Ava Monroe
Our nails can tell us a lot about our health, and changes in their appearance, texture, or growth rate can signal underlying issues. Nails that grow weird may be a result of trauma or injury to the nail or finger, prolonged nail polish wear, nutritional deficiencies, skin conditions, or even certain diseases. It's important to note that not all nail abnormalities are cause for concern, but if you notice persistent changes or are worried, it's always a good idea to consult a dermatologist or your doctor for a proper diagnosis.
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What You'll Learn
Illness, injury, and medication
Illnesses, injuries, and medication can all affect nail growth and lead to abnormal nail appearances.
Illness
Serious illnesses, such as a heart attack, COVID-19, pneumonia, measles, mumps, or scarlet fever, can interrupt nail growth, causing horizontal ridges or Beau's lines. Beau's lines can also be caused by malnutrition or a lack of nutrition. Other nutritional deficiencies, such as low levels of zinc and iron, as well as thyroid problems, can cause brittle nails.
Injury
Injuries to the nail matrix, such as pinching or crushing your finger or dropping something heavy on your toe, can cause bruising, ridges, or discolouration. In some cases, the nail may fall off. Minor damage to the nail matrix can temporarily change the nail's appearance, and severe damage can cause the nail to stop growing back. Nail trephination can be performed to drain trapped blood and relieve pain, but it must be done within 48 hours of the injury.
Medication
Chemotherapy and other medications can affect the nail matrix, causing Beau's lines, slow nail growth, Mees' lines (white bands), and nail colour changes. These changes usually disappear once the medication is stopped.
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Skin conditions and diseases
Several skin conditions and diseases can affect nail growth and appearance. Here are some of the most common ones:
Eczema: Severe eczema can interfere with nail growth, leading to Beau's lines (horizontal ridges), pitting, texture changes, and colour changes.
Psoriasis: A common chronic autoimmune disease that primarily affects the skin. Up to 80% of people with psoriasis develop nail psoriasis, which can cause white lines, pitting, and crumbling of the nails.
Subungual Melanoma: A type of skin cancer that affects the nail matrix. It is characterised by brown or black discolouration of the nail. Any change in the appearance or texture of the nail could indicate a nail matrix problem, and early detection is crucial.
Yellow Nail Syndrome: Nails with this condition thicken and turn yellow to yellow-green. They may lack a cuticle and pull away from the nail bed. This syndrome is associated with lung disorders, lymphoedema, and compromised respiration.
Koilonychia (Spoon Nails): Nails with this condition are thin, flattened, and curved inward, resembling spoons. It is often associated with iron deficiency anaemia.
Leukonychia: Characterised by white streaks or spots on the nails, leukonychia is often caused by medications or underlying diseases.
Peripheral Artery Disease (PAD): PAD is caused by narrowed arteries due to fatty buildup, leading to reduced blood flow to the arms or legs. This results in poor nutrition and oxygen supply to the fingertips, causing slow nail growth or even complete cessation of growth.
It is important to note that nail abnormalities can also be caused by factors such as injuries, certain medications, and lifestyle changes. If you notice any persistent changes in your nail growth or appearance, it is always best to consult a dermatologist or your healthcare provider for a proper diagnosis and treatment plan.
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Nail abnormalities
Healthy nails are smooth with consistent colouring. However, there are several reasons why your nails may grow abnormally.
Causes of nail abnormalities
- Injury to the nail matrix: Dropping something heavy on your finger or toe can cause bruising, ridges, or discolouration.
- Malnourishment: Deep grooves that run horizontally across the nail, known as Beau's lines, can be a sign of malnourishment.
- Infection: A nail infection, or paronychia, can cause redness and swelling around the nail. Without treatment, a nail infection can worsen.
- Chemotherapy: Chemotherapy affects rapidly dividing cells, including hair follicles and nail matrices, leading to hair loss and interrupted nail growth.
- Diseases: Conditions such as eczema, psoriasis, alopecia areata, and peripheral artery disease can cause nail abnormalities.
- Medications: Some medications can cause white bands across the nails (known as Mees' lines) and nail colour changes.
- Skin conditions: Up to 80% of people with psoriasis develop nail psoriasis, which can cause white lines, pitting, and crumbling.
- Cancer: Subungual melanoma, or nail matrix melanoma, is a type of skin cancer that affects the nail matrix. It requires surgery to remove the affected area.
- Ageing: As you age, your nails may become more brittle and develop vertical ridges.
If you notice any abnormalities in your nails, it is important to consult a doctor to rule out any serious conditions.
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Nail infections
Paronychia can result from a staph infection, caused by Staphylococcus aureus bacteria. Other bacteria, such as Streptococcus pyogenes, can also cause the infection. Bacteria can enter through cuts, broken skin, hangnails, ingrown nails, or irritation from water, chemicals, or trauma to the nail bed or cuticle area. Some medications can also cause paronychia, including retinoids, anti-cancer medications, HIV medications, and certain antibiotics.
Fungal nail infections are another common type of nail infection. These infections cause the nail to become thick, discoloured, and brittle, often starting at the edge of the nail and spreading. Toenails are more commonly affected, but it can also occur on fingernails. Fungal nail infections can spread from person to person, especially in places like communal showers and gyms.
It is important to seek medical advice if you suspect a nail infection. A dermatologist can examine your nails and provide appropriate treatment options.
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Nutritional deficits
Nutritional deficiencies can cause nail abnormalities, and nails can act as a window to internal health. While nail changes due to nutritional deficiencies are usually minor, they can be indicative of more serious underlying issues.
Protein deficiency, for example, can cause Beau's lines—transverse linear depressions in the nail plate, which may be accompanied by pitting or small, pinhole-like dots. These are often seen in people with malnutrition or chronic alcoholism. Kwashiorkor, a nutritional syndrome caused by severe protein malnutrition, can also lead to soft and thin nails.
Iron deficiency is another common nutritional deficiency that can affect nail health. It can cause nails to become thin, spoon-shaped, and dip down in the middle, a condition called koilonychia. Iron deficiency can also cause brittle, weak, and peeling nails, which are prone to cracking and splitting.
Zinc deficiency is another possible cause of nail abnormalities, presenting as scattered white spots on the nails.
Other nutritional deficiencies that can impact nail health include hypoalbuminaemia, which is associated with Muehrcke's lines, and Wilson's disease, which causes elevated nail copper concentrations.
It is important to note that nail changes can also be caused by external factors such as injury, certain medications, and overexposure to moisture or chemicals. If you are concerned about nail abnormalities, it is always best to consult a healthcare professional.
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Frequently asked questions
This could be due to a number of reasons, including injury, fever, chemotherapy, or stress.
Discolouration can be caused by trauma or injury to the nail. It can also be a sign of a nail infection.
Brittle nails are often a result of aging, but they can also be caused by certain diseases and conditions, such as low levels of zinc and iron, or thyroid problems.
Curved nails, also known as "clubbing", can be a result of low oxygen in the blood.
Pitting, or small depressions on the nail surface, can be a sign of nail psoriasis or alopecia areata.
