Noah Sinclair
Ridges in fingernails can indicate underlying health conditions and nutrient deficiencies. Vertical ridges, also known as onychorrhexis, are usually harmless and are often caused by the natural ageing process, but they can also be a symptom of a health condition such as hypothyroidism, iron deficiency, or Witkop syndrome. Horizontal ridges, or Beau's lines, are often linked to more serious health issues, including severe infections, diabetes, nutritional deficiencies, and peripheral vascular disease. If you notice new ridges or lines in your nails, it is important to consult a healthcare professional to determine the underlying cause and receive appropriate treatment.
| Characteristics | Values |
|---|---|
| Vertical Ridges | Onychorrhexis, aging, hypothyroidism, iron deficiency, twenty-nail dystrophy, Witkop syndrome, rheumatology diseases (gout, rheumatoid arthritis, osteoarthritis, and systemic sclerosis), peripheral vascular disease, severe illness with high fever, nail trauma, skin conditions |
| Horizontal Ridges | Beau's lines, malnutrition, serious nail injury, diabetes, nutritional deficiencies, zinc deficiency, peripheral vascular disease, severe illness with high fever, nail trauma, skin conditions |
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Ageing
Ridges in fingernails are usually harmless but can indicate ageing or other health problems. Vertical ridges, also known as onychorrhexis, are one of the most common signs of ageing. These ridges often look like thin grooves running from the bottom of the nail to the tip and tend to become more pronounced over time as nails get thinner and more
Onychorrhexis involves the nail matrix, which is responsible for nail growth. Issues with the production of skin cells and the skin protein keratin can cause changes to how nails grow, leading to onychorrhexis. While it is often associated with ageing, onychorrhexis can also be a symptom of another health problem. These conditions include Witkop syndrome, a hereditary genetic disease that leads to vertical fingernail ridges, and rheumatological diseases such as gout, rheumatoid arthritis, osteoarthritis, and systemic sclerosis. Systemic amyloidosis, a rare disease characterised by amyloid protein buildup in organs and tissues, can also affect the nails.
Nail trauma, such as injury to the nails, picking at them, or exposure to strong chemicals, can also damage the nail matrix and affect nail growth, resulting in vertical ridges. Additionally, certain medications, particularly chemotherapy drugs, can cause Beau's lines, which manifest as deep horizontal ridges.
While vertical ridges due to ageing may not be entirely preventable, there are measures to improve nail health and reduce their appearance. Maintaining proper nail care is essential, including regular moisturisation and avoiding nail-damaging behaviours such as biting or picking. Using a nail buffer can help smooth ridges, but excessive buffing can weaken the nails. Consulting with a dermatologist is advisable to determine the underlying cause and receive appropriate treatment recommendations.
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Health conditions
Ridges in your nails may indicate an underlying health condition or nutrient deficiency. Vertical ridges, also known as onychorrhexis, are often a sign of aging, but can also be caused by hypothyroidism, iron deficiency, or Witkop syndrome, a hereditary genetic disease. Horizontal ridges, or Beau's lines, can point to more serious issues such as malnutrition, severe infections, diabetes, nutritional deficiencies, or even acute kidney disease.
Onychorrhexis is a condition that causes vertical ridges and splitting of the nails, often accompanied by brittleness and breakage. While it is usually not a cause for concern, it can sometimes be linked to other health problems. Issues with the production of skin cells and the skin protein keratin can lead to onychorrhexis, affecting nail growth.
Witkop syndrome is a genetic disease that results in vertical ridging in fingernails, as well as missing teeth and indented toenails (koilonychia or spoon nails).
Beau's lines are deep horizontal ridges that can indicate a serious underlying condition. They may be caused by chemotherapy, peripheral vascular disease (PAD), severe illnesses with high fevers (such as COVID-19, measles, or pneumonia), or nutritional deficiencies like zinc deficiency. These ridges can even halt nail growth until the underlying condition is addressed.
If you notice nail ridges, it is important to consult a doctor or dermatologist, especially if other symptoms are present. They may order blood and urine tests to check for potential health issues and recommend treatments to improve the appearance of your nails.
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Nutrient deficiencies
Ridges in your nails can be a sign of a nutrient or vitamin deficiency. While vertical ridges are usually harmless and are often a sign of aging, horizontal ridges can indicate malnutrition or serious nail injury.
Zinc deficiency can cause Beau's lines, which are horizontal ridges on fingernails. They can also cause white spots on your nails. Iron deficiency can cause vertical nail ridges and koilonychia (spoon nails). Spoon nails have a depression in the middle, like the center of your nail was scooped out. You may be able to hold a drop of water on your nail.
Deficiencies in folic acid, iron, and protein can also cause central ridges. White streaks on your nails, rather than indented ridges, can point to issues like psoriasis or chronic kidney disease. However, most small white streaks or spots on your fingernails are not indicative of serious health issues. The majority occur due to injuries or even light impact, such as tapping your nails on hard surfaces. An exception to this is Muehrcke's lines, which are parallel white lines that extend across your nails and indicate low protein levels in your blood.
If you notice ridges in your nails, it is important to consult a doctor or dermatologist, who can examine your nails and advise you on any necessary dietary changes or supplements.
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Skin conditions
Ridges in fingernails are often signs of other health problems. Vertical ridges, also known as longitudinal striations or bands, are usually harmless and are a common effect of the ageing process, as nails get thinner and more brittle. They can, however, sometimes be a sign of an underlying medical issue, such as hypothyroidism, which can cause nails to become thick, brittle, and crumbly.
Horizontal ridges, known as Beau's lines, are often a symptom of more serious conditions. They can be caused by chemotherapy, peripheral vascular disease, severe illness with a high fever, such as COVID-19, or nutritional deficiencies. Zinc deficiency, for example, can cause Beau's lines and white spots on the nails. Iron deficiency can cause vertical ridges and koilonychia (spoon nails).
If the cause of the fingernail ridges is unclear, a dermatologist may take nail clippings to analyse for signs of infection. Treatment will focus on the underlying cause of the changes to the nails. For example, if Beau's lines are caused by diabetes, managing blood sugar may reduce these horizontal ridges.
If the ridges are caused by a skin condition, such as eczema, treatment may include moisturisers for the hands or topical ointments to reduce symptoms. If low levels of minerals or vitamins are the cause, altering your diet or taking supplements may be recommended.
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Nail trauma
Nail injuries can also occur when the nail is cut, torn, smashed, or bruised, or when the nail is torn away from the skin. This can result in the nail splitting, cracking, or lifting away from the nail bed. Repeated trauma to toenails, caused by ill-fitting shoes, can lead to deformities in the nails, resembling a fungal infection. Nails can become thickened or discoloured and can lift away from the nail bed.
Habits such as nail biting and cuticle biting can also cause trauma to the nails. Nail biting is a common cause of acute paronychia, a type of infection where bacteria get underneath the tissue at the side of the nail, causing swelling and irritation. Repetitive picking at the thumb nail and cuticle with the index finger can produce horizontal hatch marks in the middle of the nail.
Treatment for nail trauma depends on the type and seriousness of the injury. For minor injuries, you may be able to care for the nail at home by stopping any bleeding and cleaning the wound. For more serious injuries, you may need to go to an urgent care centre or emergency room, where they will numb the area and treat the wound. They may create a small hole in the nail to drain blood and fluid, relieve pressure, and reduce pain. In some cases, the nail may need to be removed, and the nail bed repaired.
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Frequently asked questions
Vertical ridges in fingernails, also known as onychorrhexis, can be caused by aging, iron deficiency, or underlying health conditions such as hypothyroidism or rheumatological diseases.
Yes, Witkop syndrome is a hereditary genetic disease that can lead to vertical ridging in fingernails, among other symptoms.
Horizontal ridges, also known as Beau's lines, can be caused by serious illnesses, nutritional deficiencies, chemotherapy, or injury to the nail.
While vertical ridges may not be completely removable, you can improve the appearance of your nails by applying moisturizer to your nails and cuticles daily and using a nail buffer sparingly to smooth the ridges.
If you notice sudden changes in your nails, such as pain, discoloration, or other unusual symptoms, it is recommended to consult a doctor to determine the underlying cause and receive appropriate treatment.
