Liam Carter
Changes in nail shape can be harmless, but they can also indicate an underlying health condition. Spoon-shaped nails, for instance, could be a sign of iron deficiency, while clubbed nails, which curve around the fingertips, can be caused by low oxygen in the blood and are associated with heart and lung diseases. Beau's lines, or depressions that run across the fingernail, may indicate malnourishment. Washboard nails with grooves and ridges in the centre of the thumb could be the result of a habit of picking or pushing back the cuticles. While nail changes rarely signify a serious issue, it's important to consult a doctor or dermatologist if you're concerned about any alterations in nail shape, colour, or texture.
| Characteristics | Values |
|---|---|
| Shape | Spoon-shaped, pitted, clubbed, washboard, curved, separated |
| Colour | Dark streak, greenish-black, yellow, non-uniform white spots or lines |
| Texture | Thick, thin, soft, spongy, swollen, bumpy, ridged |
| Temperature | Warm to the touch |
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Iron deficiency
Changes in the shape of your fingernails can be caused by several factors, one of the most common being iron deficiency. Iron deficiency can lead to a condition known as koilonychia or spoon nails, where nails become soft and concave, resembling a spoon. This condition can affect both fingernails and toenails.
While spoon nails can sometimes be genetic or caused by external factors, they are often a sign of iron deficiency, which is the most common cause of spoon nails in children. Iron-deficiency anaemia can cause a person's nail bed to become pale and lead to nail abnormalities, including spoon nails. The exact mechanism behind this is not fully understood, but it is believed that reduced iron levels in epithelial cells may play a role. Additionally, poor blood flow to the hands and feet, which is associated with iron deficiency, can weaken the connective tissue under the nail plate, contributing to the spoon-like shape.
If you suspect that your nail shape changes are due to iron deficiency, it is recommended to consult a healthcare professional. They can provide tests to determine the underlying cause and suggest appropriate treatment options. Treatment for iron deficiency may include dietary changes or supplements to increase iron intake and correct the nail abnormalities.
To increase iron intake, individuals can incorporate iron-rich foods into their diet, such as beans, lentils, dark chocolate, fortified bread and breakfast cereals, iron-rich fruits like dates and raisins, leafy greens such as spinach and kale, meat and seafood, and nuts and seeds. In some cases, supplements may be recommended to ensure adequate iron levels.
In addition to iron deficiency, nail shape changes can also be caused by other nutritional deficiencies, such as vitamin B or B12 deficiencies. External factors, such as repeated exposure to water or chemicals, can also contribute to nail shape changes, making them brittle or weak. It is always advisable to consult a doctor or healthcare provider if you notice any unusual or persistent changes in your nails, as they can provide guidance and help determine the underlying cause.
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Nail clubbing
If you notice nail clubbing, it is important to consult a healthcare provider as it is often a sign of a serious health condition that requires medical care. Treating the underlying condition may help nails return to normal, although nail clubbing is not always reversible. There is no known way to prevent nail clubbing, but you can reduce your risk of developing it by not smoking, as smoking is a leading cause of lung cancer and heart disease.
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Injury or infection
Fingernail abnormalities are often a sign of injury or infection. In some cases, they can indicate an underlying condition. If you notice any changes to your nails, it is important to consult a medical professional for proper diagnosis and treatment.
Injury
Injuries to the nail can result from various activities, such as nail biting, cuticle picking or pushing, aggressive manicuring, or cleaning under the nails with a sharp object. These actions can create tiny cracks or cuts in the nails and surrounding skin, providing an entry point for bacteria to cause an infection.
Infection
Paronychia is a common nail infection that can affect both fingernails and toenails. It is caused by bacteria or fungi entering broken skin near the cuticle and nail fold, leading to inflammation and infection. Symptoms of paronychia include redness, swelling, warmth, tenderness, and pain around the nail. In some cases, pus-filled blisters may develop, and the nail may appear detached, abnormally shaped, or discoloured.
Paronychia usually responds well to treatment, which may include oral or topical antibiotics, draining of pus, and keeping the affected area clean and dry. However, if left untreated, paronychia can lead to more serious complications, such as osteomyelitis (a bone infection) or, in rare cases, the need to remove a finger or toe to prevent the infection from spreading.
In addition to paronychia, other types of nail infections include fungal infections, which can cause crumbly nails, and bacterial infections, which can turn the nails greenish-black.
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Vertical ridges
Aging is one of the most common causes of vertical nail ridges, also called longitudinal ridges. As people age, their nails naturally get thinner and more brittle, and the ridges may become more pronounced over time. Vertical ridges are often a sign of a vitamin or nutrient deficiency, such as a lack of iron, folic acid (vitamin B9), protein, or zinc. Certain health conditions, such as hypothyroidism, can also cause vertical nail ridges. In addition, skin conditions like dry skin, eczema, and psoriasis can lead to vertical ridges.
If you have concerns about the appearance of vertical ridges on your nails, it is recommended to consult a doctor or dermatologist, who can examine your nails and determine if there is an underlying cause that requires treatment. Treating or managing any underlying conditions or nutrient deficiencies will usually allow smoother, healthier nails to grow in.
While waiting for an appointment with a doctor, there are several home care treatments that can be tried to improve the appearance of your nails. These include applying moisturizer to your nails and cuticles daily, wearing cotton gloves to bed after applying moisturizer, and taking breaks from gel manicures and artificial nails, which can dry out and weaken nails.
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Yellow nail syndrome
The appearance of nails in YNS varies; changes include a thickened nail plate with exaggerated curvature, xanthonychia (yellow discolouration), scleronychia (hardening of the nail), onycholysis (separation of the nail plate and nail bed), and slow growth. The loss of the strip of hardened skin at the base and sides of a fingernail (cuticles) may also occur.
YNS is occasionally associated with the accumulation of fluid in the membranes surrounding the lungs and lining the chest cavity (pleural effusion). Pleural effusions can cause shortness of breath, chest pain, and a cough. Additional respiratory problems may occur, such as chronic infection, inflammation of the main air passages (bronchial tubes), destruction and widening of the small air passages (bronchiectasis), sinus infections (sinusitis), and/or pneumonia.
Swelling or puffiness in different parts of the body may occur due to the accumulation of protein-rich fluid (lymph) in the soft layers of tissue under the skin (lymphedema). The legs are especially affected, with swelling typically occurring a few months after nail changes. The onset of lymphedema may also occur around puberty. Areas affected by lymphedema may feel heavy or tight, and the skin may become hardened or thickened.
While the exact cause of YNS is unknown, some experts believe it results from issues with the circulatory or lymphatic system. When these systems do not work correctly, fluid collects in the soft tissues under the skin, potentially turning the nails yellow. Some researchers suspect a genetic component, potentially involving the FOXC2 gene, as YNS has been observed to run in families. Other researchers propose a link between YNS and titanium exposure, which may be increased by joint replacements, dental implants, and certain medications.
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Frequently asked questions
Your nails could be curving downwards due to a condition known as clubbing, which is associated with low oxygen in the blood. It can be caused by lung and heart problems.
This could be koilonychia, which is associated with iron deficiency.
Pitting on the nails can be a sign of a disease that affects your entire body, such as alopecia areata.
Yellow nails can be caused by a fungal infection. In rare cases, it can indicate a more serious condition such as severe thyroid disease, lung disease, diabetes, or psoriasis.
White nails, or leukonychia, can be caused by trauma, anemia, dietary deficiencies, heart or kidney disease, or even poisoning.
