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What Fingernail Abnormalities Say About Your Health
Did you know that your fingernails can provide clues to your overall health? Normal, healthy nails should appear smooth and have consistent coloring, but as you age, you may develop vertical ridges, or your nails may be a bit more brittle. This is harmless and nothing to worry about. If you notice spots due to injury on your nails, this should grow out with the nail and not turn into a big deal.
Abnormalities that occur on the nails may warrant a closer look. These oddities such as spots, discoloration, and nail separation can be the telltale sign of viral warts, infections, and some medications, such as those used for chemotherapy.
White Nails
If the nails are mostly white with darker rims, this can indicate
liver problems, such as hepatitis. In the image below, you can see the
fingers also appear yellowish in color meaning they are jaundiced, which
is another sign of liver trouble.
Very pale nails can sometimes be a sign of other serious illnesses, such as:
Anemia
Congestive heart failure
Liver disease
Malnutrition
White Dots
If small white dots that appear on the surface of the nail that won’t
budge when you try to buff them off, this is usually due to some type
of trauma—even something as simple as a banged finger or a
too-aggressive cuticle trim. In this case, give them some time to grow
out and fade, but if they don’t go away, see your dermatologist, as it
could be the signs of other health issues such as Leukonychia.
Leukonychia
Commonly called white nails or milk spots, and is more frequently
located on fingernails compared to toenails and often can be found in
the central portion of the nail plate. The normal nail beds needs to be
pink in color showing good blood flow underneath the nail plate.
These white spots usually are completely benign, although in some
other situations it could be an indication of an underlying disease.
Bacterial or perhaps fungal infection on the nails could potentially
cause, or an unusual side effect of systemic chemotherapy. This can
be found in people with arsenic poisoning, kidney failure, respiratory
condition. Contact with extreme cold could possibly result in
progression of leukonychia, but these spots will slowly vanish over
time.
Yellow Nails Syndrome
With yellow nail syndrome, nails thicken and new growth slows. This
results in a yellowish discoloration of the nails. One of the most
common causes of yellow nails is a fungal infection. As the infection
worsens, the nail bed may retract, and nails may thicken, crumble, lack a
cuticle and detach from the nail bed in places.
Yellow nail syndrome is often a sign of respiratory disease, such as
chronic bronchitis. Yellow nail syndrome can also be related to swelling
of the hands (lymphedema). In rare cases, yellow nails can indicate a
more serious condition such as severe thyroid disease, lung disease,
diabetes or psoriasis
Bluish Nails
The medical term of Blue fingernails is cyanosis, and can be a sign
of various disorders so it should be checked out. While very cold
temperatures can temporarily slow the flow of blood through the skin
leading to a bluish color, this should go away once you warm up. In
Raynaud’s disease the fingers and toes blanch, then turn blue and may
become numb or painful when exposed to cold. The problem is simply
over-sensitivity of nerves controlling blood flow through small arteries
in the fingers, toes, nose and earlobes.
This odd coloration can also be due to low hemoglobin, which carries
the oxygen in red blood cells. Normally, blood is bright red due to the
oxygen it contains, but when oxygen levels decline, blood turns a
blue-red color.
This chronic cyanosis can be a sign of many different lung and
breathing issues like asthma, emphysema, chronic obstructive pulmonary
disease, chronic bronchitis and other respiratory disorders. It also can
be a sign of a number of heart problems, a response to high altitude or
an overdose of certain drugs such as narcotics, benzodiazepines, and
some sedatives.
Green Nails
Green nails are the result of a pseudomonal infection, which is
usually caused by the environment. This means that those who’s immune
system is already low are very susceptible to this type of nail
infection which makes the nail often appears green in color.
Nail Pitting
Small hole or ice pick-like depressions in the nails (nail pitting)
are common in people who have psoriasis, which is a condition
characterized by scaly patches on the skin. Nail pitting can also be
related to connective tissue disorders, such as Reiter’s syndrome, and
alopecia areata — an autoimmune disease that causes hair loss.
Rippled Nails
If the nail surface is rippled a lot like the pitting I discussed
above, and this may also be an early sign of psoriasis or inflammatory
arthritis. Discoloration of the nail is also common, as the skin under
the nail can seem reddish-brown.
Cracked or Split Nails
Cracked or split nail is one of the common yet disease related nail
disorders. Dry, brittle nails that frequently crack or split have been
linked to thyroid disease. Cracking or splitting combined with a
yellowish hue is more likely due to a fungal infection. Low levels of
Vitamin C, folic acid, and certain proteins in the diet are also known
to cause nail splitting.
Nail Ridges
These can either be horizontal or vertical. With vertical nail
ridges, this can signify nutrition issues, moisture loss or nutritional
absorption issues. Horizontal ridges in the nail are often associated
with diabetes, liver diseases or other chronic diseases. Either type of
ridges can also be caused by damage to the nails.
Dark Lines Beneath the Nail
If you have dark skin, it’s fairly common to have streaks of the
pigment melanin down your fingernails. However, you should still get
this checked by a doctor, as it may occasionally indicate a form of skin
cancer called subungual melanoma, the most dangerous type of skin
cancer. Generally this only affects one nail, causing the stripe to
change in appearance, and becoming wider or darker over time. The
pigmentation may also affect the surrounding skin.
Little Brown Streaks
These are thin dark lines under the fingernail that could be from
mean tiny vessels under the nail that are bleeding. These are known as
“splinter hemorrhages,” and are nothing to worry about if they are due
to the nail being injured. However, if a few nails are affected, this
may be a sign that one of the heart valves is infected, known as
“endocarditis”. Splinter haemorrhages can also be associated with
several other conditions, such as scleroderma, lupus, psoriasis and
rheumatoid arthritis.
Nail Beading or Vertical Ridging
This appears as vertical beaded ridges resembling a candle’s wax
drippings. With nail beading, the beads seem to drip down the nail like
wax, and it is associated with endocrine conditions, like diabetes
mellitus, thyroid disorders, Addison’s disease, Vitamin B
deficiency, hormonal changes, or stress.
However, just like with our skin, these “wrinkles of the nail” are
usually caused by ageing. They run from the nail bed to the tip and
generally start on one or two nails. Over time, the ridges can appear on
all nails. Gentle filing and buffing can help to smooth them.
Nail Clubbing
Clubbing of the fingertips can run in families and could be harmless.
However, if it suddenly develops, it may be a sign of an underlying
medical condition, and due to low oxygen levels in the blood, resulting
in various diseases such as lung or heart disease.
With clubbed fingertips, this natural angle is gone and the nails are
in line with the top of the fingers. Hamman-Rich syndrome, or acute
interstitial pneumonitis, (a form of pneumonia) characterized by
inflammation of the lung. With advanced interstitial lung diseases,
digital clubbing and signs of heart failure may appear. It is also
associated with inflammatory bowel disease, cardiovascular disease,
liver disease and AIDS.
Terry’s Nails
This was named for Dr. Richard Terry and is when the fingernails
and/or toenails appear white with a characteristic “ground glass”
appearance, with no lunula, or
the white crescent-shaped area of a finger nail. With the condition
known as Terry’s nails, most of the nails appear white except for a
narrow pink band at the tip. It is described as a brown arc near the
ends of the nails.
Terry’s nails can sometimes be attributed to aging. In other cases,
Terry’s nails can be a sign of a serious underlying condition. This
condition could be due to a decrease in vascularity and an increase in
connective tissue within the nail bed, and frequently occurs in the
setting of liver failure, cirrhosis, kidney failure, diabetes mellitus,
congestive heart failure, hyperthyroidism, and/or malnutrition.
Onychorrhexis
This is the presence of longitudinal striations or ridges on the nail
plate, can simply be a sign of advanced age, but it may also be
associated with conditions such as rheumatoid arthritis, peripheral
vascular disease, lichen planus, and Darier disease (broad white and red
striations in the nails). A central vertical ridge or groove (shown)
may be due to myxoid cysts that appear near the nail fold, which are
associated with osteoarthritis.
Onychorrhexis nail disorder mainly affects people who suffer from
disorders. Malnutrition or poor nutrition can affect the health and
growth of nails and make them brittle, while trauma or injury to the
nails can also result in Onychorrhexis. Repeated injuries to the nail
are often seen to give rise to this condition. Those who work for long
hours with soap and water are also at risk from this disease, as are
those who use too much nail polish remover, along with those who
are subjected to prolonged exposure to cold. Hypothyroidism is a
glandular disorder results from a deficiency of thyroid hormone
production. Reduced thyroid production happens due to a hypoactive
thyroid gland. It is one of the major causes of Onychorrhexis.
Bulimia is a condition affects young women who get depressed after
eating in excess and feel guilty about not controlling their diet and
keeping a check on their weight. Anorexia Nervosa is another
psychological disease in which the sufferer is obsessed with his or her
body weight and has a delusion of being too fat despite being emaciated.
The diagnosis of Onychorrhexis is not complicated, as the disease is
detected mainly by physical observation of the nails. Blood tests and
thyroid level examinations may be recommended if the doctor suspects
underlying conditions like Hypothyroidism.
The medical treatment of Onychorrhexis generally depends on the
underlying condition. Treatment is supposed to vary with the nature of
disease behind the appearance of Onychorrhexis. Once the causative
condition is treated, the Onychorrhexis symptoms will also disappear in a
short while. The treatment of Onychorrhexis
at home involves medications like hand creams. Using a cream or lotion
consisting of natural plant oils will keep the hand moist and help cure
the disease. Regular application of moisturizers on the skin and nails
will ensure that the symptoms do not recur.
However, Beau’s lines can result from any disease process or illness
that is severe enough to affect the growth plate of the nail.
Malnutrition and chemotherapy drugs for cancer can also cause Beau’s
lines, as can a zinc deficiency. Trauma or injury may also be a cause of
Beau’s lines or nail ridges. The timing of the disease can be estimated
by measuring the distance from the Beau’s line to the nail bed.
Spoon Shaped Nails
Spoon nails (koilonychia) are soft nails that look scooped out. The depression usually is large enough to hold a drop of liquid.
Often, spoon nails are a sign of iron deficiency anemia or a liver
condition known as hemochromatosis, in which your body absorbs too much
iron from the food you eat. Spoon nails can also be associated with
heart disease and hypothyroidism.
Onycholysis
With a condition known as onycholysis, the fingernails become loose
and can separate from the nail bed. The separated part of the nail
becomes opaque with a white, yellow or green tinge.
Sometimes detached nails are associated with injury or infection, but
in other cases nail separation is a reaction to a particular drug or
consumer product, such as nail hardeners or adhesives. Thyroid disease
and psoriasis also can cause nail separation.
Paronychia
Paronychia is the name for inflammation that causes a painful, red
and swollen nail fold, or the skin and soft tissue that surrounds and
supports the nail.
Paronychia can be acute, where it develops over a few hours, or
chronic, where it lasts more than six weeks, and is most often caused by
infection, injury or irritation. Sometimes, there’s an underlying skin
condition such as eczema or psoriasis or another medical condition such
as diabetes or HIV, and is about three times more common in women than
in men.
Chewed Nails
Biting
your nails may be nothing more than an old habit, but in some cases
it’s a sign of persistent anxiety that could benefit from treatment.
Nail biting or picking has also been linked to obsessive-compulsive
disorder, and the habit is often a way to ease anxiety or to keep at
least one part of the body occupied while the mind lacks interest.
Frustration and loneliness are additional emotional triggers that can
lead to nail biting. While some research suggests genes may play a role,
if you can’t stop, it’s worth discussing with your doctor.
