What Your Nails Say About Your Health
By Valencia Higuera
Medically reviewed by Ross Radusky, MD
You probably trim your fingernails on a regular basis, but when’s the last time you really took a closer look at your nails?
Your nails can reveal a lot about your general state of health, so it’s important to recognize the signs of healthy nails, as well as abnormalities that could indicate a medical problem.
Not sure what’s normal and what’s not? Here are some clues to help you determine what healthy nails look like, and when there could be a problem, according to the Mayo Clinic.
Signs of Normal Nails:
Uniform in color
Smooth with no grooves or pits
Attached to the skin
White lunula (“little moon”) just above the cuticle
Signs of Abnormal Nails:
Discoloration
Spots
Separation of nail from skin
Thinning or thickening
Oddly shaped
The good news is that nail changes aren’t usually anything to get riled up over. Even so, a change in appearance can sometimes point to a disease elsewhere in the body. If you notice any of the following changes in your nails, err on the side of caution and make an appointment to see a dermatologist or podiatrist.
Nail Color Changes Tied to Health Conditions
A change in nail color might not mean anything, but certain changes may be linked to the following conditions:
Leukonychia Also known as “white nail syndrome,” leukonychia can develop when there’s a defect in how the nail grows, explains Ashley Anderson, DO, a family medicine doctor with Dignity Health Medical Foundation in Davis, California. The nail will have white patches or lines, which often don’t reach the edge of the nail, or the entire nail will go white, she adds. These changes can be due to microtrauma of the nail, especially after a manicure or with artificial nails, or indicate leprosy, cirrhosis, or typhoid fever, warns the Genetic and Rare Disease Information Center (GARD).
Terry’s Nails The nail will look mostly white and grainy with a pink or red strip at the top. This change is found in about 80 percent of people with cirrhosis, according to an article published in the journal American Family Physician. It can also develop in people with congestive heart failure, kidney failure, and diabetes, according to the Mayo Clinic.
Muehrcke’s Nails Muehrcke lines usually appear as narrow pairs of whitish, horizontal bands on the fingernails (it is uncommon for them to appear on the thumbnails), according to an article published in March 2013 in the Canadian Medical Association Journal. The condition has been linked to low levels of a protein called albumin, which is found in the blood. According to an article published in the Journal of the Turkish Academy of Dermatology, this condition has also been linked to liver disease and malnutrition.
Half-and-Half Nails, or Lindsay’s Nails Half-and-half nails feature red, pink, or brown bands occupying 20 to 60 percent of the nail bed, according to an article published in April 2015 in The New England Journal of Medicine. The condition is associated with chronic kidney disease.
Mees’ Lines Mees’ lines are single or multiple narrow, whitish lines running along the width of the nail, and may involve multiple nails, according to an article published in the March–April 2015 issue of the Indian Dermatology Online Journal. They are caused by arsenic intoxication, and have also been reported with other conditions as well, such as Hodgkin lymphoma, leprosy, tuberculosis, malaria, shingles, chemotherapeutic drugs, carbon monoxide (CO) and antimony poisoning, renal and cardiac failure, pneumonia, and childbirth.
Splinter Hemorrhages These thin, dark red or brown vertical lines in the nail bed look like splinters beneath the nail, but are actually blood under the nail plate appearing in a splinter pattern, explains Tammy Gracen, a doctor of podiatric medicine based in Vancouver, British Columbia. Possible causes include trauma, collagen vascular diseases, infectious endocarditis, and heart disease. It’s also sometimes seen in people with clotting problems and those who inject drugs under the nails, Dr. Gracen adds.
Yellow Nail Syndrome This condition — where slow-growing yellow nails become thickened and curved — is associated with pulmonary disease and lymphedema, Dr. Anderson says. She also notes that some cases of yellow nail syndrome are spontaneous, although the condition does occasionally run in families, according to the National Organization for Rare Diseases (NORD).
Vertical Brown Streaks Although this is a common nail problem among people with dark skin, it shouldn’t be ignored. Dark or brown streaks on the nail can indicate a serious illness like melanoma, or something simple like a benign nevus (an overgrowth of cells) or chemical staining (nail polishes), according to the article from American Family Physician.
Nail Shape Changes Linked to Health Conditions
A wide range of health issues can also cause changes in the shape of your nails. Conditions possibly associated with these changes include:
Spoon Nails (Koilonychia) The nails are soft and look scooped out, like they can hold a drop of liquid, according to the Mayo Clinic. This can have a variety of causes, including iron deficiency anemia, hemochromatosis (when your body absorbs too much iron), hypothyroidism, and heart disease.
Clubbed Nails or Clubbing The tips of the fingers get larger, and the nails curve around the fingertips, according to the Mayo Clinic. “Nail clubbing is most often associated with cardiovascular or pulmonary disease, such as chronic obstructive pulmonary disease (COPD) and congestive heart failure,” explains Anderson. “Less common causes include inflammatory bowel disease and cirrhosis.”
Nail Texture Changes Linked to Health Conditions
Apart from the odd bump or small lines, nails are normally fairly smooth. But a texture change can occur when there’s a problem elsewhere in the body. The following conditions can cause nail texture changes:
Beau’s Lines Beau’s lines are indentations in the nails that run across the nail, according to the Mayo Clinic. Conditions associated with Beau’s lines include diabetes and peripheral vascular disease, as well as scarlet fever, measles, mumps, and pneumonia. Beau’s lines can also be a sign of zinc deficiency.
Pitting Small, pinpoint depressions can appear in the nails when there’s a problem in nail plate layering. These depressions can be shallow or deep, and are more common on fingernails than toenails, Anderson says. Pitting is seen in approximately 68 percent of people with psoriasis and nail changes, according to an article published in 2017 in the journal Reumatologia. Pitting can also appear with alopecia areata, eczema, and the autoimmune disease lichen planus.
Health Conditions Associated With Nail Separation
The following conditions can cause nail separation:
Onycholysis In this condition, the nail starts to lift up so that it’s no longer completely attached, and you’re likely to see white discoloration, according to the American Academy of Dermatology. Common causes include trauma, infection, and psoriasis.
Onychomadesis This is a temporary, acute cessation of nail growth that causes the nail to separate from the bed, Gracen explains. It can appear in one nail due to trauma, but is also seen in children following hand, foot, and mouth disease, as well as with immune diseases, psoriasis, and lichen planus, she says.
When Nail Changes Are Harmless and When to See a Professional
Your nails say a lot about your health, so don’t ignore abnormalities. While many nail changes are nothing to worry about, you won’t know this until you get checked out by a doctor.
“Any changes to the nail that don’t resolve in a few weeks and don’t have an inciting cause should be evaluated by a physician,” warns Anderson. “Additionally, any pain, swelling, or redness should be evaluated right away.”
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