Liam Carter
Nails can be a reflection of a person's state of health. Changes in the colour, shape, texture, or thickness of the fingernails or toenails can indicate an underlying health issue. Curved or ingrown nails, for example, can be a sign of iron deficiency anaemia. Nails that thicken and curve over the fingertips may be due to increased blood flow to the fingertips and can sometimes run in families. In some cases, treating the underlying health condition can help resolve nail abnormalities. In other cases, specific treatments may be required to address the nail problem directly.
| Characteristics | Values |
|---|---|
| Cause | Peripheral artery disease (PAD), skin conditions, eczema, psoriasis, nail matrix melanoma, iron deficiency, fungal infection, injury, medication, illness, aging, vitamin deficiency, thyroid problems, chronic health conditions, bacterial infection, viral warts, disorders affecting oxygen in the blood |
| Symptoms | Thickened nails, discoloured nails, pitted nails, brittle nails, spoon-shaped nails, Beau's lines, slow nail growth, white streaks, spots, pitted nails, nail abnormalities, nail dystrophy, nail loss, redness, swelling, pain, tenderness, crumbling, white lines, nail curving, nail softening, dark streaks |
| Treatment | Antifungal medication, antibiotics, surgery, chemotherapy, radiation, intravenous iron supplementation, dietary changes, drainage of trapped blood, emollient creams, vitamin supplements, clear nail polish with protein, antifungal or antibacterial drugs |
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What You'll Learn
See a doctor for a check-up
If you notice any changes to your nails, it is always a good idea to see a doctor or dermatologist for a check-up. A dermatologist is a medical doctor who specializes in treating the skin, hair, and nails. They can help identify the root cause of any nail concerns and provide appropriate treatment.
Nails can offer a glimpse into your overall health, and a sudden change in color, texture, or shape can sometimes indicate an underlying problem. For example, pale nails can signify anemia, half pink and half white nails could indicate kidney disease, and blue half-moons could be a sign of poisoning. Dark streaks under the nail could be melanoma, the deadliest form of skin cancer, and should be examined by a dermatologist as soon as possible. Other color changes, such as greenish-black nails, can indicate bacterial infections, while yellow nails could be a sign of lung disease or rheumatoid arthritis.
Changes in nail shape can also be indicative of health issues. Thick, overgrown nails, known as Ram's horn nails, can be caused by diseases such as psoriasis, ichthyosis, or circulation problems. Spoon-shaped nails that dip down in the middle can indicate an iron deficiency, and deep grooves across the width of the nail can mean that something has slowed or stopped nail growth for a while.
Nail injuries, such as bruising under the nail, can be relieved through a procedure called nail trephination, which must be performed within 48 hours of the injury. If your nail is lifting up or you notice redness and swelling, it could be a sign of infection, which can be treated with soaks and antibiotics if diagnosed early.
In summary, if you notice any unusual changes to your nails, it is always best to consult a doctor or dermatologist for a check-up. They can provide advice, diagnose any underlying issues, and recommend appropriate treatments to address your nail concerns.
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Take antifungal medication
If you have a fungal nail infection, your nail may become thick, discoloured, and brittle. This is usually a slow-developing infection, starting at the edge of the nail and spreading to the rest of it. Toenails are more commonly affected, but fingernails can also become infected.
Fungal nail infections are unlikely to get better without treatment. Antifungal medication is the typical treatment for nail fungus. You can buy antifungal creams, gels, sprays, and patches over the counter at drugstores or online. These include clotrimazole (Lotrimin) and terbinafine cream (Lamisil). Over-the-counter products are best for mild toenail fungus but may take months to work.
If over-the-counter treatments are ineffective, your doctor may prescribe antifungal tablets. Before prescribing treatment, your doctor will take a sample of your nail to test what kind of infection you have. They may also need to perform a blood test to check that your liver is functioning properly. Antifungal tablets can have side effects, including nausea, vomiting, and headaches, so your doctor will need to monitor you while you take them.
Your doctor might also prescribe an antifungal medicine that you paint on your nails. This will look like a clear nail polish and will contain a drug like ciclopirox. You will be given instructions on how often to use it, but usually, you paint it on the affected toenail once a day. Let it dry for 30 seconds before putting on socks or shoes. Once a week, remove the polish with rubbing alcohol and trim away as much of the diseased nail as you can, using clippers or scissors. Studies show antifungal nail polish is less effective than taking pills, so your doctor may combine the two treatments.
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Drain blood from under the nail
To perform the procedure, the provider will first clean the nail and the surrounding area with soap and water to remove any dirt or debris. They will then use a wound-cleansing solution, such as chlorhexidine, to further clean the area. Once the area is clean, the provider will use a needle, an electrocautery device, or a special tool designed for trephination to make a small hole in the nail. The device will be positioned over the middle of the bruise, and gentle pressure will be applied to create a hole just deep enough to release the blood.
It is important to perform nail trephination as soon as possible after the injury, ideally within 24 to 48 hours. This is because the procedure works best before the blood has had a chance to clot. After the procedure, it is normal to experience drainage through the hole in the nail for the next 24 to 36 hours. To care for the nail after the procedure, keep the area dry and clean and follow your provider's instructions for changing bandages.
Nail trephination is a safe and common procedure that rarely leads to complications. However, there is a small risk of developing an infection or minor injury to the nail bed. If you are experiencing severe pain due to a bruise under your nail, it is important to see a healthcare provider to determine if nail trephination is the appropriate treatment option for you.
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Wear comfortable shoes
Ingrown toenails are one of the most common and painful toenail problems. They occur when the corner or side of the toenail grows into the flesh. Ill-fitting shoes can trigger ingrown toenails and cause toenail pain. To prevent this, wear proper-fitting shoes with a wide toe box and trim your toenails straight across and not too short. Your toes must always have enough room to move up and down and even side to side. If your toes are cramped, they will be rendered immobile, and extra force will be exerted on them. This can lead to toe blisters, abrasions, corns, bunions, and ingrown nails.
Toenail fungus is another common issue that can be caused by wearing the same sweaty shoes or boots every day. Fungi thrive in dark and damp environments, so keeping your feet dry and wearing comfortable, breathable shoes can help prevent toenail fungus. Prescription antifungal pills are the typical treatment for nail fungus.
Additionally, certain health conditions can affect your nail matrix and interfere with nail growth. Peripheral artery disease (PAD), for example, causes reduced blood flow to your legs and feet, affecting your nail matrix and slowing nail growth. Severe eczema can also interfere with nail growth, and psoriasis can cause white lines, pitting, and crumbling of the nails. In such cases, it is important to manage the underlying condition with the help of a doctor and take any prescribed medications.
If you experience abnormal changes to your toenails, such as pain, itching, or discoloration, see a doctor. They can provide guidance on proper foot care and help identify any underlying issues causing your nails to grow incorrectly.
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Take iron supplements
While there is insufficient evidence that nail problems are usually cured by taking vitamin supplements, taking iron supplements can help strengthen nails and improve their growth. Iron is needed to provide your cells with adequate oxygen, which is necessary for healthy nails. An iron deficiency can affect the shape and appearance of your nails, causing them to become brittle or take on a "spoon nails" shape, also known as koilonychia.
To fix an iron deficiency, you can increase your consumption of iron-rich foods, such as meat (especially red meat), seafood, beans, and leafy greens. You may also consider taking a daily iron supplement, but it is recommended to consult with your physician before making any drastic changes to your diet or taking supplements.
It is important to note that it may take 4-6 months before seeing any results from taking iron supplements, as this is the average length of time it takes for a nail to grow from the matrix to the free edge. In the meantime, it is crucial to be patient and allow the damaged nail to grow out and be replaced with a new, healthy nail.
Additionally, vitamin B12 plays a role in iron absorption, so consuming adequate amounts of B12 through your diet or supplements can also support nail health. A deficiency in vitamin B12 can lead to changes in nail pigmentation and texture.
While taking iron supplements can help address iron deficiency, it is always a good idea to consult a healthcare professional to understand the underlying causes of your nail issues and determine the best course of action.
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Frequently asked questions
Ingrown nails are nails that curve far inward at the sides. They can be caused by wearing tight shoes or improper nail cutting. Treatment may involve removing part or all of the nail.
Nail abnormalities can be caused by problems with the colour, shape, texture, or thickness of the nails. This can be due to low levels of zinc and iron, thyroid problems, or certain diseases and conditions.
Nail trephination is a procedure that drains trapped blood from under the nail. It provides pain relief and helps the new nail grow in correctly. It must be performed within 48 hours of the injury.
Keep your nails short and avoid using nail polish. Use an emollient cream after washing or bathing. Bring your own manicure tools to salons and do not allow manicurists to work on your cuticles.
