Caleb Foster
Did you know that your nails are made of the same substance that forms your hair and skin? This substance is called keratin, a protein that helps protect against infection. Nails are constantly growing, but this process slows down as we age, and growth rates vary between fingers and toes. The growing part of the nail is under the skin at the nail's proximal end under the epidermis, which is the only living part of a nail. The nail root, or nail matrix, is the base of the nail underneath the skin, and it produces most of the nail's volume. The nail bed, which sits on top of tiny blood vessels, gives nails their pink colour. About 80% of nail growth comes from the nail matrix, while the other 20% comes from the nail bed.
| Characteristics | Values |
|---|---|
| Where nails grow from | The nail root, hidden under the cuticle |
| Nail root location | Underneath the skin at the base of the nail |
| Nail growth | The matrix constantly produces new keratin that gathers at the nail plate and slowly pushes the nail forward |
| Nail growth rate | Fingernails: 2.5-3mm per month; Toenails: slightly slower |
| Nail bed | The flat surface under the nails, which sits on top of tiny blood vessels that feed it and give nails their pink color |
| Nail bed function | Provides a smooth surface for nail growth and protection |
| Germinal matrix | Located underneath the cuticle, it is responsible for most of a nail's growth |
| Hyponychium | The area between the free edge of the nail plate and the skin of the fingertip |
| Eponychium | The tissue that produces the cuticle |
| Paronychium | The skin that overlaps onto the sides of the nail plate |
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What You'll Learn
The nail root and germinal matrix
The nail root is the base of the nail, located underneath the skin. It extends several millimetres into the finger and produces most of the nail's volume. The germinal matrix, or nail matrix, is related to the nail root. It lies beneath the skin, at the inner edge of the nail plate, and is responsible for most of the nail's growth. This is where new cells grow and then advance forward to form the nail. The matrix constantly produces new keratin, which gathers at the nail plate and pushes the nail forward, causing it to grow.
The nail matrix is an exceptionally delicate structure, and any damage to it can affect the overall health and appearance of the nail. Injuries or health conditions can damage the nail matrix, causing various nail imperfections such as white spots or ridges, and weakening the nail plate. Certain types of fungus can infect the nail matrix, usually the toenails. Illnesses such as a heart attack, COVID-19, or pneumonia can interrupt nail growth and cause horizontal ridges. Peripheral artery disease (PAD), which reduces blood flow to the legs and feet, can also slow nail growth. Skin conditions such as severe eczema and psoriasis can also interfere with nail growth and cause changes to the nails.
The nail matrix is made of special cells that produce new nail plate cells. Each nail matrix produces 196 layers of cells that combine to form each fingernail or toenail. The cells start off soft but then harden and fill with keratin as they age. The length and shape of the matrix determine the thickness and shape of nail growth. A longer matrix will result in a thicker nail, while a flatter matrix will produce a flatter nail. The matrix is protected by the proximal nail fold, and any trauma to this area can easily damage the soft cells beneath.
The lunula, the white crescent shape at the base of the nail, is the only visible part of the nail matrix. However, some people do not have visible lunulas. Maintaining the health of the matrix is crucial for optimal nail growth. Proper care and protection of the matrix can promote nail growth and prevent potential damage. This includes practices that prioritise nail hygiene, avoid excessive pressure or trauma to the matrix area, and ensure a well-balanced diet for strong and healthy nails.
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Nail growth and the nail bed
The nail matrix is where your fingernails and toenails form. It is made of special cells that constantly produce new keratin, which gathers at the nail plate and slowly pushes the nail forward, causing it to grow. The nail matrix has two parts: the germinal matrix, which is responsible for about 90% of nail growth, and the sterile matrix, which accounts for the remaining 10% of cells and is crucial for keeping the nail attached to the underlying skin. The nail root, located at the base of the nail underneath the skin, produces most of the nail's volume and extends several millimetres into the finger. About 80% of the fingernail arises from the nail root, which determines its length, while the other 20% comes from the nail bed, which determines its thickness.
The nail bed is the area under the nail plate, extending from the edge of the nail root to the tissue known as the hyponychium. It contains blood vessels, nerves, and melanocytes that produce melanin. As the root grows, the nail moves down the nail bed, adding material to the underside of the nail to increase its thickness. A healthy nail bed is smooth, but improper nail growth can cause the nail to split or develop ridges. While genetics plays a significant role in determining the size and shape of nail beds, there are ways to make them appear longer. For example, letting your nails grow out will result in a longer white tip, visually elongating the nail bed. Pushing back the cuticles after soaking them in warm water can also give the appearance of a longer nail bed.
The nail plate, or nail body, refers to the visible hard nail area from the nail root to the free edge. It is made of translucent keratin protein, with several layers of dead, compacted cells providing strength and flexibility. The pinkish appearance of the nail is due to the blood vessels underneath it. The nail plate is firmly attached to the nail bed and does not contain any nerves or blood vessels.
The growth rate of nails varies between individuals and even between different fingers, typically slowing down with poor circulation and ageing. On average, fingernails grow at a rate of about 3 millimetres per month, while toenails grow slightly slower. Nail growth patterns can provide insights into an individual's health, with certain changes indicating illnesses, nutrient deficiencies, drug reactions, or local injuries.
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Fingernail functions and uses
Fingernails are composed of several soft tissue structures that help support the hard nail plate, the most visible part of the nail. The nail plate is made of translucent keratin, a protein that is also present in the hair and skin. The pinkish appearance of the nail comes from the blood vessels underneath it. The growing part of the nail is under the skin at the nail's proximal end under the epidermis, which is the only living part of the nail.
Fingernails serve a number of functions and have various uses. Firstly, they help protect the fingers from injury and infection. They also strengthen a person's fingertips when performing regular tasks, such as gripping objects. The network of nerves under the nails is why nail injuries can be painful. Additionally, fingernails can help with fine motor skills, such as separating objects or picking things up. They can even be used for self-defence, as DNA collected from fingernails during an attack can be used as evidence in the criminal justice system.
The growth of fingernails can also provide insight into a person's health. Nail growth records have been used as a diagnostic tool since ancient times. Changes in nail colour, shape, or texture may indicate illness in other areas of the body, nutrient deficiencies, drug reactions, poisoning, or local injury. For example, bluish or purple fingernail beds may be a symptom of peripheral cyanosis, indicating oxygen deprivation. Deep, horizontally transverse grooves known as "Beau's lines" may form across the nails due to ageing or disease. Healthcare and pre-hospital-care providers may also use the fingernail beds as a cursory indicator of distal tissue perfusion in individuals who may be dehydrated or in shock.
Finally, fingernails can be used for cosmetic purposes. For instance, dip powder nails are sealed using an activator and do not require UV/LED light to be cured.
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Health conditions affecting nails
Fingernails and toenails are made from a protein called keratin. This protein also makes up skin and hair. The growth rate of nails tends to slow down due to poor circulation and aging. Nails grow from cells that multiply within the base of the nail, then layer on top of each other and harden. This process is called keratinisation.
Nail health is closely associated with how well your body is functioning in other areas. Changes in the colour, texture, and shape of your nails can be harmless, but they can also indicate a health condition. Here are some health conditions that can affect your nails:
Vitamin deficiencies and chronic conditions
Vitamin deficiencies can cause nail issues such as brittle, weak, and peeling nails. Iron deficiency can also cause concave-shaped nails, known as "spooning".
Poor diet and digestion
Poor nutritional intake and poor digestion can lead to nail issues. Dr. Sara Norris, a naturopathic doctor, notes that "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."
Skin diseases
Skin diseases such as eczema, dermatitis, psoriasis, lichen planus, and lupus can affect the nails. Abnormalities may include pits, grooves, crumbling nails, and unusual nail shapes.
Infections
Fingernail and toenail infections are common, often caused by fungi. Infections can lead to discolouration, thickening, and other nail issues.
Thyroid disease
Thyroid disease can affect the shape, integrity, and colour of nails. Hypothyroidism, for example, can cause brittle nails.
Cancer
Discolouration of the nails, particularly dark streaks, can be a sign of melanoma, the most serious type of skin cancer. Curved nails, known as "clubbing", can be a sign of disease in the lungs, heart, or liver.
Other conditions
Other health conditions that can affect the nails include hangnails, ingrown nails, paronychia (a skin infection), and onychogryphosis (thickened nails). Treatments for certain diseases can also impact nail health, such as chemotherapy causing nails to grow slowly or stop growing.
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Nail structure and anatomy
The nail is a protective plate found at the tips of the digits (fingers and toes) of almost all primates. They are made of a tough, rigid protein called alpha-keratin, which is also found in hair and skin. The nail consists of the nail plate, the nail matrix, and the nail bed below it, and the grooves surrounding it.
The nail matrix, also known as the germinal matrix, is the actively growing tissue that generates new cells. It lies beneath the skin, at the inner edge of the nail plate, and is responsible for most of a nail's growth. The matrix will continue to produce cells as long as it remains healthy and receives nutrition. As new cells are made, they push older cells forward, causing the nail to grow. The nail matrix is the only living part of a nail.
The nail plate, or corpus unguis, is the visible hard nail area from the nail root to the free edge. It is made of translucent keratin protein and is the hardest and most visible part of the nail. The width and thickness of the nail plate are determined by the size, length, and thickness of the matrix, while the shape of the fingertip bone determines whether the nail plate is flat, arched, or hooked. The grooves surrounding the nail plate are known as nail folds or nail grooves. They are soft tissue structures that protect the edges of the nail plate from trauma and provide support for the sides of the nail, keeping it in place.
The nail bed, or sterile matrix, is the soft tissue and skin underneath the nail plate that helps support healthy nail growth. It contains blood vessels, nerves, and melanocytes that produce melanin. The nail bed nourishes the nail plate through a network of blood vessels and determines the nail's shape and thickness. The nail bed extends from the edge of the nail root, or lunula, to the hyponychium. The lunula is the whitish crescent-shaped base of the visible nail, where the nail matrix and nail bed meet. The hyponychium is the skin under the free edge of the nail plate, at the very tip of the finger or toe. It acts as a barrier, protecting the sensitive nail bed from exposure to external elements.
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Frequently asked questions
Your nails grow from the nail root, which is hidden under the cuticle.
The nail root is the base of the nail underneath the skin. It originates from the actively growing tissue known as the matrix.
The matrix lies beneath the skin at the inner edge of the nail plate. It is responsible for most of the nail's growth. It produces new keratin that gathers at the nail plate and pushes the nail forward.
The nail plate is the hard nail area from the nail root to the free edge. It is made of translucent keratin protein.
