Isla Bennett
Your fingernails can provide important clues about your health and signal any health issues. Physicians can use them to diagnose conditions ranging from dermatological problems to kidney disease or even autoimmune disorders. Nails are made of keratin, a tough material that grows in the direction of your fingertip into a hard plate. They protect the ends of your fingers and toes and help you grip objects. While most of the time changes in the nail are harmless, if you notice that the change in shape, colour, or texture is more permanent, then you should always consult a doctor.
| Characteristics | Values |
|---|---|
| White spots | Leukonychia, heavy metal poisoning, liver or kidney failure, trauma, calcium deficiency |
| Dark lines | Potential symptom of melanoma, moles, vitamin deficiencies, chemotherapy |
| Black lines | Splinter haemorrhages, dilated and burst capillaries, potential symptoms of psoriasis |
| Redness | Congested capillaries, symptoms of psoriasis |
| Beau's lines | Acute kidney disease |
| Koilonychia | Kidney disease, iron-deficiency anemia, nutritional deficiencies caused by conditions like COPD, heart failure, diabetes |
| Nail clubbing | Liver or kidney disease, lung disease, gut disorders, low blood oxygen levels |
| Spoon-shaped nails | Iron-deficiency anemia |
| Slow nail growth | Fever, injury, chemotherapy, stress |
| Yellow nails | Ageing, nail lacquers, acrylic nails, smoking, yellow nail syndrome, respiratory issues, limb swelling |
| Ridges | Direct trauma, severe illness |
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What You'll Learn
- White spots or discolouration can indicate heavy metal poisoning, liver disease, kidney disease, or diabetes
- Dark lines or streaks can be a sign of skin cancer or melanoma
- Ridges or indentations can indicate nutritional deficiencies, kidney disease, or psoriasis
- Spoon-shaped nails can be a sign of iron deficiency or anaemia
- Slow nail growth can be caused by fever, injury, chemotherapy, or stress
White spots or discolouration can indicate heavy metal poisoning, liver disease, kidney disease, or diabetes
White spots or discolouration on your nails are usually the result of a nail injury called leukonychia. They are very common and often do not indicate a serious problem. However, in rare cases, they can be indicative of more serious underlying health issues, such as heavy metal poisoning, liver disease, kidney disease, or diabetes.
White spots on your nails can be caused by mineral deficiency, particularly zinc and calcium deficiencies. They can also be caused by certain medications, such as chemotherapy for cancer and sulfonamides for bacterial infections.
Heavy metal poisoning from arsenic and lead can cause lines to develop on your nail plates. If you are experiencing other symptoms of heavy metal poisoning, such as nausea, vomiting, abdominal pain, and neurological issues, seek immediate medical attention. A blood test can detect abnormal levels of these metals in your body.
If your nails have turned completely white, it could be a sign of protein deficiency in the bloodstream, which can indicate liver disease, kidney disease, or diabetes. Liver diseases such as cirrhosis of the liver can cause the entire nail to turn white. Kidney disease can also cause nail discolouration, and in some cases, white spots on the nails can be an early indicator of kidney failure.
While these serious underlying conditions are possible causes of white spots or discolouration on your nails, they are quite rare. If you are concerned about persistent or worsening white spots on your nails, it is recommended to consult a doctor for a proper diagnosis and treatment.
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Dark lines or streaks can be a sign of skin cancer or melanoma
Dark lines or streaks on the nails can be a sign of subungual melanoma, a type of skin cancer that begins in the cells called melanocytes. Melanocytes are responsible for producing melanin, which gives skin its colour. When these cells are activated, melanin production increases, resulting in hyperpigmentation and the formation of vertical stripes under the nail. Subungual melanoma is often detected later than other cancers because people are unaware of the warning signs. Therefore, learning to recognise the signs of nail melanoma is crucial for early treatment.
The presence of dark brown or black streaks on the surface of the nail is a characteristic symptom of subungual melanoma. These streaks typically extend from the bottom to the top of the nail, resembling a line drawn with a marker. The melanoma may be more advanced if the skin surrounding the nail also darkens or if the nail begins to separate from the nail bed. It is important to note that these dark lines can be challenging to distinguish from benign causes of melanonychia, such as trauma, nutritional deficiencies, or medication. However, any suspicious marks should be examined by a healthcare professional.
To diagnose subungual melanoma, healthcare professionals will examine the discoloured areas using a dermatoscope, a specific type of microscope. They will also review the patient's medical history to identify potential causes of melanonychia. While the exact cause of nail melanoma is unknown, certain factors can increase the risk, including having darker skin, a personal or family history of melanoma, and being older than 50.
If you notice any unusual dark lines or streaks on your nails, it is essential to consult a doctor as soon as possible. Early detection of subungual melanoma significantly improves the chances of successful treatment. While most benign cases of melanonychia do not require treatment, they typically do not disappear on their own. On the other hand, malignant melanonychia requires prompt medical intervention, which may include tumour removal or, in severe cases, amputation of the affected finger or toe.
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Ridges or indentations can indicate nutritional deficiencies, kidney disease, or psoriasis
Ridges or indentations on the nails can be indicative of several health conditions, including nutritional deficiencies, kidney disease, or psoriasis.
Nutritional Deficiencies
A change in the appearance of your nails, such as the development of ridges or indentations, can indicate a nutritional deficiency. For example, spoon-shaped nails, also known as koilonychia, can be a sign of iron-deficiency anaemia. This condition causes the nails to grow in a dented, spoon-like shape instead of straight.
Kidney Disease
Nail abnormalities are also associated with kidney disease. Changes in nail colour, texture, or shape can be indicative of underlying kidney dysfunction. Specifically, people with kidney disease may develop abnormal ridges or Beau's lines, which appear as horizontal dents in the nails. These ridges can run either horizontally or vertically. Additionally, kidney disease can cause a condition called splinter haemorrhage, where the capillaries under the nail become fragile and break easily.
Psoriasis
Nail psoriasis is an autoimmune condition that affects the nails, causing discolouration, pitting, and other changes. It is characterised by dents or pits, known as cupuliform depressions, which can vary in size and depth. While nail psoriasis is typically associated with a psoriatic rash on other body parts, it can also manifest as an isolated nail condition. It is important to note that nail psoriasis is a chronic condition without a cure, but treatments are available to alleviate symptoms.
If you notice persistent changes in the shape, colour, or texture of your nails, it is advisable to consult a doctor to determine the underlying cause and receive appropriate guidance and treatment.
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Spoon-shaped nails can be a sign of iron deficiency or anaemia
Spoon-shaped nails, also known as koilonychia, can indicate an iron deficiency or anaemia. Koilonychia is a condition where nails grow in an indented shape, resembling a spoon. This shape forms gradually, with flattened nails being the first sign, followed by the development of a deep indentation that can hold a drop of water.
Koilonychia is often associated with iron deficiency anaemia, where the body lacks sufficient iron to produce haemoglobin, the protein responsible for carrying oxygen in red blood cells. Without enough haemoglobin, the nails receive inadequate oxygen, leading to changes in their structure and appearance. This results in spoon-shaped nails, which can be a subtle indicator of iron deficiency anaemia.
People with certain risk factors are more likely to experience spoon-shaped nails. These risk factors include consuming a vegetarian diet, living at high altitudes, having lupus, poor blood flow to the hands or feet, malnutrition, or an eating disorder. Additionally, underlying conditions such as celiac disease, cancer, intestinal bleeding, or excessive menstruation can contribute to iron deficiency, which may then manifest as koilonychia.
If you notice spoon-shaped nails, it is important to consult a healthcare provider. They can help determine the underlying cause and provide appropriate treatment options, often by addressing the iron deficiency or anaemia. This may involve dietary changes or supplements to increase iron intake, such as consuming iron-rich foods like beans, leafy greens, meat, seafood, and certain fruits and nuts.
While spoon-shaped nails can be a sign of iron deficiency or anaemia, it is important to remember that nail changes can also occur due to trauma or injury to the nail bed. Therefore, consulting a healthcare professional is crucial for an accurate diagnosis and appropriate treatment plan.
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Slow nail growth can be caused by fever, injury, chemotherapy, or stress
Fingernails are an extension of the skin, made from a super-tough protein called keratin, which shields the toes and fingers from trauma. They can reveal a lot about a person's health, and physicians can use them to diagnose conditions ranging from dermatological problems to kidney disease or autoimmune disorders. For example, "clubbing" of the nails, where the ends of the fingers swell and the nail becomes curved and rounded, can indicate liver or kidney disease, lung disease, or gut disorders. Nails can also develop leukonychia, or white spots, which are generally harmless and the result of minor trauma, but can sometimes indicate liver or kidney failure. Beau's lines, or horizontal ridges, can be a symptom of acute kidney disease.
Nail changes can also be caused by chemotherapy, which can disrupt the growth cycles of new cells in the body. Nails may become thinner and more brittle and may even fall off during chemo. Chemotherapy can also cause nail separation from the skin below, changes in nail colour, shape, or texture, and slowed nail growth.
Slow nail growth can be caused by several factors, including fever, injury, chemotherapy, and stress. Fever can be a sign of infection, which can lead to nail changes such as redness, discharge, or drainage around the nails. Injury to the nails can include stubbing your toe, trapping your fingernail in a door, or dropping a heavy object on your foot. Chemotherapy, as mentioned earlier, can disrupt nail growth and cause other nail changes. Finally, stress can also contribute to slow nail growth, as nails can be affected by the body's overall health and well-being.
While most nail changes are harmless, if you notice persistent changes in shape, colour, or texture, it is essential to consult a doctor. They can provide advice, treatments, and medications to manage any symptoms and underlying health conditions.
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Frequently asked questions
Fingernails are made of keratin, a tough protein also found in hair and skin. They can provide clues about our health, helping to diagnose conditions ranging from dermatological problems to kidney disease or autoimmune disorders. For example, white nails or spots (leukonychia) could suggest heavy metal poisoning, liver disease, or diabetes. Dark streaks could indicate skin cancer, while red streaks may be a sign of heart infection.
Spoon-shaped nails, or koilonychia, can be a sign of iron-deficiency anaemia. This is because a lack of iron means the body cannot make enough of the molecule that red blood cells need to carry oxygen.
Slow nail growth or the cessation of nail growth can be caused by a serious illness, fever, injury, chemotherapy, or major stress.
