Sophia Delgado
Ridges in nails, also known as nail ridging, can be vertical or horizontal. Vertical ridges, also known as longitudinal striations or bands, are often a sign of aging, while horizontal ridges, known as Beau's lines, can indicate issues like malnutrition, serious nail injury, or an underlying illness. While vertical ridges are common and not dangerous, horizontal ridges could be a symptom of a more serious health issue. If you notice new ridges or lines in your nails, it is important to consult a healthcare professional to determine the underlying cause and receive appropriate treatment.
| Characteristics | Values |
|---|---|
| Type of lines | Vertical or horizontal |
| Cause | Ageing, nutritional deficiencies, skin conditions, nail trauma, chronic conditions, emotional stress, etc. |
| Treatment | Treating underlying causes; applying creams, moisturisers, and ointments; keeping nails trimmed; avoiding manicures, artificial nails, and harsh nail products |
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What You'll Learn
Horizontal nail ridges, or Beau's lines
Beau's lines can be caused by a variety of factors, including:
- Chemotherapy
- Damage from using artificial or acrylic nails or getting gel manicures for long periods
- Injury to the nail, such as slamming your finger in a door or dropping something on your foot
- Peripheral vascular disease (PAD)
- Severe illness with a high fever, such as COVID-19, measles, or pneumonia
- Nutritional deficiencies, such as zinc deficiency, which can cause Beau's lines and white spots on the nails, or iron deficiency, which can cause vertical nail ridges and koilonychia (spoon nails)
- Chronic conditions that interfere with blood flow to the nail matrix, such as hypothyroidism, peripheral artery disease (PAD), or Raynaud's phenomenon
- Skin conditions, such as eczema
- Mental and emotional stress, such as severe emotional stress or anxiety disorders
If you notice Beau's lines, it is important to see a healthcare provider to rule out any possible health conditions. Treatment for Beau's lines focuses on addressing the underlying cause. For example, if Beau's lines are caused by diabetes, successfully managing blood sugar may reduce these horizontal nail ridges. Similarly, treating skin conditions like eczema with moisturizers or topical ointments may help reduce symptoms and improve nail health. In some cases, altering your diet or taking supplements to boost nutrient levels may be recommended.
While Beau's lines themselves are not harmful, they can indicate an underlying health condition or nutrient deficiency that requires attention. With proper treatment and care, new, smooth nails can grow in place of those with ridges.
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Vertical nail ridges and ageing
Vertical nail ridges, also called longitudinal ridges, are commonly caused by the ageing process. They are harmless and very common, with most people having some faint vertical nail ridges when they are younger. These ridges tend to become more pronounced over time as nails naturally get thinner and more brittle.
Age-related vertical nail ridges cannot be removed, but they can be buffed and smoothed. However, it is important to note that over-buffing, more than once a month, can weaken the nails. To avoid this, it is recommended to stick with moisturising the nails and keeping them trimmed. Applying a heavy moisturising cream to the nails and cuticles can help prevent dry, brittle nails, which make ridges look more pronounced. This can be done daily and before bed, with thin cotton gloves worn after application to protect sheets.
Vertical nail ridges can also be caused by certain health conditions and nutrient deficiencies. For example, iron deficiency may cause vertical nail ridges, as can skin conditions such as dry skin or eczema. In these cases, treating the underlying cause can help new, smoother nails to grow.
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Nail trauma and injury
Injuries can occur when the nail is cut, torn, smashed, or bruised, or when the nail is torn away from the skin. For example, smashing your finger in a door, hitting it with a hammer or other heavy object, or cutting it with a knife or other sharp object can cause a nail injury. Repeated trauma to toenails, caused by ill-fitting shoes, can lead to deformities in the nails. Nails can also be accidentally torn or split, or a splinter can get under the nail.
There are five categories of nail injuries, and often, a combination of these injuries occurs simultaneously. A subungual hematoma (nail bruise) is a collection of blood under the nail, usually red or purple-black, which fades to blue over a few weeks. The entire finger or toe throbs and is painful to touch or move. A nail laceration refers to a cut through the nail, nail bed, cuticle, or lateral nail folds, with blood visible on the skin. A fingertip amputation means that a portion of the fingertip, including part or all of the nail, has been removed from the rest of the finger. The bone may or may not be visible.
If you experience a nail injury, make sure your tetanus vaccination is up to date. If the nail is torn or jagged, trim it to avoid further injury. If your nail lifts completely off the nail bed, it may be most comfortable to replace the nail and hold it in place with a bandage. Nails will not reattach once they have separated from the nail bed, but a new nail will usually slowly regrow. If blood under the nail occupies more than half of the nail area, see a doctor as it could indicate a bone fracture or tissue tear.
For a large bruise, a doctor may create a small hole in the nail to drain blood and fluid and relieve pressure and pain. If the bone is broken or the bruise is very large, the nail may need to be removed, and the nail bed repaired. Part or all of the nail may be removed, and cuts in the nail bed will be closed with stitches. The nail will be reattached with glue or stitches, or replaced with a special type of material. Antibiotics may be prescribed to prevent infection.
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Nutritional deficiencies
Other nutritional deficiencies that can affect your nails include vitamin A, C, and D deficiencies. Biotin is also highly recommended to aid in nail health, but more research is needed to understand the full extent of its benefits.
Nail changes in protein and energy deficiency and malnutrition include soft and thin nails, and impaired nail growth. In the case of marasmus, a wasting syndrome resulting from prolonged starvation, nail growth is impaired, and the body weight is reduced by 40-50%. Another nail change reported in malnutrition is longitudinal melanonychia, which refers to the blackish discolouration of the nail plate. Terry's nails, apparent leukonychia over the proximal nail bed with a distal pink or brown band, can also be a sign of malnutrition, especially in the elderly.
Nails are a mirror of your internal constitution and nutritional status. While nail changes due to nutritional deficiencies are mostly minor and non-specific, almost any nutritional deficiency can produce significant changes in the nail plate. For example, in children with kwashiorkor, there is an increased sodium and calcium concentration and decreased magnesium concentration in the nails. The iron content of nails may be lower in patients with iron deficiency anaemia.
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Medical conditions
Ridges in nails can be caused by various factors, including aging, skin conditions, and nutrient deficiencies. However, in some cases, they may also indicate an underlying medical condition. Here are some possible medical conditions that could contribute to the appearance of lines in your nails:
Onychorrhexis
Onychorrhexis is a condition that causes vertical ridges, nail splitting, and brittle nails. It is primarily associated with aging but can occasionally indicate an underlying health problem. Issues with the production of skin cells and the skin protein keratin can lead to onychorrhexis, affecting nail growth. While it is usually not a cause for concern, you should consult a doctor if you suspect it is linked to another health condition.
Beau's Lines
Beau's lines are horizontal ridges or dents in the nails, indicating that an illness, injury, or skin condition interrupted nail growth. They are often deeper than vertical ridges and may suggest a more serious condition. Beau's lines have been linked to severe infections, diabetes, nutritional deficiencies, and even acute kidney disease. Repeated occurrences of Beau's lines could signal a chronic condition that requires medical attention.
Thyroid Disease
Hypothyroidism can cause vertical nail ridges, resulting in thick, brittle nails that may crumble or break easily. The fingertips may also appear puffy, and the nails may take on a more rounded shape. Medication for thyroid disease often improves or resolves these nail-related issues.
Nutritional Deficiencies
Vitamin and mineral deficiencies, such as a lack of iron, zinc, protein, or vitamins A, C, and D, can contribute to the development of ridges in nails. Ensuring proper nutrition can help address this issue and promote healthier nail growth.
Skin Conditions
Skin conditions like eczema or very dry skin can lead to vertical lines on your nails. Proper nail and skin care, including moisturizing, can help alleviate this issue.
It is important to consult a healthcare provider if you notice new ridges or lines in your nails, as they can provide guidance on treatment options and help determine any underlying causes that may require medical attention.
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Frequently asked questions
Lines in nails, also known as ridges, can be caused by a variety of factors. Vertical lines are often a sign of aging, while horizontal lines, known as Beau's lines, can indicate malnutrition, serious nail injury, or an underlying illness or injury that interrupted nail growth.
Horizontal lines, or Beau's lines, can be a symptom of serious health issues, including severe infections, diabetes, nutritional deficiencies, peripheral artery disease, hypothyroidism, and kidney disease. Repeated Beau's lines could be a sign of an underlying condition interrupting nail growth.
If you have lines in your nails, it is important to consult a healthcare professional to determine the underlying cause. Treatment will depend on the specific cause but may include addressing nutritional deficiencies, treating any underlying health conditions, and improving nail care practices.
While the ridges may not completely go away, you can improve the appearance of your nails by applying moisturizer to your nails and cuticles daily, using creams or moisturizers for any skin conditions such as eczema, and avoiding manicures, artificial nails, and harsh nail products.
