Sophia Delgado
Fingernails and toenails can sometimes curve or grow downwards as they lengthen. This could be a natural trait or a sign of underlying health issues. Curved nails can be caused by several factors, including nutritional deficiencies, fungal infections, or certain medications. In some cases, it may be due to improper footwear or toenail cutting. Additionally, underlying health conditions, such as diabetes, circulation problems, or autoimmune diseases, can also contribute to nail curling. Seeking medical advice is recommended if nail curling is accompanied by other symptoms or if there are concerns about potential health risks.
| Characteristics | Values |
|---|---|
| Cause | Underlying health issues, such as nutritional deficiencies, autoimmune issues, fungal infections, or psoriasis |
| Type | Clubbing, Spoon Nails (Koilonychia), Pincer Nails, Ingrown Nails |
| Treatment | Filing, trimming, or cutting nails properly, medication, laser treatment, surgery |
| Prevention | Moisturizing hands and nails with oil, wearing properly sized footwear, avoiding tight socks and shoes |
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What You'll Learn
Nutritional deficiencies
Vitamin and Mineral Deficiencies
Deficiencies in certain vitamins and minerals can lead to nail abnormalities. For example:
- Vitamin B deficiency can cause longitudinal furrows or ridges on nails, which run from the tips to the cuticles.
- Vitamin D deficiency has been associated with longitudinal melanonychia, characterised by blackish discolouration of the nail plate.
- Iron deficiency, the most common cause of spoon nails (koilonychia), can result in soft, thin, and concave nails that curve inward.
- Zinc deficiency is linked to horizontal grooves on nails known as Beau's lines, as well as white spots on the nails called leukonychia punctata.
- Selenium deficiency may cause horizontal white lines across the nail bed, known as leukonychia striata.
- Copper deficiency is another possible cause of spoon nails.
Protein and Energy Deficiency
Malnutrition and protein-energy deficiency can also impact nail health. Kwashiorkor, a condition resulting from severe protein malnutrition, can lead to soft and thin nails. Marasmus, caused by prolonged starvation, may result in fissured nails and impaired nail growth.
Other Nutritional Anomalies
In addition to specific vitamin and mineral deficiencies, other nutritional anomalies can affect the nails. For instance, children with kwashiorkor may exhibit increased sodium and calcium concentrations and decreased magnesium levels in their nails. Anemia, often associated with iron deficiency, can cause pallor of the nail bed.
While nail changes can provide valuable insights into nutritional deficiencies, it is important to note that they are not always the first indicator of a problem. A comprehensive physical examination, including observations of hair, skin, and eyes, can help assess an individual's overall health and nutritional status.
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Underlying health issues
Changes in the shape of your nails can sometimes be indicative of an underlying health issue. Curving nails can be a harmless trait that runs in the family, but they can also be a sign of disease. If the curving of the nails occurs with other symptoms, it is important to seek medical treatment.
Curving nails can be a result of nutritional deficiencies, such as low iron levels, which can lead to iron deficiency anaemia. Spoon-shaped nails, or koilonychia, can be a sign of iron deficiency. People can develop an iron deficiency due to various reasons, including high-altitude environments. Vitamin B12 deficiency can also cause nail changes.
Nail abnormalities can also be caused by skin diseases such as eczema, psoriasis, and lichen planus infection. About 90% of people with psoriasis develop the condition on their nails at some point. Symptoms may include thickening, curving, and shallow or deep holes in the nail.
In addition, curving nails can be a sign of more serious health issues. Clubbing of the nails, or "clubbed fingers", is generally related to a cardiac (heart) or pulmonary (lung) problem but can also be caused by nutritional and environmental factors. Raynaud's, a rare disorder that affects the arteries, can also cause nail curving.
Other potential causes of nail problems include injury, infection, and trauma. Toenail problems can be caused by ill-fitting shoes, poor circulation, and poor nerve supply.
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Pincer nails
There are three types of pincer nail deformities (PND), as proposed by Baran et al.: the common pincer nail or trumpet nail (type 1), the plicated nail (similar to an ingrown nail, type 2), and the rare tile-shaped nail (type 3). Type 1 is characterised by an increase in transverse curvature, forming an omega or trumpet shape. Type 2 presents with lateral edges that sharply bend to form vertical sheets, pressing into the lateral nail groove and mimicking an ingrown nail. Type 3 involves a larger increase in transverse curvature along the longitudinal axis, resulting in a tile shape.
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Ingrown toenails
An ingrown toenail is a common condition in which the corner or side of a toenail grows into the soft flesh, causing pain, inflamed skin, swelling, and sometimes an infection. This usually affects the big toe.
- Tight or ill-fitting shoes: Shoes that are too tight or place too much pressure on the toes can cause the nail to grow into the surrounding tissue.
- Improper nail trimming: Cutting toenails too short, especially on the sides of the big toes, or rounding the corners can cause the nail to grow into the flesh.
- Trauma: Stubbing or banging the toe can result in an ingrown toenail.
- Genetics: In some cases, people may be born with a nail that is too large for their toe, making it prone to ingrowth.
- Poor blood circulation: Poor blood flow to the feet can increase the risk of complications from ingrown toenails.
However, if the pain is severe, there is a lot of inflammation or discharge, or the infection keeps returning, it is recommended to seek medical help. Treatment options may include oral antibiotics or partial or complete removal of the ingrown toenail.
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Genetic factors
The shape of our nails can be influenced by several factors, including genetics. While nail curvature is common and not usually a cause for concern, it can sometimes indicate an underlying health issue.
Curved nails can be a natural trait and may run in families. For instance, the thickening of tissue underneath the nail can cause the fingertips to become rounded, with the nails curving over them. This condition tends to be harmless and can also be observed in children, where it reflects the immaturity of their nails.
Ichthyosis is a rare genetic skin condition that can cause nail deformation. It is usually diagnosed at birth, when a baby is born with a collodion membrane on their skin. In such cases, the body is unable to shed dead skin cells, leading to thickened or deformed nails.
Another rare genetic disorder, Raynaud's disease, can also cause nail curvature. It affects the arteries, causing them to narrow and block blood flow to the fingers or toes. Hemochromatosis, a condition where the body absorbs too much iron, can also lead to koilonychia (spoon nails). Nail-patella syndrome is another genetic condition that can cause problems with nails, kneecaps, hip bones, and elbows.
In addition to these specific genetic disorders, nail configuration is influenced by genetic factors more broadly. For example, studies have investigated the use of human nail clippings as a source of DNA for genetic analysis, indicating the role of genetics in nail shape.
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Frequently asked questions
There are several reasons why nails might curl under. It could be a natural trait, or it could be due to nutritional deficiencies, such as a lack of iron, vitamin B12, zinc or biotin. It could also be caused by environmental factors, underlying health issues, or autoimmune diseases.
There are two types of nail curvature to be aware of: Clubbing and Spoon Nails (Koilonychia). Clubbing causes nails to curve around the fingertips and can be a sign of low oxygen levels in the blood, signalling potential lung or heart issues. Spoon Nails cause nails to curve upward, creating a spoon-like appearance, and can be linked to iron deficiency or certain autoimmune diseases.
Nails with Spoon Nails will look thin and have raised ridges. The condition can also be identified by the presence of shallow or deep holes in the nail.
Curled toenails can lead to discomfort and pose potential health concerns. Conditions like pincer nails or ingrown toenails can result from improper footwear or toenail cutting, leading to infections and complications, especially for individuals with systemic conditions like diabetes. Chronic curled toenail problems can also signal underlying health issues such as iron deficiency anaemia.
To prevent curled nails, you can adopt good nail care practices, such as proper nail-cutting techniques, wearing well-fitting footwear, and moisturising your nails with cuticle oil or olive oil to strengthen them. If you are experiencing persistent problems or underlying health conditions, seek treatment from a healthcare professional or podiatrist, who may recommend trimming, lifting, or removing part of the nail.
