Caleb Foster
Your fingernails and toenails can reveal a lot about your health. While nail abnormalities are rarely the first sign of a serious underlying illness, certain changes in colour, texture, or shape can be a warning sign of specific diseases. For example, white nails can indicate liver problems, anemia, dietary deficiencies, heart or kidney disease, or even poisoning. Yellow nails are often a sign of a fungal infection, but in rare cases, they could indicate lung disease or rheumatoid arthritis. If you notice any significant changes to your nails, it's always a good idea to consult a dermatologist to determine whether the change is harmless or requires medical attention.
| Characteristics | Values |
|---|---|
| White nails | Could be the result of trauma, anemia, dietary deficiencies, heart or <co: 0,3>kidney disease, poisoning, or liver problems |
| Yellow nails | Could be a sign of a fungal infection, lung disease, rheumatoid arthritis, or a serious nail infection |
| Black or dark red lines | Could be a sign of trauma, psoriasis, endocarditis, or nail melanoma |
| Horizontal nail ridges | Could be a sign of kidney disease or another underlying condition |
| Vertical nail ridges | Usually appear later in life and are not a cause for concern unless accompanied by other symptoms |
| Spoon-shaped nails | Could be a sign of iron deficiency |
| Curved nails | Could be a harmless trait, or a sign of disease |
| Pitted nails | Could be a sign of alopecia areata or another disease that affects the entire body |
| Dry, brittle nails | Could be a sign of thyroid disease |
| Nail biting or picking | Could be a sign of anxiety or obsessive-compulsive disorder |
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What You'll Learn
- White nails may indicate trauma, anemia, dietary deficiencies, or poisoning
- Yellow nails could be a fungal infection, lung disease, or rheumatoid arthritis
- Brittle nails could be caused by hypothyroidism or iron deficiency
- Ridges and pits could be a sign of psoriasis or inflammatory arthritis
- Curved nails could be a sign of lung cancer, heart issues, or liver problems
White nails may indicate trauma, anemia, dietary deficiencies, or poisoning
White nails, also known as leukonychia, can be a partial or complete discolouration of the nail plate on one or more fingernails or toenails. The nail loses its general pink undertone and appears white. While leukonychia is often harmless, it may indicate trauma, anemia, dietary deficiencies, or poisoning.
Leukonychia can be classified by its underlying pathology, distribution, or development. True leukonychia refers to discolouration due to abnormal nail plate keratinisation, while apparent leukonychia is secondary to disease of the nail bed. This distinction is important because true leukonychia will not be hidden by applying pressure to the nail plate, whereas apparent leukonychia will disappear with pressure.
White nails can be acquired or congenital. Familial leukonychia is typically inherited recessively, but dominant patterns are possible due to a mutation in the phospholipase C delta-1 gene. This mutation results in all nails appearing milky and porcelain white. Acquired leukonychia, on the other hand, is secondary to systemic disease. It is important to note that congenital leukonychia may also be a sign of an underlying systemic disease.
White nails may be a sign of anemia, an iron deficiency resulting in spoon nails. This condition can affect both the fingernails and toenails, causing the nail to appear concave horizontally or vertically. In addition to anemia, spoon nails have been associated with inflammatory skin diseases like psoriasis, hypo- or hyperthyroidism, and autoimmune disorders.
While nail changes can accompany various conditions, they are rarely the first sign. Many nail abnormalities are harmless, and not everyone with white nails has a serious underlying illness. However, if you are concerned about the appearance of your nails, it is recommended to consult a doctor or dermatologist.
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Yellow nails could be a fungal infection, lung disease, or rheumatoid arthritis
Yellowing of the nails could be indicative of a fungal infection, lung disease, or rheumatoid arthritis.
Yellow nail syndrome is a rare disorder characterised by malformations of the finger and toenails, lung and airway abnormalities, and swelling due to the accumulation of protein-rich fluid (lymph) in the soft layers of tissue under the skin (lymphedema). This swelling often occurs in the arms and legs. Individuals with yellow nail syndrome may have a history of respiratory problems, including shortness of breath, chest pain, and a cough. Other respiratory issues that may be present include chronic infection and inflammation of the bronchial tubes (bronchitis), destruction and widening of the small air passages out of the lung (bronchiectasis), sinusitis, and recurrent pneumonias.
Yellow nails can also be a symptom of rheumatoid arthritis (RA). Other nail changes caused by RA include longitudinal ridging, splinter hemorrhages, spider veins, and spider angiomas. A rheumatologist may examine a person's nails during the diagnostic process to rule out conditions with similar symptoms, such as psoriatic arthritis, which also affects the nails. Treating RA directly may help reduce these nail changes, and in some cases, the nail changes caused by RA may improve without therapy.
If you are concerned about the colour of your nails, it is best to consult a medical professional.
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Brittle nails could be caused by hypothyroidism or iron deficiency
Your nails can be a window into your overall health, including how well your thyroid functions. One of the most common nail problems is onychoschizia, or brittle nails, which can be caused by repeated wetting and drying of the nails. However, in some cases, brittle nails can also indicate an underlying health issue such as hypothyroidism or iron deficiency.
Hypothyroidism
Thyroid diseases such as hypothyroidism, or low thyroid levels, can cause nail issues. Common nail complaints associated with hypothyroidism include weak nails that break easily, grow slowly, or are thin. In addition, hypothyroidism can cause the nail plate to pull away from the skin of the nail bed, a condition called onycholysis or Plummer’s nail. A 2022 study found that those with autoimmune thyroid disorders had a higher percentage of nail brittleness than those with non-autoimmune thyroid conditions.
Iron Deficiency
Iron deficiency can also lead to brittle nails. Spoon nails, where the nail appears concave horizontally or vertically, are often associated with iron deficiency anaemia. This condition can affect both the fingernails and toenails. In addition to concave-shaped nails, iron deficiency can also cause nail ridges and vertical cracks.
Treatment and Prevention
If you suspect your brittle nails are caused by hypothyroidism, the first course of action is usually thyroid hormone replacement treatment to help manage thyroid hormone levels. For brittle nails due to iron deficiency, adding iron-rich foods to your diet or taking an iron supplement may help.
To prevent and treat brittle nails, it is important to keep your nails moisturized by applying lotions, especially after any activity that might dry them out. Using gloves while doing water-intensive tasks can also help prevent nail brittleness. Keeping your nails short and avoiding nail polish can also help strengthen them.
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Ridges and pits could be a sign of psoriasis or inflammatory arthritis
Ridges and pits on your nails may be a sign of psoriasis or inflammatory arthritis. Psoriasis is an autoimmune condition that affects over 50% of people with psoriasis and around 86% of people with psoriatic arthritis. It causes discoloration, pitting, and changes in your fingernails and toenails. The skin underneath your nails (nail bed) may change colors and appear yellow, red, pink, or brown. These changes are called salmon patches or oil drop spots.
Pitting, also known as cupuliform depressions, causes your nails to develop small or large dents or pits. They can be shallow or deep, and you may only have one or two pits on your nails, or you may have more than ten per nail. Pitting can be treated with tazarotene (Tazorac), a topical cream or gel, or with corticosteroid injections into the nail matrix.
If you have psoriasis, your nails may also develop horizontal ridges, known as Beau's lines, which can be treated by gently buffing the surface of your nails to smooth them. Vertical ridges, on the other hand, are generally not a cause for concern unless accompanied by other symptoms.
In addition to nail changes, psoriasis and inflammatory arthritis can cause nail disease. Nail disease is more common in people with both PsA and psoriasis than in those with psoriasis alone. It is important to note that nail polish and/or a nail hardener can be used to conceal pitting and other signs of psoriasis, but it is recommended to check with your doctor first.
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Curved nails could be a sign of lung cancer, heart issues, or liver problems
Changes in the shape and colour of your nails can indicate underlying health issues. Curved nails, or nail clubbing, can be a sign of lung cancer, as well as other lung issues, heart problems, and liver disease. Nail clubbing is a change in the appearance and structure of the nails, causing them to curve downwards and resemble the shape of an upside-down spoon. It can make the nails appear wider and swollen, with the last section of the finger looking large or bulging.
Lung cancer is the most common cause of nail clubbing, but it is not the only one. Other conditions that can cause nail clubbing include congenital heart defects, chronic lung infections, celiac disease, Graves' disease, and liver disease. Clubbing often occurs in heart and lung diseases that result in reduced oxygen in the blood.
While nail clubbing can be a sign of these serious health issues, it is important to remember that not everyone with lung or heart problems will experience nail clubbing, and there are often other symptoms present as well. Additionally, some people may have nail clubbing without any underlying health issues. If you notice any changes in your nails, it is always best to consult a healthcare professional for proper diagnosis and treatment.
In the case of Jean Williams Taylor, a British woman, her curved fingernail, growing downward at a sharp angle, prompted her to seek medical advice. After undergoing various tests, she was diagnosed with cancer in both lungs, highlighting the potential significance of curved nails as an indicator of lung issues.
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Frequently asked questions
White nails, or leukonychia, can be caused by trauma, anemia, dietary deficiencies, heart or
Yellow nails are most commonly caused by a fungal infection. They can also indicate lung disease, rheumatoid arthritis, or a serious nail infection.
Brittle nails are usually caused by repeated wetting and drying of the nails. They can also be a sign of hypothyroidism, iron deficiency, or thyroid disease.
