Noah Sinclair
Deformed nails, also known as dystrophic nails, are a sign that something is wrong with your nails or nailbed. They are often thickened, discoloured, or have changed in shape. Deformities are usually considered to be gross changes in nail shape, whereas dystrophies are changes in nail texture or composition. Dystrophic nails can be caused by a number of factors, including trauma, congenital abnormalities, psoriasis, lichen planus, benign tumours, and occasionally cancer.
| Characteristics | Values |
|---|---|
| Definition | Deformities are gross changes in nail shape, whereas dystrophies are changes in nail texture or composition |
| Causes | Toenail fungus, skin conditions, trauma, congenital abnormalities, psoriasis, lichen planus, benign tumours, cancer, chronic picking or rubbing of the skin behind the nail, long-term exposure to moisture or nail polish, bacterial infection |
| Symptoms | Deformed, thickened, discoloured, pulling away from or coming off the skin under the nail, painful, ingrown toenails, lengthwise split or ridged appearance of thumbnails, nails that are brittle or peeling |
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What You'll Learn
Dystrophic nails
Deformities and dystrophies are often considered together, but they are slightly different. Deformities are generally considered to be gross changes in nail shape, whereas dystrophies are changes in nail texture or composition. About 50% of nail dystrophies result from fungal infection. The remainder result from various causes, including trauma, congenital abnormalities, psoriasis, lichen planus, benign tumours, and occasionally cancer.
Fungal infections cause changes in the colour, texture and shape of the nails. Chronic picking or rubbing of the skin behind the nail can cause median nail dystrophy, which gives a lengthwise split or ridged appearance of the thumbnails. Long-term exposure to moisture or nail polish can cause nails to peel and become brittle.
Nail dystrophies can also be associated with systemic problems. For example, a characteristic spoon-shaped (concave) nail is associated with iron-deficiency anaemia. Yellow nails with increased thickening and hypercurvature are characteristic of yellow nail syndrome. Terry nails are almost all opaque white except for a narrow brown-to-pink band at the distal edge of the nail. Beau lines are associated with chemotherapy, with each line corresponding to a cycle of treatment.
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Deformities vs dystrophies
Deformities and dystrophies are often considered together, but they are slightly different. Deformities are generally considered to be gross changes in nail shape, whereas dystrophies are changes in nail texture or composition. For example, crushing the base of the nail or the nail bed may cause a permanent deformity, whereas chronic picking or rubbing of the skin behind the nail can cause median nail dystrophy, which gives a lengthwise split or ridged appearance of the thumbnails.
Dystrophic nails are a sign that something else is wrong with your nails or nailbed. They can be caused by an infection or injury that damages your nail or nailbed. They can also be caused by toenail fungus, trauma to the nail, or a skin condition such as psoriasis. Dystrophic nails can be thickened, discoloured, or painful, especially if they curve into your skin and cause ingrown toenails. About 50% of nail dystrophies result from fungal infection, with the remainder caused by trauma, congenital abnormalities, lichen planus, benign tumours, and occasionally cancer.
Onychomycosis, a cause of nail dystrophy, may be obvious on examination, but often samples of the nail plate and subungual debris are taken and sent for histopathologic examination and periodic acid-Schiff (PAS) examination, culture, or, more recently, polymerase chain reaction (PCR) analysis.
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Causes of nail deformities
Deformities are often considered together with dystrophies, but the two are slightly different; deformities are generally considered to be gross changes in nail shape, whereas dystrophies are changes in nail texture or composition. Dystrophic nails are not a disease, but a sign that something else is wrong with your nails or nailbed.
Dystrophic nails can be caused by an infection or injury that damages your nail or nailbed. This could be a toenail fungus, a skin condition such as psoriasis, or trauma to the nail, such as slamming your finger in a door or dropping something heavy on your foot. Chronic picking or rubbing of the skin behind the nail can cause median nail dystrophy, which gives a lengthwise split or ridged appearance of the thumbnails. Long-term exposure to moisture or nail polish can also cause nails to peel and become brittle.
About 50% of nail dystrophies result from fungal infection. The remainder result from various causes, including trauma, congenital abnormalities, psoriasis, lichen planus, benign tumours, and occasionally cancer.
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Treatment of nail deformities
Deformities are often considered together with dystrophies, but the two are slightly different; deformities are generally considered to be gross changes in nail shape, whereas dystrophies are changes in nail texture or composition. Dystrophic nails are not a disease, but a sign that something else is wrong with your nails or nailbed.
Nail deformities can be treated in a number of ways, depending on the cause. If the deformity is caused by a fungal infection, such as toenail fungus, this can be treated with medication. If the deformity is caused by trauma, such as slamming your finger in a door, this may require surgery to repair the damage. If the deformity is caused by a skin condition, such as psoriasis, treatment may involve managing the underlying condition. In some cases, nail deformities may be permanent, and the focus of treatment may be on managing pain or other symptoms.
If you are experiencing nail deformities, it is important to see a healthcare provider, who can examine your nails and discuss your health history to determine the underlying cause. Treatment options may include:
- Medication: This may include antifungal medications for toenail fungus or antibiotics for bacterial infections.
- Surgery: If the deformity is caused by trauma, surgery may be required to repair the damage.
- Managing underlying conditions: If the deformity is caused by a skin condition or other underlying condition, treatment may involve managing that condition. For example, treatment for psoriasis may include topical medications, light therapy, or systemic medications.
- Pain management: If the nail deformity is causing pain, treatment may focus on managing that pain. This may include over-the-counter pain medications or, in some cases, prescription painkillers.
It is important to note that treatment options may vary depending on the specific type of nail deformity and the underlying cause. It is always best to consult with a healthcare provider for personalised advice and treatment recommendations.
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Prevention of nail deformities
Dystrophic nails are not a disease, but a sign that something else is wrong with your nails or nailbed. Deformities are considered to be gross changes in nail shape, whereas dystrophies are changes in nail texture or composition.
To prevent nail deformities, it is important to take care of your nails and avoid any trauma to the nail or nailbed. This includes avoiding slamming your fingers in doors or dropping heavy objects on your feet. Chronic picking or rubbing of the skin behind the nail can cause median nail dystrophy, so this should be avoided. Long-term exposure to moisture or nail polish can cause nails to peel and become brittle, so limiting exposure to these things can help prevent nail deformities.
Fungal infections are a common cause of nail dystrophies, so keeping your nails clean and dry can help prevent this. Toenail fungus can be contagious, so it is important to avoid sharing nail clippers or other nail tools with others. If you have a skin condition that affects your nails, such as psoriasis, you may be more prone to nail deformities. In this case, managing your skin condition through proper treatment and care can help prevent nail problems.
In some cases, nail deformities may be caused by congenital abnormalities, benign tumours, or, occasionally, cancer. Regular check-ups with a healthcare provider can help identify any potential issues early on and prevent nail deformities from developing.
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Frequently asked questions
Dystrophic nails are deformed, thickened or discoloured. They are a sign that something else is wrong with your nails or nailbed.
Dystrophic nails can be caused by a number of things, including toenail fungus, trauma to the nail, psoriasis, lichen planus, benign tumours, and occasionally cancer.
Dystrophic nails can be yellow, white or brown in colour. They may be thicker than normal, and can pull away from or come off the skin under the nail.
Dystrophic nails can be contagious if they are caused by toenail fungus. However, if the problem is caused by trauma or psoriasis, they are not contagious.
