Have you noticed a change to any of your nails lately? A change in color, texture, or shape can be harmless, but it can also be a sign of disease. If you notice any of the following changes to a fingernail or toenail, it’s time to see a board-certified dermatologist.
Medical name: Acral lentiginous melanomaDark streak If a fingernail or toenail has a new or changing dark streak, it’s time to see a dermatologist for a skin cancer check. That dark streak could be melanoma, the most serious type of skin cancer.
Not every dark streak is a melanoma, but it’s always good to have a dermatologist examine one. Caught early and treated, that may be the only treatment you need.Allowed to grow, treatment becomes more difficult.
Medical name: OnycholysisNail lifting up If a nail starts to lift up so that it’s no longer completely attached, you’ll likely see white discoloration, as shown here. When a nail lifts up, the cause is often:
Injury from an aggressive manicureInjury form cleaning under your nails with a sharp objectA dermatologist should examine any nail that’s lifting up. You may need treatment to clear an infection. A dermatologist can also give you some tips that may help the new nail grow out normally.
Medical name: ParonychiaRedness and swelling around a nail If you have redness and swelling around a nail, you may have an infection. When diagnosed early, you can often treat an infection with soaks and antibiotics. If an open sore forms, you’ll need more extensive treatment.
Medical name: ParonychiaGreenish black color When bacteria cause a nail infection, the nail can turn greenish black as shown here.Without treatment, a nail infection tends to worsen. Treatment can get rid of your pain and tenderness and help clear the infection.
Medical name: PittingPitted nails If you have dents in your nails that look like they were made by an icepick, this could be a sign that you have a disease that affects your entire body.People who have pits in their nails may have:
Atopic dermatitisAlopecia areataSeeing a board-certified dermatologist for a diagnosis is important. Dermatologists are the specialists who diagnose and treat these diseases. Treatment can help you feel more comfortable and prevent the disease from worsening.
Medical name: Yellow nail syndromeYellow nails Wearing red nail polish without a base coat or smoking can turn your nails yellow. If your nails turn yellow, thicken, and seem to stop growing, it could be a sign of something going on inside your body.Lung disease and rheumatoid arthritis can cause yellow nails. You may also have a serious nail infection, which requires treatment.
Medical name: Beau linesDeep grooves (or gaps) Lines that run the length of a nail are common and usually nothing to worry about. If you see deep grooves that run the width of your nail like the ones shown in this picture, it means that something slowed (or stopped) your nails from growing for a while.When something causes your nail(s) to completely stop growing for a while, you may see a gap. If this happens, you’ll have a place on your nail(s) that’s missing nail. The medical name for this condition is onychomadesis (on-ah-coe-ma-dee-sis).A fever, injury, chemotherapy, or major stress can cause your nails to grow slowly or stop growing.If you cannot think of what could may have caused your nails to grow slowly or stop growing, see your dermatologist or primary care doctor. Once you find and get rid of the cause, nails often start growing normally.
Medical name: OnychogryphosisRam’s horn nails This happens when the nails thicken and overgrow. Some people get Ram’s horns because the condition runs in the family.If you have a disease, such as psoriasis, ichthyosis, or circulation problems, you may also develop Ram’s horn nails.Cutting and treating these nails requires help from a podiatrist or dermatologist.
Medical name: KoilonychiaThin, spoon-shaped nails If you have thin fingernails that dip down in the middle and look like spoons, you may not be getting enough iron. People develop an iron deficiency for many reasons, including:
Lack of proper nutrition
A health problem with their stomach or intestinesSensitivity to gluten (celiac disease)High altitudeGetting a proper diagnosis and treatment can help you feel better.
Medical name: OnychotillomaniaWashboard nails If you have grooves and ridges in the center of your thumb that look like the ones shown in this picture, you may have developed a habit of picking at (or pushing back) the cuticles on your thumbnails. Many people are unaware that they do this.A dermatologist may be able to help you break the habit, allowing healthy nails to grow out.
Medical name: ClubbingCurved nails The curving can begin so gradually that many people are unaware it's happening. As the nails continue to curve downward, fingertips often swell and the nails start to feel spongy when pressed on.If you notice your fingernails start to curve, it’s time to see a board-certified dermatologist. Curved nails can be a harmless trait, which runs in the family. Curved nails can also be a sign that you have a disease in the:
Lungs
HeartLiverStomach or intestine
Color change A disease inside your body can cause your nails to change color. Certain color changes can be a warning sign of a specific disease, as the following table shows.
Color
Disease or other health problem
Blue nails
Not enough oxygen in your bloodstream
White nails
Liver disease, diabetes
Pale nails
Anemia
Half pink, half white nails
Kidney disease
Yellow nails
Lung disease, nail infection
Dusky red half-moons
Could be lupus, heart disease, alopecia areata, arthritis, dermatomyositis
Blue half-moons
Could be sign of poisoning
Seeing a change to your nails or the half-moons doesn’t always mean that you have a disease.
Still, it’s important to see a board-certified dermatologist if you notice any changes. Board-certified dermatologists specialize in diagnosing and treating the skin, hair, and nails. They have the expertise to tell you whether the change is harmless or requires medical testing.
Images 4, 5, 7, 9, 10, and 11 used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Images 3, 12: Getty Images
Images from the Journal of the American Academy of Dermatology
Image 2: J Am Acad Dermatol. 2014;70(4):748-62.
Image 6: J Am Acad Dermatol. 2007;57:1-27.
Image 8: J Am Acad Dermatol. 2015;73:849-55.
References Braswell MA, Daniel CR, et al. “Beau lines, onychomadesis, and retronychia: A unifying hypothesis.” J Am Acad Dermatol 2015; 73:849-55.
Fawcett RS, Hart TM, et al. “Nail abnormalities: Clues to systemic disease.” Am Fam Physician. 2004;69(6):1417-24.
Kiaravuthisan MM, Sasseville D, et al. Psoriasis of the nail: Anatomy, pathology, clinical presentation, and a review of the literature on therapy.” J Am Acad Dermatol 2007;57:1-27.
Kumar V, Aggarwal S, et al. “Nailing the diagnosis: Koilonychia.” Perm J. 2012;16(3): 65.
Ring DS. “Inexpensive solution for habit-tic deformity.” Arch Dermatol. 2010;146(11):1222-3.
A dermatologist should examine any nail that's lifting up. You may need treatment to clear an infection. A dermatologist can also give you some tips that may help the new nail grow out normally. If you have redness and swelling around a nail, you may have an infection.
To prescribe the correct medication, many dermatologists will examine a sample of the nail to identify the fungus at fault. Dark streaks: A new or changing dark streak under the fingernail could be melanoma, a type of skin cancer. The same types of cancer that occur on the skin can also develop in the nails.
Nail abnormalities are problems with the color, shape, texture, or thickness of the fingernails or toenails. Yellow nail syndrome is characterized by yellow nails that lack a cuticle, grow slowly, and are loose or detached (onycholysis).
The most common symptom of subungual melanoma is a discolored line that appears on your nail. It's usually brown or black and runs from top to bottom (vertical). In some cases, the line can be irregularly shaped and increase in length and width over time.
If your fungus doesn't clear up at home, you should check in with a dermatologist (a skin, hair, and nail specialist) or podiatrist (a foot doctor.) They may gently scrape under your nail to get rid of some of the fungus or send it to the lab for diagnosis. They can also prescribe stronger medicines. Topical medicines.
Terry's nails is a type of nail discoloration. The nailbeds look “washed out,” except for a thin reddish-brown strip near the tip. Often, Terry's nails is a symptom of a chronic condition, such as liver failure or diabetes. Sometimes, it is a sign of aging.
Half-and-half nails, or Lindsay nails, which are observed in patients with chronic kidney disease, have sharp demarcation of nail beds: the proximal portion of each nail is whitish; and the distal portion, which occupies 20% to 60% of the nail length, is red, pink, or brown.
Horizontal ridges, also known as Beau's lines, that run across the nail indicate that your nail growth slowed or stopped and that it could be related to a health condition. Common causes include high fever, vitamin deficiency, injury, diabetes and peripheral vascular disease.
A low level or lack of oxygen circulating in your red blood cells can cause blue fingernails. Other causes can include chronic conditions and cold temperatures.
Hapalonychia (soft nails) has been associated with deficiencies of vitamins A and D among other causes. Longitudinal melanonychia of the nail plate has been reported in vitamin D deficiency.
Nail changes in vitamin B12 deficiency present as hyperpigmentation of nails like bluish discoloration of nails, blue-black pigmentation with dark longitudinal streaks, and longitudinal and reticulate darkened streaks. The nail pigmentation associated with B12 deficiency is more frequent in patients with dark skin.
Consult a doctor if you are worried about any of the following symptoms of nail abnormalities: changes in nail shape, such as curling or clubbing. discoloration, such as dark or white streaks, or other changes in color. changes in thickness, such as thinning or thickening of nails.
Nail changes including discoloration, crumbling, onycholysis, Beau lines, ridging, pitting, thinning, etc., have been described in T-cell lymphomas [1, 2].
Koilonychia is an abnormal shape of the fingernail. The nail has raised ridges and is thin and curved inward. This disorder is associated with iron deficiency anemia. Leukonychia is white streaks or spots on the nails often due to drugs or disease.
Fingernail and toenail disorders can cause sensitivity and pain, as well as inhibit social relationships, employment, and daily activities. If you are experiencing any of these symptoms, it is important to have your nails evaluated by a board-certified dermatologist as soon as possible.
Dermatology diagnoses and treats skin, hair and nail disorders, from melanoma to hair loss. Dermatology focuses on the diagnosis, treatment and prevention of skin, hair and nail disorders. It's a rewarding discipline that comprises many subspecialties, but it's also a competitive field with limited residency slots.
Diagnosing nail melanomas is challenging. Dermatologists should have a low threshold to perform a biopsy of the nail matrix when there are concerning signs and symptoms for nail melanoma. Residents should gain confidence and competency in performing nail biopsies during residency.
Despite being an integral part of dermatologic surgery, nail surgery is infrequently performed in daily practice. Indeed, it is frequently considered difficult, time-consuming, and the results take a long time to be observed.
Introduction: My name is Rueben Jacobs, I am a cooperative, beautiful, kind, comfortable, glamorous, open, magnificent person who loves writing and wants to share my knowledge and understanding with you.
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