What are nail abnormalities?

Healthy nails appear smooth and have consistent coloring. As you age, you
may develop vertical ridges, or your nails may be a bit more brittle. This is
harmless. Spots due to injury should grow out with the nail.

Abnormalities — such as spots, discoloration, and nail separation — can

result from injuries to the fingers and hands, viral warts (periungual warts),
infections (onychomycosis), and some medications, such as those used
for chemotherapy.

Certain medical conditions can also change the appearance of your

fingernails. However, these changes can be difficult to interpret. Your
fingernails’ appearance alone isn’t enough to diagnose a specific illness. A
doctor will use this information, along with your other symptoms and a
physical exam, to make a diagnosis.

You should always consult your doctor if you have any questions about
changes in your nails.

Abnormalities of the fingernail

Some changes in your nails are due to medical conditions that need attention.
See your doctor if you have any of these symptoms:

 discoloration (dark streaks, white streaks, or changes in nail color)

 changes in nail shape (curling or clubbing)
 changes in nail thickness (thickening or thinning)
 nails that become brittle
 nails that are pitted
  bleeding around nails
 swelling or redness around nails
 pain around nails
 a nail separating from the skin

These nail changes can be caused by a variety of different conditions,

including ones we describe below.

Beau’s lines

Depressions that run across your fingernail are called Beau’s lines. These can
be a sign of malnourishment. Other conditions that cause Beau’s lines are:

 diseases that cause a high fever such as measles, mumps, and scarlet

fever
 peripheral vascular disease
  pneumonia
 uncontrolled diabetes
 zinc deficiency

Clubbing

Clubbing is when your nails thicken and curve around your fingertips, a
process that generally takes years. This can be the result of low oxygen in the
blood and is associated with:

 cardiovascular diseases
 inflammatory bowel disease
 liver diseases
 pulmonary diseases
 AIDS
Koilonychia (spooning)

Koilonychia is when your fingernails have raised ridges and scoop outward,
like spoons. It’s also called “spooning.” Sometimes the nail is curved enough
to hold a drop of liquid. Spooning can be a sign that you have:

 iron deficiency anemia

 heart disease
 hemochromatosis, a liver disorder that causes too much iron to be
absorbed from food
 lupus erythematosus, an autoimmune disorder that causes inflammation
 hypothyroidism
 Raynaud’s disease, a condition that limits your blood circulation

Leukonychia (white spots)

Nonuniform white spots or lines on the nail are called leukonychia. They’re
usually the result of a minor trauma and are harmless in healthy individuals.
Sometimes leukonychia is associated with poor health or nutritional
deficiencies. Factors can include infectious, metabolic, or systemic diseases
as well as certain drugs.

Mees’ lines
Mees’ lines are transverse white lines. This can be a sign of arsenic
poisoning. If you have this symptom, your doctor will take hair or tissue
samples to check for arsenic in your body.

Onycholysis
When the nail plate separates from the nail bed, it causes a white
discoloration. This is called onycholysis. This can be due to infection, trauma,
or products used on the nails.

Other causes for onycholysis include:

 psoriasis
 thyroid disease

Pitting
Pitting refers to small depressions, or little pits, in the nail. It’s common in
people who have psoriasis, a skin condition that causes the skin to be dry,
red, and irritated. Some systemic diseases can also cause pitting.

Terry’s nails
When the tip of each nail has a dark band, it’s called Terry’s nails. This is
often due to aging, but it can also be caused by:

 congestive heart failure

 diabetes
 liver disease

Yellow nail syndrome

Yellow nail syndrome is when the nails get thicker and don’t grow as fast as
normal. Sometimes the nail lacks a cuticle and may even pull away from the
nail bed. This can be the result of:

 internal malignancies
 lymphedema, swelling of the hands
 pleural effusions, fluid buildup between the lungs and chest cavity
 respiratory illnesses such as chronic bronchitis or sinusitis
 rheumatoid arthritis

These are just some of the signs of abnormal fingernails. Having any of these
signs isn’t proof of any medical condition. You’ll need to visit your doctor to
determine if your condition is serious. In many cases, proper care of your nails
is enough to correct their appearance.
How to care for your nails
You can prevent many nail abnormalities by taking good care of your nails. Follow
these general guidelines to keep your nails healthy:

Tips
 Don’t bite or tear at your nails, or pull on hangnails.
 Always use nails clippers and trim them after you bathe, when nails are still
soft.
 Keep your nails dry and clean.
 Using sharp manicure scissors, trim your nails straight across, rounding the tips
gently.

If you have a problem with brittle or weak nails, keep them short to avoid breakage.
Use lotion on your nails and cuticles to keep the nail and nail beds moisturized.

Shop for nail lotions

If you get professional manicures or pedicures, make sure your nail salon is properly
certified and that nail technicians use proper sterilization techniques. You should
avoid long-term use of nail polish and nail polish removers.

Shop for manicure scissors

Consult your doctor if you notice a problem with your nails to rule out any serious