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What Your Fingernails Reveal

Your nails deserve regular attention, and not just for appearance’s sake. They play an often-overlooked part in day-to-day living, constantly protecting our delicate fingertips and providing a hard, sharp tool for hands-on work. They are also a barometer of our general health and often hold the clue to a range of diseases.

Hands and feet come in all sorts of shapes and sizes, but in general each nail should be a regular symmetrical shape and a smooth peachy-pink color. As we get older they may become thicker and less smooth, but these changes can also be a sign of a problem. So what should you look out for in nails and what action should you take?

Horizontal ridgesFinernail health

Ridges or indentations going from side to side across the nail are a sign that the formation of new nail, which occurs in an area called the nail fold (furthest from the fingertip), is disrupted. Many factors may be involved including infections, skin diseases such as psoriasis, severe heart disease, malnutrition, low calcium intake and some drug treatments especially chemotherapy. Injuries to the nail fold can also cause horizontal ridges.

Check your general health and make sure your diet is tip-top. By the time the ridges start to move down the nail, any health threat may have passed. If ridges persist, see your doctor.

Vertical ridges

Thicker ridges running vertically from the nail fold out to the fingertip can often develop as we get older. Thankfully, they are usually nothing to worry about.

You can simply smooth out these ridges by filing them down with a double-sided polishing nail file.

Discolored nails

Chronic fungal infection is the most common cause of yellowing nails. About one in ten adults (and one in five of those who are over 80) have a fungal nail infection, usually affecting a toenail. It isn’t just a cosmetic problem – in people with diabetes, fungal infections increase the risk of bacterial infection, leading to foot ulcers and gangrene, so it’s important to keep an eye on them. Many other condition can discolor the nails too, including chronic bacterial infections elsewhere in the body, jaundice and some drug treatments.

Keep feet as clean as possible, and dry thoroughly after washing. Ask your pharmacist about anti-fungal treatments – the key is to stick to the treatment meticulously.

White spots

White spots are common and usually a sign of disruption to the nail structure caused by minor trauma (all day long we batter our nails as we use our hands for all sorts of tasks). If you have lots of white spots, however, it’s worth checking for causes, such as low calcium, as well as anemia and chronic diseases such as diabetes. Constant use of nail polish can also leave white marks on the nail surface.

Make sure you are getting enough calcium and iron in your diet. Try moisturizing your nails regularly as this will help to keep them supple. Try changing to a milder nail-polish remover.

Split nails

Brittle or split nails may occur in many diseases (including an under or over active thyroid gland) but are also just more common in later life.

Rule out fungal infection. Avoid excessive use of detergents and other harsh chemicals, and moisturize regularly. Biotin or vitamin B7 supplements can help to strengthen nails. Talk to your doctor if you have other symptoms.

Spoon-shaped nails

Known as koilonychia, nails which sink down in the center are linked to several diseases, including iron-deficiency anemia, Raynauds disease (where the blood vessels to the extremities go into episodes of spasm), lupus (an autoimmune disease), and haematochromatosis (an inherited disorder of iron storage).

Talk to your doctor, especially if you have other unexplained symptoms including tiredness (this could suggest anemia). Make sure you have plenty of iron in your diet or take a supplement.

Pale nails

Pale nails can be a sign that the nail has come away from the nail bed below, and will soon fall off. They can also be a sign of more generalized serious disease including liver cirrhosis, heart disease, diabetes and an overactive thyroid.

If you had more than one damaged white nail, talk to your GP to rule out more serious problems.

Black nails

Many conditions can discolor the nails, but a black nail is usually the result of trauma with bleeding into the nail. Psoriasis can cause the nails to turn red or brown, or pitted, while a chronic bacterial infection can cause a greenish-black tinge, and kidney failure can leave the nails brown at the tips. Vertical dark stripes are a common normal variant in people with darker skin.

A damaged black nail will fall off with time. Always monitor dark patches in a nail. If they grow or affect the nail fold, they could be a pigmented cancer called a subungual melanoma.

Must-do checklist

  • Try to keep nails neatly trimmed
  • Avoid excess exposure to strong chemicals
  • Try not to dig, poke at or lift nails
  • When filing nails, move the file in only one direction (outwards from the middle).
  • Think about your diet and aim to include adequate amounts of, in particular, calcium, vitamin D, vitamin C, iodine, copper and zinc. B vitamins are important too, especially biotin.
  • Look for a high quality supplement which contains nutrients that specifically support the health of your nails.
  • Get your doctor to check any persistent abnormality of the nail. Although rare, tumors can develop under the nail but may be mistaken for less serious problems.

Did you know?

According to the American Academy of Dermatology, your nails grow faster in the summer than they do in the winter.