You can’t judge a book by its cover but you can spot poor health by a person’s fingernails. The condition of the nails and surrounding skin are tell-tale signs of what is going on inside and otherwise unseen.
Most of us were born with healthy nails. But time and toxins take their toll and leave imprints on the tops of the fingers. Normal, healthy fingernails are smooth and evenly colored.
Brittle nails and vertical ridges are harmless signs of aging. Injured nails can produce spots which usually grow out with the nail.
Hand injuries are not the only cause of spots, discoloration, and even nail separation. Viral (periungual) warts, infections (onychomycosis), and some chemotherapy medications also result in nail abnormalities.
Changes in your fingernails may signal an illness but are more guidelines than rules. See your doctor if you think your nails indicate a more serious underlying disease. A physical exam and review of all your symptoms are needed for a definite diagnosis.
However, there are some nail changes that are strongly linked to medical problems. Bring any one of these conditions to a doctor’s attention:
- Pitted nails
- Changes in nail shape (curling or clubbing)
- A nail separating from the skin
- Discoloration (dark streaks, white streaks, or changes in nail color)
- Changes in nail thickness (thickening or thinning)
- Brittle nails
- Bleeding around nails
- Swelling or redness around nails
- Pain around nails
Pitted nails have small depressions that look like they came from the world’s tiniest ice pick. Nail pitting often occurs in people who have psoriasis (scaly skin patches). It may also indicate a connective tissue disorder (such as Reiter’s syndrome) or alopecia areala (an autoimmune disease that causes hair loss).
Nail clubbing happens when the fingertips get bigger and the nails curve around the fingertips. Normally, this process takes years to develop. It can flag low blood oxygen content, various types of pulmonary (lung) diseases, heart disease, inflammatory bowel disease, liver disease, and AIDS.
Beau’s lines are usually the result of an injury. These depressions or indentations that run width-wise across the nails occur when the tissues under the cuticle stop growing until the injury heals. The lines should then grow out. They are associated with malnourishment, uncontrolled diabetes, peripheral vascular disease, illnesses associated with a high fever (such as scarlet fever), measles, mumps, and pneumonia. zinc deficiency may be indicated by Beau’s lines.
Nail separation or onycholysis [oh-nee-ko-LIE-sis] is a medical condition where the fingernails loosen and sometimes detach from the nail bed. The separated part of the nail turns opaque with a white, yellow, or green tinge. Several things can cause nails to detach: injury, infection, a bad drug or consumer product reaction (think nail hardeners and adhesives), thyroid disease, and psoriases.
Yellow nail syndrome gets its name because the nail area actually turns yellow as nails thicken and new growth slows. The cuticle may disappear so that the nail detaches in places. Yellow nails are a natural sign of aging but may be caused by using acrylic nails or nail polish. Smoking can impart a yellow tinge to nails. If the nails are also thick and crumbly, a fungal infection may be the source. Otherwise, respiratory disease (such as chronic bronchitis) and swelling of the hands (lymphedema) may be indicated by yellow nail syndrome.
Koilonychia [coil-ON-kee-ya] is a medical condition where the nails become thin, soft, and shaped like a spoon that can be cupped enough to hold a drop of water. It looks like the center of the nail has been removed with an ice cream scoop. The nail thins and the outer edges curl upward. More common on the fingers than the toes, the nail may crack and the outer part may detach from the nail bed. Anemia (low red blood cell count) or iron deficiency is the usual cause for spoon nails. If so, other symptoms commonly associated are fatigue, pale skin, shortness of breath, and weakness. Koilonychia can affect a single digit, some of them, or all of them.