Caleb Foster
Changes in the appearance of our nails, such as curving, can be harmless traits that run in the family, but they can also indicate underlying health issues. Curved nails, also known as spoon nails, can be a sign of nutritional deficiencies, autoimmune conditions, or diseases of the heart, lungs, or digestive system. If you notice significant changes in your nails, it is important to consult a healthcare professional for advice and treatment.
| Characteristics | Values |
|---|---|
| Appearance | Nails may appear smooth, thin, concave, or scooped out like a spoon |
| Texture | Nails may feel spongy, soft, or warm to the touch |
| Fingertips | Swelling or clubbing of the fingertips |
| Shape | Curved, pitted, or with raised ridges |
| Colour | White discolouration, yellow, greenish-black, or red |
| Nail Bed | Nail lifting or separating from the bone |
| Health | May indicate nutritional deficiencies, autoimmune disorders, or underlying health conditions |
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What You'll Learn
Nutritional deficiencies
Curved nails, also known as spoon nails, can be a sign of nutritional deficiencies. This condition, called koilonychia, causes nails to become concave and take on a scooped-out appearance. While curved nails can sometimes be a harmless trait that runs in the family, they can also indicate underlying health issues.
Iron deficiency is the most common nutritional deficiency associated with spoon nails. It is the leading cause of koilonychia and can lead to weak, curled nails. People with iron deficiency may be prescribed supplements by their doctor. However, it is important to consult a healthcare professional before taking any supplements, as they can have adverse effects.
Vitamin B12 deficiency is another possible cause of curved nails. Low levels of vitamin B12 can result in changes in nail texture and structure. Deficiencies in other nutrients, such as zinc or biotin, can also impact nail health and contribute to nail curvature.
In addition to nutritional deficiencies, spoon nails can be a symptom of autoimmune disorders, such as psoriasis, or underlying health conditions affecting the heart, lungs, or digestive system. Conditions like asthma, chronic bronchitis, or low oxygen levels can also influence nail growth and curvature. Therefore, it is important to monitor your nails and consult a healthcare professional if you notice significant changes or other accompanying symptoms.
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Autoimmune conditions
Changes in the shape of your fingernails, such as curving, can sometimes be a harmless trait that runs in the family, or a result of injury or trauma. However, curving nails can also indicate an underlying health issue, such as an autoimmune disorder or disease.
One possible autoimmune disorder that can cause fingernails to curve is psoriasis, a skin condition that causes the skin to be dry, red, and irritated. Psoriasis affects the nails of about 90% of people who have the condition, and can cause nail thickening, curving, and shallow or deep holes in the nail.
Another potential autoimmune condition linked to nail abnormalities is psoriatic arthritis, which is associated with onycholysis, or nail lifting. Onycholysis can cause the nail to separate from the nail bed, resulting in white or yellow discolouration.
Curved nails, specifically those with raised ridges that scoop outward like spoons, could be a sign of koilonychia. This condition is also known as "spooning" and can be associated with various issues, including iron deficiency anaemia, malnutrition, hemochromatosis, coronary disease, thyroid disorders, and psoriasis.
If you notice persistent changes to your nails, it is important to consult a healthcare professional, especially if other symptoms are present. A doctor can help identify any underlying health issues and recommend an appropriate treatment plan.
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Psoriasis
Curving nails can be a harmless trait that runs in the family. However, it can also be a sign of an underlying health issue, such as psoriasis.
Nail psoriasis is a subtype of psoriasis that affects the nails on your fingers and toes. It is characterised by nail pitting, onycholysis (distal nail plate separation from the nail bed), and the oil drop sign (discolouration of the nail).
Symptoms
Nail psoriasis can manifest in a variety of ways, including:
- Discolouration: The nail bed may change colour, appearing yellow, red, pink, or brown.
- Pitting: Small dents or pits can form on the nails, ranging from 0.4 to 2 millimetres in size, and can be shallow or deep.
- Changes in nail structure: Grooves may develop horizontally across the nails (Beau's lines), and nails may become so thin that they crumble.
- Thickening: Nails may become thicker.
- Separating: The thick layer of skin underneath the nail may peel and slowly separate from the nail bed.
- Crumbling: Nails may start to crumble.
- Roughness: Nails may become rough.
- Blood under the nail: A thin line of blood may appear under the nail.
- Nail lifting: The nail may lift up and separate from the finger.
Treatment
There is no cure for nail psoriasis, but treatments can help alleviate symptoms. Treatment options include:
- Corticosteroids: Injections or topical creams, ointments, or nail polishes containing corticosteroids can be applied directly to or near the nails to treat the buildup under the nails, nail ridges, thickening, and separating.
- Laser treatments: While lasers have been studied as a treatment for nail psoriasis, more research is needed before they can be recommended.
- Systemic medication: For severe psoriasis, a dermatologist may prescribe medication that treats both the skin and nails.
- Turmeric: Curcumin, a chemical found in turmeric, has anti-inflammatory and anti-fungal properties that may relieve symptoms of nail psoriasis.
- Nail care: Keeping nails trimmed, clean, and moisturised can help prevent infection and improve the appearance of nails.
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Fungal infections
Fingernails that curve outward could be caused by fungal infections. Fungi that are already present in or on the body can cause nail infections. Fungi enter through small cracks in the nail or the nearby skin, causing infection. Fungi are normally present in and on the body alongside various bacteria. However, when a fungus begins to overgrow, it can cause an infection.
Fungal nail infections are common and can affect any part of the body. Toenails are more frequently affected than fingernails, likely because toes are usually confined to shoes, which provide a warm, moist environment for fungi to thrive in. The same fungi that cause jock itch, athlete's foot, and ringworm can cause nail infections. Distal subungual infections are the most common type of fungal nail infection and can develop in both fingernails and toenails. When infected, the outer edge of the nail has a jagged appearance with white and/or yellow streaks across the nail. The infection invades the nail bed and underside of the nail. White superficial infections usually affect toenails. A certain type of fungus attacks the top layers of the nail and creates well-defined white spots on the nail. Eventually, these white patches cover the entire nail, which becomes rough, soft, and prone to crumbling. Spots on the nail may become pitted and flaky. Proximal subungual infections are uncommon but can affect both fingernails and toenails. Yellow spots appear at the base of the nail as the infection spreads upward. This infection can commonly occur in people with compromised immune systems.
Candida yeasts cause another type of infection. It can invade nails previously damaged by a prior infection or injury. Candida more commonly affects fingernails and occurs in people who frequently soak their hands in water. These infections usually start with the cuticle around the nail, which becomes swollen, red, and tender to the touch. The nail itself may partially lift off the nail bed or fall off completely.
If you have a fungal nail infection, antifungal medication may be recommended. Antifungal medication comes in tablets or a special paint you apply directly to the nail. A small sample of the infected nail may need to be taken and sent off for testing before treatment starts, to confirm that you have a fungal infection. If you prefer not to take antifungal tablets, your doctor may suggest you try antifungal nail paint instead. Nail paint isn't generally considered to be as effective as tablets because it can be difficult for it to reach the deeper layers of the nail. However, it doesn't usually cause any side effects. Terbinafine and itraconazole are the two most commonly prescribed antifungal medications. These usually need to be taken once or twice a day for several months to ensure the infection has completely cleared up. Laser treatment is a possible option for stubborn fungal infections. The laser emits high doses of light energy, which are used to destroy the fungus.
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Genetic factors
While changes to the shape, thickness, or colour of nails can sometimes be harmless, they can also indicate an underlying health issue. Curved nails, also known as koilonychia or spoon nails, can be caused by several factors, including genetic factors.
Curved nails can sometimes be a harmless trait that runs in the family. However, it is important to monitor any changes in your nails and consult a dermatologist if you notice any unusual symptoms.
In some cases, koilonychia or spoon nails can be genetic. People living at high altitudes have a higher likelihood of developing spoon nails. Additionally, there may be a genetic propensity for an increase in the automatic curvature force, which can contribute to nail deformation.
Several other genetic disorders can also cause nail abnormalities. For example, about 90% of people with psoriasis develop symptoms on their nails, including curving, thickening, and shallow or deep holes in the nail. Raynaud's, a rare genetic disorder affecting the arteries, can also cause changes in nail shape.
Furthermore, certain diseases that affect the entire body can lead to nail pitting, which may be indicative of an underlying genetic condition. For instance, people with dents in their nails may have alopecia areata, an autoimmune disorder that can cause hair loss. While the symptoms of this disorder can fluctuate, it is important to seek medical advice to manage the condition effectively.
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Frequently asked questions
Curved fingernails can be caused by various factors, including nutritional deficiencies, autoimmune conditions, and underlying health issues. In some cases, it may be a harmless trait that runs in the family. However, it is important to monitor your nails for significant changes and consult a healthcare professional if you have any concerns.
Symptoms associated with curved fingernails include fingernail pits or dents, nail discolouration, and swelling or sponginess of the fingertips. Some individuals may also experience changes in nail texture, thickness, or strength. It is important to note that these symptoms may indicate an underlying health condition, so seeking medical advice is recommended.
If you notice your fingernails starting to curve, it is recommended to consult a board-certified dermatologist or a healthcare professional. They can help diagnose and treat any underlying conditions that may be causing the curvature. Additionally, maintaining nail health by gently filing, trimming, and moisturising your nails can help prevent excessive curving.
