Isla Bennett
Many factors can cause nails to grow in unusual ways. For example, if you frequently pick at your cuticles, you may have what’s called a habit-tic nail trauma, which can cause your nail plate to grow unevenly. Additionally, severe injuries can cause nails to fall off, and they may not grow back evenly or at all if the nail matrix is severely damaged. Health conditions, nutrient deficiencies, and medications can also cause ridges, dents, discolouration, or changes in nail shape.
| Characteristics | Values |
|---|---|
| Cause | Injury, illness, skin conditions, diseases, hormonal changes, nutritional deficiencies, medications, age, family history, stress, or poor trimming |
| Symptoms | Lifting, discoloration, deep grooves, thickening, curving, spoon-shaped, pitting, crumbling, swelling, sponginess, or falling off |
| Treatment | Draining blood, surgery, medication, trimming nails straight across, moisturizing, avoiding nail biting, or consulting a dermatologist |
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What You'll Learn
Health conditions and nutrient deficiencies
Fingernails are vital indicators of overall health and can reveal insights about one's well-being. Nails are predominantly made up of keratin, a protein that is integral to nail tissue formation. Ensuring an adequate intake of dietary protein is critical for producing keratin and maintaining strong, healthy nails.
A healthy nail matrix, the area where fingernails and toenails form, is essential for healthy nails. Various conditions and injuries can damage the nail matrix and interfere with nail growth. For instance, injuries to the nail matrix can cause the nail to lift and separate from the nail bed, resulting in white discoloration. In such cases, a dermatologist can provide treatment to clear any infection and offer guidance to promote normal nail growth. Additionally, certain health conditions, such as psoriasis, ichthyosis, or circulation problems, can lead to thickened and overgrown nails, also known as Ram's horn nails.
Certain health conditions and nutrient deficiencies can also impact nail growth and appearance. Spoon-shaped nails, or koilonychia, can indicate anemia or an iron deficiency. Iron is essential for transporting oxygen to all cells in the body, including those in the nails. Soft or flexible nails, a condition called Hapalonychia, have been linked to nutritional deficiencies, particularly insufficient calcium intake. Calcium is a vital mineral that plays a crucial role in the structure of nails. Vitamin D is also important, as it enhances the body's absorption of calcium.
Weak nails may be associated with vitamin and mineral deficiencies. For example, scattered white spots on the nails can indicate a zinc deficiency. Additionally, brittle nails might be a sign of hypothyroidism or an iron deficiency. Consuming a variety of whole foods, including fruits, vegetables, and whole grains, usually provides the necessary vitamins and minerals for nail health. If needed, taking a multivitamin with calcium and B vitamins can help address potential deficiencies.
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Nail matrix injuries
The nail matrix is the area where your fingernails and toenails start to grow. It is responsible for nail growth and is located at the base of the nail. The nail matrix creates new cells that become your fingernails or toenails. A healthy nail matrix is essential for healthy nails.
The nail matrix has two parts: the germinal matrix and the sterile matrix. About 90% of nail growth comes from the germinal matrix, while the remaining 10% comes from the sterile matrix, which is also responsible for keeping your nail attached to the underlying skin.
Injuries and certain health conditions can damage your nail matrix and interfere with nail growth. Minor damage to your nail matrix can temporarily change your nail's appearance, and you might notice a change in how your nail feels to the touch. A severe injury could cause your nail to fall off.
Mechanical injuries are a common cause of nail matrix damage. This can include pinching or crushing your finger, or dropping something heavy on your toe. Trauma to the nail can cause the production of new nail cells to stop for as long as three weeks. Nail growth will usually resume at a faster rate and steady after about 100 days. You may notice the nail appears thicker than usual.
Other causes of nail matrix damage include:
- Cuticle picking: Individuals who pick at the cuticle, which serves a protective function, may notice a wavy nail plate. This is due to matrix damage under the influence of too much pressure in the lunula area, where the nail is still soft and delicate.
- Improper use of a drill: Pressing the drill too hard and too deep around the cuticles may damage the matrix.
- Cuticle cutting with a cuticle pusher: Excessive pressure can lead to nail plate distortion (rippling) and even matrix damage.
- Infections: Fungal infections, particularly in the toenails, can cause thick, yellow, cracked, or cloudy nails.
- Illnesses: Serious health events like a heart attack, COVID-19, or pneumonia can interrupt nail growth and cause horizontal ridges in your nails (Beau's lines).
- Medications: Chemotherapy and other medications can affect the nail matrix, causing Beau's lines or slow nail growth. Medications may also cause white bands across the nails (Mees' lines) and nail colour changes.
- Subungual melanoma: Cancerous cells grow in the nail matrix, causing changes in pigments in the nail known as melanin. This results in a distinct striped discolouration.
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Skin conditions
Several skin conditions can affect nail growth and cause nails to grow in an abnormal shape. Here are some common skin conditions that can impact nail health:
Eczema: Severe eczema can affect the nail matrix and temporarily interfere with nail growth. Beau's lines (horizontal ridges), pitting (small, pinhole-like dots), and texture or colour changes may be observed in individuals with severe eczema. Proper nail care, including daily moisturization of the nails and cuticles, can help relieve dry skin associated with eczema and improve the appearance of nails.
Psoriasis: Nail psoriasis is a common complication of psoriasis, affecting up to 80% of people with the condition. It can cause white lines, pitting, and crumbling of the nails. Psoriasis can also cause the skin around the nails to become sore, red, swollen, and warm, which may indicate an infection or ingrown toenail.
Subungual Melanoma: Subungual melanoma, or nail matrix melanoma, is a type of skin cancer that affects the nail matrix. It presents as brown or black discolouration on the nail. Peripheral artery disease (PAD), which reduces blood flow to the legs and feet, can also impact nail growth and cause nails to grow more slowly.
Nutritional Deficiencies: Certain nutritional deficiencies, such as zinc deficiency, can lead to Beau's lines and white spots on the nails. Ensuring adequate nutrient intake through a balanced diet or supplements may help address these issues.
Infections: Fungal infections, particularly in the toenails, can disrupt nail growth. Toenail fungus may manifest as thick, yellow, cracked, or cloudy nails. Bacterial infections, such as paronychia (an infection of the skin around the nails), can also cause nail abnormalities and require medical attention.
It is important to consult a dermatologist or healthcare provider if you notice any persistent changes in your nails, as they can provide expert advice and treatment options for managing these skin conditions and promoting healthy nail growth.
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Thyroid disease
The thyroid is a butterfly-shaped gland in the neck that produces hormones, which play a key role in regulating heartbeat, breathing, and other functions. Thyroid hormones also help with growth and development, including nail growth. Therefore, changes in the appearance of your nails could indicate a thyroid disorder.
Those with low thyroid levels (hypothyroidism) often experience weak nails that break easily, grow slowly, or are thin and brittle with vertical ridges. Nails may also crumble, and the fingertips may appear puffy. In contrast, those with elevated thyroid hormone levels (hyperthyroidism) may have "spoon-shaped" nails, or a condition called onycholysis, where the nail plate pulls away from the skin of the nail bed.
Nail changes may help with the early detection and diagnosis of a thyroid disorder. A 2022 study found that those with a thyroid disorder frequently report nail brittleness. Onycholysis, in particular, is an early indicator of thyroid disease. Other nail-related conditions associated with hypothyroidism include slow-growing, thin nails, and splitting at the tips of the nails. Those with hyperthyroidism may also experience nail brittleness, as well as koilonychia (spoon nails) and changes associated with onycholysis.
If you notice any changes in your nails, it is important to consult a healthcare provider to determine the underlying cause. Treating the cause can usually improve the appearance of your nails and allow healthy nails to grow in. For example, medication for thyroid disease often resolves related nail problems.
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Fungal infections
While there are many reasons why nails may not grow straight, one possibility is a fungal infection. Fungal nail infections cause the nail to become thickened, discoloured, and distorted, with the nail often becoming easy to break. While it is a slow-developing infection, it can spread to multiple nails and is unlikely to get better without treatment.
Fungal nail infections are characterised by the nail becoming thick, discoloured, and brittle. The discolouration can manifest as white or yellow hues. Sometimes, the whole nail can break off, causing pain and swelling in the surrounding skin. These infections typically start at the edge of the nail and gradually spread to the rest of the nail.
Fungal nail infections are not considered serious, but they can be challenging to treat and may require prolonged treatment regimens. Treatment options include topical antifungal medications that are brushed onto the nail and must be used consistently for several months. If topical treatments are ineffective, oral antifungal tablets may be prescribed by a healthcare professional. It is important to note that oral antifungal medications may not be suitable for individuals with certain medical conditions.
To prevent fungal nail infections, it is advisable to maintain good nail hygiene and be cautious when using nail salons, ensuring sterilisation of tools. Additionally, addressing any underlying conditions, such as circulation problems or psoriasis, can help reduce the risk of fungal nail infections. Early detection and treatment of fungal nail infections are crucial, as they can become more challenging to manage if left untreated.
If you suspect a fungal nail infection, it is recommended to consult a healthcare professional, such as a dermatologist or your primary care physician, for a proper diagnosis and tailored treatment plan. They may take a sample of your nail or perform a blood test to determine the specific type of infection and rule out any underlying conditions.
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Frequently asked questions
There could be many reasons for this. It could be due to an injury, such as slamming your finger in a door, or it could be caused by a health condition or nutrient deficiency. For example, iron deficiency often causes spoon nails, which are nails with a depression in the middle.
If you are concerned about the appearance or shape of your nails, you should speak to a healthcare professional. They will be able to advise you on any treatment options and recommend dietary changes or supplements if necessary.
You can lower your risk of nail problems by taking care of your nails. This includes cleaning your nails with a soft brush, keeping them moisturized, and wearing rubber gloves when cleaning or using chemical products.
Several health conditions have been linked to nail abnormalities, including thyroid disease, lupus, heart disease, and celiac disease. Certain nutritional deficiencies, such as iron or zinc deficiency, can also cause changes to your nail shape and texture.
