Red streaks on your nail bed are not commonly seen unless you have an injury. Splinter hemorrhages are small longitudinal streaks of blood that appear on the undersurface of nails. They can signify a cardiac infection that affects the valves or the inner lining of the heart.
    • Endocarditis, or heart infection, is usually caused by a bacterial infection, and the risk is higher if you have:
      • Implanted heart devices
      • Congenital heart defects
      • History of drug use
      • Heart attacks
      • You may have other symptoms such as
      • Flu-like symptoms
      • Weight loss
      • Muscle soreness
      • Coughing
11. Yellow nails: Yellow nail syndrome is a condition in which the nails turn completely yellow. Such nails become thick and have a very slow rate of growth. This condition may be related to pulmonary issues. You may have overly curled nails that separate them from the nail bed. Smoking can cause yellow nails by blocking oxygen from the fingernails. Nicotine and tar from the cigarette stain the nails. Yellow nails may result due to fungal infection, diabetes, or thyroid disease.
12. Clubbing of nails: During low oxygen blood saturation for an extended period, the tips of the fingers grow, creating the impression of rounded clubs.
    • Clubbing of nails are most commonly seen with:
      • Pulmonary problems
      • Gastrointestinal disorders such as ulcerative colitis and Crohn's disease
      • Liver cirrhosis
      • Cancers
13. Severely bitten nails: Nail-biting is a typical practice, but persistent biting or picking at the skin surrounding the nails may be an indication of obsessive-compulsive disorder (OCD). Anxiety can be a major cause of nail-biting because it might divert your attention away from the source of your anxiety. Try to be more aware of circumstances during which you bite your nails so that you can identify your trigger and deal with it correctly. You may acquire a stress ball or find another activity to fidget when you are stressed that won't harm your nails. To treat OCD-related nail-biting, psychiatric consultation may be required.
14. Dull nails: Your nail health can suffer because of lack of sleep. Weak and dull nails can indicate that you aren't getting the recommended eight hours of sleep per night. If your nails aren't as healthy and bright as usual, it could be a sign that your body is fighting an infection. When you have a cold, your body may cease nourishing your nails because it is more vital to spend energy to combat the cold.
15. Onycholysis: Nail separation or lifting of nails is known as onycholysis, which is a painless condition in which the nail separates from the pink nail bed. The affected nails may be prone to catching on objects, which can be painful. As a result, it is crucial to gently trim affected nails. Onycholysis normally resolves in a few months after the underlying reason is recognized and treated when the old nail grows out and is replaced or reattached.
    • It is caused by:
      • Psoriasis
      • Fungal infections
      • Raynaud’s disease
      • Thyroid disorders
      • Lupus
      • Allergic reactions to nail products
      • Drug reactions
16. Koilonychia: Koilonychia is also referred to as spoon nails because your fingernails have elevated ridges that scoop outward like spoons. This condition is indicative of iron shortage (anemia) and cardiac diseases.
    • Spooning of nails may also indicate:
      • Hemochromatosis (buildup of iron in the tissues at toxic levels)
      • Lupus erythematosus (autoimmune disorder)
      • Hypothyroidism (underactive thyroid gland)
      • Raynaud’s disease (circulatory disorder)
17. Paronychia: Paronychia is an infection and inflammation of the skin around the nail. Cuticles keep bacteria, fungus, yeast, and mold from growing underneath your nails and infecting you. As cuticles are pushed back, the seal between the skin and nail is lost and result in paronychia.
18. Cysts on nails: Small cysts from near or on the cuticles in this disorder. This condition may be an indication of arthritis.
19. Darrier disease: Darrier disease is a hereditary condition that presents itself as skin rash. Broad, white or reddish lines appear on the nails. In rare circumstances, the nail tip breaks off in a V form.

If your nails show signs of one of the major changes listed above, it is crucial to address the underlying health issue. When your health improves, so will your nails. A healthy balanced diet and proper personal hygiene will, in most situations, ensure strong nails and a healthy you.