Isla Bennett
Crooked nails can be caused by regular pressure exerted on thin nails when performing everyday tasks. For instance, the way one holds a pen, computer mouse, or a car door can cause nails to grow bent. In some cases, bent nails can be hereditary or caused by an injury to the nail bed. Additionally, spoon-shaped nails, known as koilonychia, can be caused by iron deficiency or vitamin B deficiency, and are often seen in infants and toddlers. Curved nails, known as clubbing, can be a harmless trait that runs in the family, but they can also indicate an underlying health issue, especially if they develop later in life.
| Characteristics | Values |
|---|---|
| Cause of bent nails | Pressure from writing or holding objects |
| Previous injury to the finger | |
| Nutritional deficiencies, such as iron or vitamin B | |
| Underlying health conditions, e.g., lupus, psoriasis, or circulation problems | |
| Frequent use of products containing petroleum | |
| Living at high altitudes | |
| Treatment/Prevention | Applying a firm coating on the nail, such as gel polish or acrylic |
| Correcting the shape with a file | |
| Treating the underlying cause, e.g., iron supplements for iron deficiency | |
| Dietary changes, such as eating a balanced diet | |
| Keeping nails clean, moisturized, and trimmed | |
| Using rubber gloves when cleaning or working with chemicals |
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What You'll Learn
Pressure from writing or holding objects
The way you hold a pen, or how you grip objects like a computer mouse, can put pressure on your nails and cause them to grow bent over time. This is more likely to happen to the nails on your dominant hand—the hand you use to write with.
If you want to prevent your nails from growing bent, you can try to be mindful of how you hold things. For example, if you tend to hold a pen by pressing down on it with your nails, try to get used to holding it without putting pressure on your nails.
You can also try to keep your nails short so that they're less likely to bend. Or, if you want to hide the fact that they're bent, you can apply a firm coating to your nail, such as gel polish, builder gel, acrylic, or dip powder, and correct the shape with a file.
It's worth noting that bent nails can also be caused by other factors, such as injuries. For example, if you smashed your finger in a door as a child, your nail could start to grow bent at the angle of the scar.
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Previous injury to the finger
A previous injury to the finger can cause nails to grow bent. The fingernail is an important part of fingertip function, providing support for the finger pad and improving sensation. When injured, the nail can be cut, torn, smashed, bruised, or even torn away from the skin. This can cause a subungual hematoma, or a collection of blood under the nail, which can result in a red or purple-black colour that fades to blue over a few weeks. The entire finger may throb and be painful to touch or move.
In more severe cases, a fracture of the bone under the nail can occur, known as a distal tuft fracture. An x-ray is typically required to diagnose this condition. If the bone is broken, a wire may need to be placed in the finger to keep the bone in place. Smashing a finger in a door, hitting it with a hammer, or cutting it with a knife can all lead to such injuries.
Injuries to the nail matrix, the area responsible for nail growth, can also cause nails to grow bent. Minor damage to the nail matrix can temporarily change the nail's appearance, while severe injuries can cause the nail to fall off. Once the nail matrix heals, the nail will usually start to grow again, although this may take several weeks. In cases of severe damage, some or all of the nail may not grow back.
Additionally, certain habits can cause nails to grow bent. For example, individuals may develop "washboard nails" if they frequently pick at or push back their cuticles. This habit can be addressed with the help of a dermatologist, allowing healthy nails to grow out. Similarly, individuals may apply pressure to their nails through everyday activities such as writing or holding objects, causing the nails to bend over time.
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Iron deficiency
Spoon-shaped nails, or koilonychia, are often a sign of iron deficiency. This condition can be caused by a variety of factors, including the following:
- Inability to absorb iron
- Insufficient iron intake
- Celiac disease
- Cancer
- Bleeding in the intestinal tract
- Excessive menstruation
- Vegetarian diet
- Poor blood flow to fingers or toes
- Autoimmune diseases, such as lupus
If you suspect you have an iron deficiency, it is recommended to consult a healthcare professional, who may advise dietary changes or supplements to address the issue. Iron-rich foods include beans, lentils, dark chocolate, fortified bread and cereals, leafy greens like spinach and kale, meat, seafood, nuts, and seeds.
It is worth noting that spoon nails can also be caused by other factors, such as fungal nail infections, inflammatory skin diseases like psoriasis, hypo- or hyperthyroidism, or autoimmune disorders. In babies, spoon nails are common and usually flatten as they grow.
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Vitamin B deficiency
While nail issues are often caused by injury or overexposure to moisture, they can also be a sign of vitamin deficiencies and chronic conditions. Dr. Sara Norris, a naturopathic doctor based in Los Angeles, explains that:
> “For the general population, nail health is most often an indicator of poor nutritional intake or poor digestion. Brittle, weak, and peeling nails are the most common concerns I see in my practice, and these symptoms are more often the result of a poor diet than of systemic disease.”
Vitamin B12 deficiency can lead to grooves that run from the nail bed to the edge, giving the nail surface an uneven and lacklustre finish. This can be rectified by eating vitamin B12-rich foods such as meat, fish, dairy, and eggs, or by taking a vitamin B12 supplement.
It is worth noting that nail issues do not always indicate a serious underlying illness. Vertical ridges on nails, for example, generally appear later in life and are not a cause for concern unless accompanied by other symptoms such as colour changes. Horizontal ridges, or Beau's lines, may be indicative of kidney disease or another underlying condition.
In addition to vitamin B12, a deficiency in vitamin D can also cause nail issues. Doctors recommend taking a high-strength vitamin D supplement to help with nail malformations such as dimples and pinhead-sized dents on the fingernails, which are usually triggered by allergic or immune-related skin problems.
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Psoriasis
Nail psoriasis is characterised by an overreaction of the immune system, resulting in new skin cells growing too rapidly. Typically, new skin cells grow every 28 to 30 days, but in individuals with psoriasis, this process occurs every three to four days, leading to a skin rash. This rapid cell growth can also impact the nails, causing them to thin and crumble. In some cases, the thick layer of skin underneath the nail may start to peel and separate from the nail bed, a condition known as onycholysis. Onycholysis can further increase the risk of developing nail fungus.
Discolouration is another common symptom of nail psoriasis. The skin beneath the nails (nail bed) may exhibit colour changes, known as salmon patches or oil drop spots, which can appear yellow, red, pink, or brown. Additionally, nails affected by psoriasis may develop dents or pits, ranging in size from 0.4 millimetres to 2 millimetres. These pits can be shallow or deep, with each nail potentially having one or two pits or more than ten.
Nail psoriasis can also cause structural changes to the nails, leading to the development of horizontal grooves known as Beau's lines. Nails may also start to curve downwards, a condition called clubbing. This curving can occur gradually and may go unnoticed initially. As the nails continue to curve, the fingertips may swell, and the nails may feel spongy to the touch.
Treatment options are available to alleviate the symptoms of nail psoriasis. Topical treatments, such as strong corticosteroids, can be applied directly to the nails once or twice daily to address mild cases or those affecting a limited number of nails. Tazarotene, a medication derived from vitamin A, can be used to treat pitting, nail separation, and discolouration, although it may irritate the surrounding skin. In more severe cases, injections of corticosteroids or other psoriasis medications may be administered directly into or near the affected nails to treat nail ridges, thickening, and nail separation.
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Frequently asked questions
There are many reasons why nails grow bent. It could be due to an injury, such as smashing your finger in a door, or from the pressure of holding everyday objects like pens or a computer mouse.
Ingrown nails are when nails curve far inward at the sides. They can be caused by wearing tight shoes or cutting your nails improperly.
Koilonychia, also known as spoon nails, is when nails have an indented shape, like a spoon. It is often a sign of iron deficiency or vitamin B deficiency, but can also be hereditary.
Onychogryphosis, also known as Ram's horn nails, is when nails thicken and overgrow. It can be caused by a disease such as psoriasis, ichthyosis, or circulation problems, or it can run in families.
