Noah Sinclair
Dark lines on your nails can be caused by a number of factors, ranging from harmless to severe. Melanonychia, a condition where pigment cells deposit melanin into the nail, is a common cause of black or brown lines on nails. This can be caused by inflammatory skin diseases, malnutrition, medication, or cancer. Another cause of black lines on the nails is a splinter hemorrhage, which occurs when blood vessels under the nail are damaged due to trauma or underlying health conditions. Less commonly, black lines on the nails can indicate the presence of melanoma, a dangerous form of skin cancer. It is important to consult a doctor if you notice any dark lines on your nails, as they may be an indication of a more serious health condition.
| Characteristics | Values |
|---|---|
| Condition | Melanonychia |
| Other names | Melanonychia striata, Longitudinal melanonychia |
| Appearance | Dark lines, stripes or bands on the nail that are brown, black or grey in colour |
| Occurrence | Can appear on one or multiple nails |
| Causes | Melanocytic activation, melanocytic hyperplasia, race, pregnancy, infections, inflammation, medication, poor nutrition, tumours, trauma, systemic disease |
| Treatment | Depends on the underlying cause, may require removal of the tumour or cancerous area |
| Condition | Splinter Hemorrhages |
| Appearance | Small black or reddish-brown lines that resemble thin wooden splinters |
| Occurrence | Usually occur in one nail, can appear in multiple nails |
| Causes | Damage to blood vessels under the nail, injuries, underlying health conditions |
| Treatment | Usually does not require treatment, healthcare provider will determine treatment if necessary |
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What You'll Learn
- Melanonychia: a brown or black colour in your nail, which can be benign or cancerous
- Splinter haemorrhages: tiny streaks of blood under the nail plate, caused by damage to blood vessels
- Nutritional deficiencies: a lack of protein, vitamin B12, B9 or vitamin D can cause dark lines in nails
- Nail injuries: trauma to the nail can cause black lines, which usually grow out with the nail
- Melanoma: a dangerous form of
Melanonychia: a brown or black colour in your nail, which can be benign or cancerous
Melanonychia is characterised by brown or black discolouration of the nail plate, which can affect both finger and toenails. It can appear in one nail, several nails, or all nails. It is derived from the Greek words "Melas", meaning black, and "Onyx", meaning nail.
The discolouration occurs when melanocytes, the pigment cells in the nails of fingers and toes, are activated to produce melanin, which gives skin its colour. This activation results in a pigmented band, known as longitudinal melanonychia, which appears as brown, black, or grey bands that run from the nail bed to the tip of the nail.
There are two primary processes that cause melanonychia:
- Melanocytic activation: This occurs when melanocytes are activated, increasing the production and deposition of melanin into the nail cells without increasing the number of melanocytes. This can be caused by trauma, nutritional deficiencies (such as a lack of protein, vitamin D, or vitamin B12), medication, and inflammatory skin diseases.
- Melanocytic hyperplasia: This involves an increased number of melanocyte cells in the nails, which can be benign or malignant. Causes include race, pregnancy, infections, and inflammatory skin diseases.
Melanonychia can have a range of causes, from harmless to potentially fatal. The most serious cause is melanoma of the nail bed, which can be diagnosed using the ABCDEF criteria:
- Age: Most common in people aged 20 to 90, particularly in their 50s to 70s.
- Band of colour: A brown-black band wider than 1/8th of an inch, with an irregular or blurred border.
- Change in size or growth rate: This may refer to a lack of change if melanonychia has been treated.
- Digit involved: Usually the thumb or big toe, and more common in the dominant hand or foot.
- Extension of colour: The colour extends onto the surrounding tissues.
- Family or personal history: Consider family or personal history of melanoma or unusual moles.
If melanonychia is malignant, the cancerous area must be removed, which may result in losing all or part of the nail or even the affected finger or toe. Therefore, it is important to consult a doctor for any dark streaks in the nails, as they can indicate other health issues.
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Splinter haemorrhages: tiny streaks of blood under the nail plate, caused by damage to blood vessels
A black or reddish-brown vertical line underneath your nail may be a splinter haemorrhage. Splinter haemorrhages are tiny streaks of blood under the nail plate, caused by damage to the small blood vessels underneath the nail. They are named so because they resemble a splinter under the fingernail. They are non-blanchable and can be 1 to 3 mm in length. They occur in the dermis after rupture of the capillaries that follow the linear configuration of the epidermal-dermal ridges. The blood attaches to the nail plate and moves distally as the nail grows.
Splinter haemorrhages can be caused by tiny clots that damage the small capillaries under the nails. They may also be caused by vessel damage from swelling of the blood vessels (vasculitis) or septic emboli in the small vessels. They can occur with an infection of the heart valves (endocarditis) and are present in 15-33% of patients with infective endocarditis. They are more common in older people and are more frequent in men and dark-skinned people. The most common cause of splinter haemorrhages is trauma, including the application of an acrylic nail.
Splinter haemorrhages may be an adverse effect of medications that impair blood vessels in the nail bed, although this is uncommon. These medications include antithrombotics and anticoagulants, such as aspirin and warfarin, cancer chemotherapeutic agents, tetracycline, and ganciclovir. They are also more commonly associated with nail psoriasis, but can also occur with eczema, vasculitis, or onychomycosis. Systemic disease may be the cause if the splinter haemorrhages appear in several nails, are located in the proximal portion of the nail plate, or are painful.
If you can recall a trauma to the nail, it’s likely the splinter haemorrhage will grow out with time. If you experience symptoms besides the nail condition, you should see your doctor for a thorough examination and diagnosis.
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Nutritional deficiencies: a lack of protein, vitamin B12, B9 or vitamin D can cause dark lines in nails
Dark lines in your nails can be caused by a lack of certain nutrients in your diet. This condition is known as melanonychia and is characterised by brown or black stripes that usually start at the bottom of your nail bed and continue to the top. While melanonychia can occur naturally in people with darker complexions, it can also be a sign of nutritional deficiencies, trauma, or medication.
Vitamin B12 is essential for maintaining healthy nails, and a deficiency can lead to dark lines in the nails. To increase your vitamin B12 intake, include more meat, fish, dairy, and eggs in your diet, or consider taking a vitamin B12 supplement. Additionally, vitamin D plays a crucial role in nail health, and insufficient levels can contribute to the development of dark lines. High-strength vitamin D supplements are recommended by some doctors to address this deficiency.
Protein deficiency is another potential cause of dark lines in nails. Ensuring adequate protein intake is important for nail health and can help prevent this issue. Vitamin B9, also known as folate, is another nutrient that, when deficient, can lead to dark lines in the nails. However, it is important to note that vitamin B9 deficiency is less commonly associated with this condition compared to deficiencies in protein, vitamin B12, or vitamin D.
While nutritional deficiencies can be a contributing factor, dark lines in nails can also result from various other conditions, including nail trauma, melanoma, and psoriasis. Therefore, if you notice persistent or concerning symptoms, it is always advisable to consult a healthcare professional for a thorough examination and accurate diagnosis.
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Nail injuries: trauma to the nail can cause black lines, which usually grow out with the nail
Trauma to the nail is one of the most common causes of black lines on nails, known as splinter hemorrhages. This occurs when something hurts the nail bed and bursts a blood vessel underneath it. Stubbing your toe or getting acrylic nails put on are common ways to experience this trauma.
Splinter hemorrhages resemble thin wooden splinters under your nail and are usually 1 to 3 millimetres long. They are typically black or reddish-brown in colour and appear closer to the end of your nails, although any part of the nail may be affected. They normally only appear on one nail and will usually grow out with the nail.
If you experience a splinter hemorrhage due to trauma or injury, it will go away on its own and is not a cause for concern. However, if you haven't sustained an injury, it may be a sign of a more serious underlying condition, such as an infection, disease or condition that can damage your blood vessels. In this case, you should contact your healthcare provider to determine the underlying cause.
Another cause of black lines on the nails is melanonychia, which occurs when pigment cells deposit melanin into the nail. Melanonychia can appear as brown, black or grey bands that run from the nail bed to the tip of the nail. This condition can occur naturally, especially in people with a dark complexion, but it can also be caused by trauma, nutritional deficiencies or medication. Melanonychia can be benign or cancerous, so it is important to have a doctor examine any dark streaks in your nails.
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Melanoma: a dangerous form of skin cancer
Dark lines on your nails can be caused by a variety of factors, ranging from harmless to severe. One of the most serious potential causes is melanoma, a dangerous form of skin cancer known as subungual melanoma. This type of cancer is challenging to detect in its early stages due to its similarity to benign conditions such as melanonychia.
Melanonychia is a condition characterized by brown or black discoloration of the nail, usually appearing as stripes that extend from the nail bed to the tip. It can affect both fingernails and toenails and can occur in one or multiple nails. While melanonychia can have various causes, including trauma, nutritional deficiencies, and medication, it can also be an indication of melanoma, especially if certain criteria are met.
To diagnose melanoma of the nail bed, doctors use the ABCDEF criteria:
- Age: Most commonly occurs in individuals aged 20 to 90, with a higher prevalence in the 50s to 70s age group.
- Band of Color: Look for a brown-black band wider than 1/8th of an inch with an irregular or blurred border.
- Change: Observe any changes in the size or growth rate of the band, including a lack of change if melanonychia has been treated.
- Digit Involved: Typically affects the thumb or big toe of the dominant hand or foot. Melanoma is more concerning when it occurs on a single digit rather than multiple digits.
- Extension: Note if the pigmentation extends onto the surrounding tissues, such as the skin around the nail.
- Family History: Consider any personal or family history of melanoma or unusual moles.
If you notice any dark stripes on your nails that cannot be attributed to a known cause, such as injury or medication, it is crucial to consult a healthcare professional for a thorough examination and diagnosis. A nail biopsy may be performed to determine the presence of cancerous cells, and treatment options may include surgical removal of the affected area and skin grafting. While less common, other causes of black streaks on the nails include splinter hemorrhages, which are small areas of bleeding under the nails due to trauma or underlying health conditions, and Beau lines, which are horizontal stripes caused by interrupted nail growth or injuries.
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Frequently asked questions
There are several reasons why you might have black streaks on your nails. The most common cause is a splinter hemorrhage, which occurs when small blood vessels under the nail are damaged due to an injury. Other possible causes include melanonychia, which is an increase in melanin deposits in the nail, and nail melanoma, a dangerous form of skin cancer.
Melanonychia can appear as brown, black, or grey bands that run from the nail bed to the tip of the nail. It can affect one nail, multiple nails, or all nails and may be a natural occurrence for people with darker skin tones.
The treatment for melanonychia depends on the underlying cause. If it is due to a nutritional deficiency, such as a lack of protein, vitamin B12, or vitamin D, addressing the deficiency may help. If it is caused by an infection or medication, treating the underlying issue may resolve the melanonychia. In some cases, it may be necessary to remove the affected nail or perform a skin graft.
It is recommended to see a doctor for any dark streaks on your nails as they may indicate a serious health condition such as melanoma. Additionally, if you have not sustained an injury and the black streaks appear on multiple nails, it is important to seek medical advice as it could indicate an underlying condition.
There are no specific home remedies mentioned for removing black streaks from nails. However, if the streaks are due to a nutritional deficiency, improving your diet or taking supplements may help. It is important to consult a healthcare professional for personalized advice and to rule out any serious underlying causes.
