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.
2 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.
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.
Fungus or yeast cause changes in the color, texture, and shape of the nails. Bacterial infection may cause a change in nail color or painful areas of infection under the nail or in the surrounding skin. Severe infections may cause nail loss. Paronychia is an infection around the nailfold and cuticle.
Symptoms of nail psoriasis include: Discoloration: The skin underneath your nails (nail bed) may change colors. These changes, called salmon patches or oil drop spots, may look yellow, red, pink or brown. Pitting: Your nails may develop dents or pits (cupuliform depressions).
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.
Healthy nails are generally pink. Very pale nails may indicate illnesses, such as anemia, congestive heart failure or liver disease. Poor nutrition also may be a culprit. It's a good idea to get very pale nails checked by a doctor.
The examination of the hand and nails can lead to a number of diagnoses. Some of these include liver disease (Terry's nails), kidney disease (Lindsay's nails), lung disease (nail clubbing), endocarditis and many others.
Vitamin D acts as an antioxidant and a deficiency may lead to the formation of fine lines. Vitamin deficiency also causes brittle nails. It also slows down the wound healing process, so chances are that the occasional pimple is going to take a while to go away and might even leave a pigmentation spot.
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.
Zinc deficiency can cause Beau's lines and white spots on your nails. Iron deficiency can cause vertical nail ridges and koilonychia (spoon nails). Spoon nails have a depression in the middle, like the center of your nail was scooped out. You may be able to hold a drop of water on your nail.
A dermatopathologist is a highly trained physician who specializes in diagnosing disorders of the skin under a microscope. They are a dermatologist or pathologist with extra board certification in evaluating skin, hair and nail diseases.
Dermatologists are doctors who are experts in diagnosing and treatmenting nail, hair, and skin disorders. Some of the skin, hair and nail diseases are due to underlying medical conditions. For instance, itch (pruritus) can be due to underlying kidney, liver, thyroid, diabetes or blood disorders.
What do dermatologists use on their faces? It's pretty basic, according to Russak: antioxidants, retinol, and SPF. "Those three staples will protect and prevent just fine," she says.
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.
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.
During diagnosis, a rheumatologist may examine a person's nails as part of the diagnostic process. This may help them rule out certain conditions that present similarly to RA but have some distinct features. For example, psoriatic arthritis and RA both affect the joints and involve inflammation throughout the body.
The examination of the hand and nails can lead to a number of diagnoses. Some of these include liver disease (Terry's nails), kidney disease (Lindsay's nails), lung disease (nail clubbing), endocarditis and many others.
Introduction: My name is Horacio Brakus JD, I am a lively, splendid, jolly, vivacious, vast, cheerful, agreeable person who loves writing and wants to share my knowledge and understanding with you.
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