Nail problems can occur at any time throughout your life. While some issues are quite innocent, others may have underlying health implications. Knowing which ones to worry about (and which ones to dismiss) empowers you to know what actions to take.
Your nails (all 20 of them) are a great barometer of your general health. According to leading dermatologists, changes in the body – that are otherwise undiagnosed – may be visible in the nails first. Examining your toenails and fingernails occasionally is just good advice. If you wear polish all the time, you may want to re-think that strategy because you cannot see what’s hidden.
Ridges in the nails are by far, the biggest complaint. But did you know that they can be either vertical or horizontal? While one of these issues is a cause for concern, the other one is not. Find out more below about which nail problems are cause for worry.
Nail Problems That May Indicate Health Issues
Horizontal Ridges – These are called Beau’s lines and are ridges in the nail that run horizontally across the nail bed width. They may be present on one nail or on all and are actually ridges in the nail plate.
Health concerns: Raynaud’s disease, diabetes, psoriasis, trauma to the nail bed, skin disorders, malnutrition, malabsorption, respiratory disease, autoimmunity, exposure to harsh toxins, and loss of moisture. Drugs used in chemo and beta-blockers can sometimes result in these type of ridges while some ridges occur more from aging.
Actions to take: Nails grow about 1mm every 6-10/days. Doctors can use this measurement to estimate when the problem actually began.
Other types of horizontal ridges include:
Muehrcke Lines – Seen as an interruption in nail pigmentation. Indicates, kidney and liver disease, malnutrition, chemotherapy.
Transverse Ridges – Indicate of a history of severe illness. Indicates a terminal illness, such as cancer.
Aldrich Mee’s Lines – Discolored lines running across the nails. Indicates arsenic poisoning or poisoning from other heavy, toxic material.
Terry’ Nails – Seen as a white nail plate. Anyone with Terry’ nails will also have a horizontal band at the tip of the nail. Indicates diabetes, HIV, kidney disorders or liver disease.
Vertical ridges – Nail problems such as vertical ridges are not a health concern. They are mostly attributed to aging or heredity and are quite common.
White Horizontal Lines or Bands – Known as “Mees lines”, these white bands run across the entire width of the nail bed. They may affect all or one nail, occurring about the same location on each. As the nail grows out, so does the line – allowing doctor’s to postdate onset.
Health concern: These are always a sign of arsenic poisoning! Although the condition is quite rare, hair and tissue samples should be tested to verify it.
Actions to take: Call your doctor immediately and make an appointment. Do not eat or drink anything pre-made until the issue is resolved.
A Vertical black line – A black discoloration that runs vertically (from cuticle to tip) or streaks and grows from the nail bed and is usually on one single nail. About 75 percent of cases involve the thumb or big toe alone. A black discoloration that grows increasingly wider at the cuticle is even more worrisome because it means whatever is producing it is getting more aggressive.
Other nail problems you might see are deeply pigmented skin below the nail.
Health concerns: Melanoma, the deadliest form of skin cancer. People with darker skin are more prone to subungual melanoma than Caucasians. However, dark skinned races have also been known to have more dark lines that are benign (not problematic).
Actions to take: Your doctor should always inspect any suspicious dark lines in the nail because of the risk of cancer. Some black lines may have harmless causes such as injury. A biopsy can always set your mind at ease.
Little vertical red lines – Small red lines (that look more like brownish streaks) in the nail and run from cuticle to tip are known as splinter hemorrhages and are caused by bleeding under the nail bed.
Health concerns: These streaks may indicate heart problems caused by tiny clots that damage small capillaries. Splinters are associated with a condition of the heart valve known as endocarditis but can also be caused by nail injuries.
Actions to take: Discuss nail changes with your doctor who can evaluate and treat underlying causes.
Clubbed nails – Especially widened nails that bulge out and curve down (like an upside down spoon) are called clubbed nails.
Health concerns: Although widened nails develop over many months and years, they are a common sign of lung disease or lung cancer.
Actions to take: If you have shortness of breath or constant coughing, it’s time to get a physical and discuss options with your health care provider.
Pitted Nails – Nails that have pits or are rippled are called pitted nails. If you can’t see them well, you can feel them by running your finger pads across them.
Health concerns: Around 10-50 percent of people with psoriasis have tiny hole pockets in their nails. Also, 3/4ths of those have psoriatic arthritis. More rarely, people with Reiter’s syndrome (or other disorders of the connective tissues) show these types of nail problems.
Actions to take: Prescribed medications may help treat the underlying causes. When treatment starts early, the nail bed can often be restored.
White spots on nails – The most common of all nail problems, white spots on nails (called leukonychia) are NOT indicative of an underlying deficiency (calcium or zinc) nor do they have a medical cause. They are typically the result to an injury of the nail bed. By the time the spot shows up, time has passed so you may or may not remember any injury to the nail bed. Sometimes, they can indicate a reaction to nail polish and may be a sign of a mild infection.
*Note: Nails that turn completely white indicate liver disease but by the time the entire nail turns completely white, you’d probably have other symptoms as well.
Brittle Nails – Nails that are break, crack and split (and may or may not have vertical ridges) are said to be “hypothyroidism nails”.
Health concerns: Brittle nails are indicative of hypothyroidism or of Grave’s disease caused by hyperthyroidism. When the thyroid is either overly active or under-active, metabolic functions throughout the body are disrupted, including the delivery of moisture to nails, skin, and hair.
Actions to take: Having your thyroid levels checked is a start. However, you may need to do some health evaluations yourself. Find out more here.
Separating nails – Nails that appear to be lifting off from the nail bed, is called onycholysis and often begins with the fourth or fifth fingernail. Toenails may also be affected.
Health concerns: This disorder is caused by hyperthyroidism, in which the body makes too much thyroid hormone and causes nails to grow too quickly. The condition is typically seen in younger people more than older folks.
Actions to take: Symptoms of hyperthyroidism include fatigue, increased appetite, weight gain, excessive sweating, hair loss, and protruding eyes. There are many newer medications today that can help deal with an overly active thyroid.
Crater depressions in nails – Nails that look like they have spoon-like depressions is a condition called koilonychia. Nails will also be unusually pale or stay whitish long after you press gently against one of them. The moons that appear at the cuticle may also appear to be overly-white.
Health concerns: Although spooning nails are most often associated with anemia (iron deficiency), it may also be caused by hemochromatosis or iron overload disease. Other symptoms to look for include fatigue or lethargy or there may not be any symptoms at all.
Actions to take: A CBC (complete blood count) can diagnose iron problems in the body. Anemia is one of the easiest nail problems to treat.
Protecting your health seems to be the theme for most all types of nail problems. Be sure to bookmark this page to refer to, just in case you need them!
Always consult your physician before using natural remedies, especially for anyone with preexisting conditions or anyone currently taking prescription medications. Although many efforts are made to ensure that the advice given on this site is professionally sound, the advice is not intended to replace a mutual relationship with a medical provider.
